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https://www.readbyqxmd.com/read/29470235/is-climate-associated-with-revision-for-prosthetic-joint-infection-after-primary-tka
#1
Ben Parkinson, Drew Armit, Peter McEwen, Michelle Lorimer, Ian A Harris
BACKGROUND: Climate factors have been shown to be associated with spontaneous musculoskeletal and some surgical site infections with increased rates of infection during warmer periods. To date, little research has been performed to determine if this phenomenon is associated with differences in the risk of revision for prosthetic joint infection (PJI) in primary TKA. QUESTIONS/PURPOSES: (1) Does the rate of revision for early PJI within the first year after primary TKA differ between tropical and nontropical regions? (2) Is there a seasonal variation in the rate of revision for PJI? (3) Is the geographic and seasonal variation (if present) associated with the sex, age, and/or American Society of Anesthesiologists (ASA) grade of the patient? METHODS: All 219,983 primary TKAs performed for osteoarthritis over a 5-year period (2011-2015) in the Australian Orthopaedic Association National Joint Replacement Registry were examined based on the month of the primary procedure to determine the rate of revision for PJI within 12 months...
February 21, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29455937/the-impact-of-patient-and-surgical-factors-on-the-rate-of-postoperative-infection-after-total-hip-arthroplasty-a-new-zealand-joint-registry-study
#2
James O Smith, Christopher M A Frampton, Gary J Hooper, Simon W Young
BACKGROUND: Periprosthetic joint infection (PJI) is a devastating complication after total hip arthroplasty (THA). The potential to define and modify risk factors for infection represents an important opportunity to reduce the incidence of PJI. This study uses New Zealand Joint Registry data to identify independent risk factors associated with PJI after primary THA. METHODS: Data on 91,585 THAs performed between 2000 and 2014 were analyzed. Factors associated with revision for PJI within 12 months were identified using univariate and multivariate analyses...
January 31, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29452973/the-alpha-defensin-test-for-diagnosing-periprosthetic-joint-infection-in-the-setting-of-an-adverse-local-tissue-reaction-secondary-to-a-failed-metal-on-metal-bearing-or-corrosion-at-the-head-neck-junction
#3
Kamil T Okroj, Tyler E Calkins, Erdan Kayupov, Michael M Kheir, Joshua S Bingham, Christopher P Beauchamp, Javad Parvizi, Craig J Della Valle
BACKGROUND: In patients with adverse local tissue reaction (ALTR) secondary to a failed metal-on-metal (MoM) bearing or corrosion at the head-neck junction in a metal-on-polyethylene bearing, ruling in or out periprosthetic joint infection (PJI) can be challenging. Alpha-defensin has emerged as an accurate test for PJI. The purpose of this multicenter, retrospective study was to evaluate the accuracy of the alpha-defensin synovial fluid test in detecting PJI in patients with ALTR. METHODS: We reviewed medical records of 26 patients from 3 centers with ALTR that had an alpha-defensin test performed...
January 16, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29444832/differential-contributions-of-specimen-types-culturing-and-16s-rrna-sequencing-in-diagnosis-of-prosthetic-joint-infections
#4
Lone Heimann Larsen, Vesal Khalid, Yijuan Xu, Trine Rolighed Thomsen, Henrik C Schønheyder
Prosthetic joint failure is mainly caused by infection, aseptic failure (AF), and mechanical problems. Infection detection has been improved with modified culture methods and molecular diagnostics. However, comparisons between modified and conventional microbiology methods are difficult, due to variations in specimen sampling. In this prospective, multidisciplinary study of hip or knee prosthetic failures, we assessed the contributions of different specimen types, extended culture incubations, and 16S rRNA sequencing for diagnosing prosthetic joint infections (PJI)...
February 14, 2018: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/29444666/analysis-of-total-knee-arthroplasty-revision-causes
#5
Anne Postler, Cornelia Lützner, Franziska Beyer, Eric Tille, Jörg Lützner
BACKGROUND: The number of revision Total Knee Arthroplasty (TKA) is rising in many countries. The aim of this study was the prospective assessment of the underlying causes leading to revision TKA in a tertiary care hospital and the comparison of those reasons with previously published data. METHODS: In this study patients who had revision TKA between 2010 and 2015 were prospectively included. Revision causes were categorized using all available information from patients' records including preoperative diagnostics, intraoperative findings as well as the results of the periprosthetic tissue analysis...
February 14, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29439896/high-failure-rates-of-concomitant-periprosthetic-joint-infection-and-extensor-mechanism-disruption
#6
Lucas A Anderson, Brian M Culp, Craig J Della Valle, Jeremy M Gililland, R Michael Meneghini, James A Browne, Bryan D Springer
BACKGROUND: Patients presenting with both chronic periprosthetic joint infection (PJI) and extensor mechanism disruption (EMD) pose a significant challenge. As there is little in the literature regarding outcomes of patients with concomitant PJI and EMD, we performed a multicenter study to evaluate the outcomes. METHODS: Sixty patients with concomitant diagnoses of PJI and EMD were evaluated from 5 institutions. Patient demographics, presentation type, surgical management, and outcomes including recurrent infections, final surgery, and ambulatory status were documented...
January 31, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29439725/natural-progress-of-d-dimer-following-total-joint-arthroplasty-a-baseline-for-the-diagnosis-of-the-early-postoperative-infection
#7
Yong Seuk Lee, Young-Kyun Lee, Seung Bum Han, Chang Hyun Nam, Javad Parvizi, Kyung-Hoi Koo
BACKGROUND: Early detection followed by prompt intervention is essential for the treatment of periprosthetic joint infection (PJI). D-dimer, a fibrin degradation product, characteristically changes rapidly during early postoperative period and has a short half-life. The aim of this prospective study was to measure postoperative change of D-dimer level after joint arthroplasty in conjunction with ESR and CRP. METHODS: ESR, CRP, and D-dimer levels were measured on the day before surgery, postoperative days 1, 2, 3, and 5 and weeks 2 and 6 in 65 patients who underwent elective primary total hip arthroplasty (38 hips in 38 patients) or total knee arthroplasty (27 knees in 27 patients)...
February 13, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29437054/the-effect-of-bearing-surface-on-risk-of-periprosthetic-joint-infection-in-total-hip-arthroplasty-a-systematic-review-and-meta-analysis
#8
REVIEW
A T Hexter, S M Hislop, G W Blunn, A D Liddle
AIMS: Periprosthetic joint infection (PJI) is a serious complication of total hip arthroplasty (THA). Different bearing surface materials have different surface properties and it has been suggested that the choice of bearing surface may influence the risk of PJI after THA. The objective of this meta-analysis was to compare the rate of PJI between metal-on-polyethylene (MoP), ceramic-on-polyethylene (CoP), and ceramic-on-ceramic (CoC) bearings. PATIENTS AND METHODS: Electronic databases (Medline, Embase, Cochrane library, Web of Science, and Cumulative Index of Nursing and Allied Health Literature) were searched for comparative randomized and observational studies that reported the incidence of PJI for different bearing surfaces...
February 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29433799/international-survey-among-orthopaedic-trauma-surgeons-lack-of-a-definition-of-fracture-related-infection
#9
M Morgenstern, T F Moriarty, R Kuehl, R G Richards, M A McNally, M H J Verhofstad, O Borens, C Zalavras, M Raschke, S L Kates, W J Metsemakers
INTRODUCTION: Fracture-related infection (FRI) is one of the most challenging musculoskeletal complications in orthopaedic-trauma surgery. Although the orthopaedic community has developed and adopted a consensus definition of prosthetic joint infections (PJI), it still remains unclear how the trauma surgery community defines FRI in daily clinical practice or in performing clinical research studies. The central aim of this study was to survey the opinions of a global network of trauma surgeons on the definitions and criteria they routinely use, and their opinion on the need for a unified definition of FRI...
February 6, 2018: Injury
https://www.readbyqxmd.com/read/29432263/perioperative-inpatient-use-of-selective-serotonin-reuptake-inhibitors-is-associated-with-a-reduced-risk-of-tha-and-tka-revision
#10
Jie J Yao, Hilal Maradit Kremers, Walter K Kremers, David G Lewallen, Daniel J Berry
BACKGROUND: Depression is common in the general population, and so it is likewise common among patients undergoing THA and TKA. Depression is associated with lower perioperative patient-reported outcomes and an increased risk of postoperative complications. Antidepressants are effective in managing symptoms of depression and may potentially contribute to better functional status and better clinical outcomes after THA and TKA. QUESTIONS/PURPOSES: We examined (1) whether perioperative depression is associated with all-cause revisions, revisions for aseptic loosening, revisions without infection, and periprosthetic joint infections (PJIs) in patients undergoing THA and TKA; and (2) whether perioperative antidepressant use reduces the risk of all-cause revisions, revisions for aseptic loosening, aseptic revisions, and PJIs in patients undergoing THA and TKA...
February 8, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29430604/comparison-of-culture-and-broad-range-polymerase-chain-reaction-methods-for-diagnosing-periprosthetic-joint-infection-analysis-of-joint-fluid-periprosthetic-tissue-and-sonicated-fluid
#11
Zida Huang, Qiqiao Wu, Xinyu Fang, Wenbo Li, Chaofan Zhang, Huiyi Zeng, Qijin Wang, Jianhua Lin, Wenming Zhang
PURPOSE: This study compared the diagnostic capabilities of culture and broad-range polymerase chain reaction (PCR) using joint fluid (JF), periprosthetic tissue (PT), and sonicated fluid (SF) for the diagnosis of periprosthetic joint infection (PJI). METHODS: Sixty-seven subjects underwent knee or hip revision surgery, with 53 PJI and 14 aseptic failure (AF) cases included retrospectively. JF, PT, and SF samples were collected after a suspension of antibiotics more than two weeks, and culture and broad-range PCR were performed for all samples...
February 11, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29428466/irrigation-and-debridement-for-early-periprosthetic-knee-infection-is-it-effective
#12
Rajkishen Narayanan, Afshin A Anoushiravani, Ameer M Elbuluk, Kevin K Chen, Edward M Adler, Ran Schwarzkopf
BACKGROUND: Irrigation and debridement (I&D) is performed for early management of periprosthetic joint infection (PJI) following total knee arthroplasty (TKA). Symptom reporting is a subjective measure and may miss direct management of PJI. Utilizing an objective time interval from index procedure to I&D may better inform treatment decisions. METHODS: From 2009 to 2017, retrospective review was performed of 55 knee PJI cases at our institution. All patients underwent polyethylene liner exchange and I&D for PJI...
January 9, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29415309/-the-economic-challenge-of-centralised-treatment-of-patients-with-periprosthetic-infections
#13
Michael Müller, Andrej Trampuz, Tobias Winkler, Carsten Perka
INTRODUCTION: Periprosthetic infection (PJI) is one of the most severe complications in joint arthroplasty. Correct diagnosis and adequate therapy represent an enormous interdisciplinary challenge. The necessary interdisciplinarity and complexity of treatment require therapy in centres. However, the high costs have not yet been analysed or discussed and are problematic. The aim of this work is therefore to compare the costs within a year of treatment in a department specialised in the treatment of periprosthetic infections...
February 7, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29395719/utility-of-serological-markers-for-detecting-persistent-infection-in-two-stage-revision-arthroplasty-in-patients-with-inflammatory-arthritis
#14
Jaiben George, Michael Jawad, Gannon L Curtis, Linsen T Samuel, Alison K Klika, Wael K Barsoum, Carlos A Higuera
BACKGROUND: Serum erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are commonly used for the diagnosis of persistence of infection after the first stage of 2-stage revision arthroplasty for periprosthetic joint infection (PJI). As both ESR and CRP are markers of systemic inflammation, the utility of these tests to monitor infection clearance in patients with inflammatory arthritis is unclear. METHODS: From 2001 to 2016, 44 two-stage revision total hip or knee arthroplasties in patients with an inflammatory arthritis diagnosed by a rheumatologist were identified...
December 29, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29395369/analysis-of-postoperative-and-hematogenous-prosthetic-joint-infection-microbiological-patterns-in-a-large-cohort
#15
Valérie Zeller, Younes Kerroumi, Vanina Meyssonnier, Beate Heym, Marie-Astrid Metten, Nicole Desplaces, Simon Marmor
OBJECTIVES: This study was undertaken to analyze prosthetic joint infection (PJI)-causing microorganisms and compare their distribution patterns according to PJI classification. METHODS: Cohort study from a single referral center for bone-and-joint infections from January 2004 to December 2015. RESULTS: Nine hundred and twenty-six patients, who developed 997 PJIs, involving the hip (62%), knee (35%) and/or shoulder (1%), were included. PJIs were classified as early postoperative (19%), late chronic (30%), hematogenous (35%) and undetermined (16%)...
January 29, 2018: Journal of Infection
https://www.readbyqxmd.com/read/29389759/staged-revision-with-antibiotic-spacers-for-shoulder-prosthetic-joint-infections-yields-high-infection-control
#16
Florian Grubhofer, Mohamed A ImamMD, Karl Wieser, Yvonne Achermann, Dominik C Meyer, Christian Gerber
BACKGROUND: The treatment of periprosthetic joint infection (PJI) of the shoulder with two-stage revision arthroplasty using an antibiotic-loaded cement spacer is established strategy, but there is sparse information regarding the likelihood of infection control and restoration of shoulder. QUESTIONS/PURPOSE: (1) What is the likelihood of infection control after two-stage revision using an antibiotic cement spacer for patients with PJI of the shoulder? (2) What are the improvements in Constant and Murley scores at 2 years after these staged revisions? PATIENTS AND METHODS: Between 2000 and 2013, we treated 48 patients with PJI of the shoulder using two-stage revision including an antibiotic-containing cement spacer during the first stage...
January 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29389758/is-treatment-with-dithiothreitol-more-effective-than-sonication-for-the-diagnosis-of-prosthetic-joint-infection
#17
Andrea Sambri, Matteo Cadossi, Sandro Giannini, Giovanni Pignatti, Maurilio Marcacci, Maria Pia Neri, Alessandra Maso, Elisa Storni, Simonetta Gamberini, Susanna Naldi, Arianna Torri, Silvia Zannoli, Martina Tassinari, Michela Fantini, Giuseppe Bianchi, Davide Donati, Vittorio Sambri
BACKGROUND: Prosthetic joint infection (PJI) is among the most-severe complications of a total joint arthroplasty. Identification of the causal organism is of paramount importance for successful treatment, and sonication of implants may aid in this identification. Dithiothreitol (DTT) treatment has been proposed as an alternative to sonication to improve diagnosis, reduce costs, and improve reliability of the procedure, but its efficacy remains poorly characterized. QUESTIONS/PURPOSES: (1) Are DTT and sonication more sensitive and/or more specific than standard cultures of tissue samples for the diagnosis of PJI? (2) Which test (DTT or sonication) is more sensitive when the clinician does not suspect infection before surgery? (3) Which test (DTT or sonication) is more sensitive when the clinician suspects infection before surgery? METHODS: Two hundred thirty-two patients undergoing revision of a knee or hip arthroplasty were prospectively evaluated in this randomized study...
January 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29383856/detecting-the-presence-of-bacterial-dna-and-rna-by-polymerase-chain-reaction-to-diagnose-suspected-periprosthetic-joint-infection-after-antibiotic-therapy
#18
Xin-Yu Fang, Wen-Bo Li, Chao-Fan Zhang, Zi-da Huang, Hui-Yi Zeng, Zheng Dong, Wen-Ming Zhang
OBJECTIVE: To explore the diagnostic efficiency of DNA-based and RNA-based quantitative polymerase chain reaction (qPCR) analyses for periprosthetic joint infection (PJI). METHODS: To determine the detection limit of DNA-based and RNA-based qPCR in vitro, Staphylococcus aureus and Escherichia coli strains were added to sterile synovial fluid obtained from a patient with knee osteoarthritis. Serial dilutions of samples were analyzed by DNA-based and RNA-based qPCR...
January 30, 2018: Orthopaedic Surgery
https://www.readbyqxmd.com/read/29382603/sonication-of-orthopaedic-implants-a-valuable-technique-for-diagnosis-of-prosthetic-joint-infections
#19
Sujeesh Sebastian, Rajesh Malhotra, Vishnubhatla Sreenivas, Arti Kapil, Rama Chaudhry, Benu Dhawan
INTRODUCTION: Accurate and prompt microbiological diagnosis of prosthetic joint infection (PJI) is crucial for successful antimicrobial treatment. Studies have shown the diagnostic utility of sonication of explanted implants in total joint arthroplasty but all did not use consensus statements for defining PJI. We evaluated the diagnostic utility of culture of samples obtained by sonication of explanted implants compared with periprosthetic tissue cultures (PTC) for the diagnosis of PJI using Musculoskeletal Infection Society (MSIS) consensus criteria...
January 27, 2018: Journal of Microbiological Methods
https://www.readbyqxmd.com/read/29374525/periprosthetic-joint-infection-caused-by-anaerobes-retrospective-analysis-reveals-no-need-for-prolonged-cultivation-time-if-sensitive-supplemented-growth-media-are-used
#20
Heime Rieber, Andre Frontzek, Jörg Jerosch, Michael Alefeld, Thomas Strohecker, Martin Ulatowski, Thomas Morawietz, Stefan Hinsenkamp, Andreas Bell, Dervis Kücükköylü, Lars Frommelt
BACKGROUND: In microbiological diagnosis of periprosthetic joint infection (PJI) culture media and incubation time are controversially discussed, especially if anaerobic bacteria are the causative agent. This study was conducted to demonstrate the influence of sensitive supplemented growth media on the duration of culturing anaerobes. METHODS: Twenty-five consecutive cases were included in this retrospective study. For definition of PJI, the criteria of the Musculoskeletal Infection Society (MSIS) were considered...
January 24, 2018: Anaerobe
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