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https://www.readbyqxmd.com/read/30281077/failure-after-two-stage-exchange-arthroplasty-for-treatment-of-periprosthetic-joint-infection-the-role-of-antibiotics-in-the-cement-spacer
#1
Marjan Wouthuyzen-Bakker, Michael M Kheir, Ignacio Moya, Alexander J Rondon, Matthew Kheir, Luis Lozano, Javad Parvizi, Alex Soriano
Introduction: Failure after a two-stage exchange surgery for periprosthetic joint infections (PJI) is high. Previous studies demonstrated that positive cultures at reimplantation are associated with failure afterwards. The aim of this multicenter study was to define the role of antibiotics in the cement spacer in relation to reimplantation cultures and subsequent failure. Methods: We retrospectively evaluated two-stage exchange procedures between 2000 and 2015. Culture-negative PJIs, cases in whom no cultures were obtained during reimplantation and cases without data on cement spacers were excluded...
October 3, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/30273960/a-novel-mutation-in-teneurin-3-found-to-co-segregate-in-all-affecteds-in-a-multi-generation-family-with-developmental-dysplasia-of-the-hip
#2
George Feldman, Dietmar Kappes, Jayati Mookerjee-Basu, Theresa Freeman, Andrzej Fertala, Javad Parvizi
DDH is a debilitating condition characterized by incomplete formation of the acetabulum leading to dislocation of the hip, suboptimal joint function and accelerated wear of the articular cartilage resulting in early onset crippling arthritis of the hip in 20-40 year olds. Current diagnostic tests in newborns using physical manipulation of the femur or ultrasound either under or over-diagnose this condition. Developing an accurate, cost effective diagnostic test is a goal of this study. To better understand the biologic pathways involved in acetabular development, DNA from severely affected individuals in a 4 generation family that showed inter-generational transmission of the disorder was isolated and whole exome sequenced...
October 1, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/30245124/persistent-wound-drainage-after-total-joint-arthroplasty-a-narrative-review
#3
REVIEW
Frank-Christiaan B M Wagenaar, Claudia A M Löwik, Akos Zahar, Paul C Jutte, Thorsten Gehrke, Javad Parvizi
BACKGROUND: Persistent wound drainage after total joint arthroplasty (TJA) is an important complication with potential substantial adverse consequences, in particular periprosthetic joint infection. METHODS: This review evaluated the available literature regarding several issues in the field of persistent wound drainage after TJA and offers a classification of persistent wound drainage and an algorithmic approach to the decision-making process. RESULTS: Available literature addressing the diagnosis and treatment of persistent wound drainage after TJA is scarce and an evidence-based clinical guideline is lacking...
September 3, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30187096/blood-loss-and-allogeneic-transfusion-for-surgical-treatment-of-periprosthetic-joint-infection-a-comparison-of-one-vs-two-stage-exchange-total-hip-arthroplasty
#4
Ahmad Shoib Sharqzad, Camila Cavalheiro, Akos Zahar, Christian Lausmann, Thorsten Gehrke, Daniel Kendoff, Javad Parvizi, Mustafa Citak
PURPOSE: The purpose of the current study was to compare the blood loss and the need for allogeneic transfusion after one- and two-stage exchange arthroplasty for periprosthetic joint infection (PJI) of THA. METHODS: We performed a retrospective review of all patients undergoing either one-stage or two-stage septic exchange arthroplasty at two high-volume infection referral centres. The study cohort consists of 90 patients undergoing the two-stage and 184 patients the one-stage exchange arthroplasty...
September 5, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/30150154/two-stage-exchange-arthroplasty-is-a-favorable-treatment-option-upon-diagnosis-of-a-fungal-periprosthetic-joint-infection
#5
Feng-Chih Kuo, Karan Goswami, Noam Shohat, Kier Blevins, Alexander J Rondon, Javad Parvizi
BACKGROUND: This study investigated the prevalence of medical comorbidities, risk factors, and treatment outcomes in patients with fungal periprosthetic joint infection (PJI). METHODS: All patients with fungal PJI treated from 1999 to 2014 were retrospectively identified at a single institution. Demographic data, comorbidity, and surgical variables were obtained from medical records. Patients were followed up for at least 2 years. PJI was diagnosed using the Musculoskeletal Infection Society criteria...
November 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30100137/defining-treatment-success-after-2-stage-exchange-arthroplasty-for-periprosthetic-joint-infection
#6
Timothy L Tan, Karan Goswami, Yale A Fillingham, Noam Shohat, Alexander J Rondon, Javad Parvizi
BACKGROUND: Two-stage exchange arthroplasty remains the preferred surgical treatment method for patients with chronic periprosthetic joint infection (PJI). The success of this procedure is not known exactly as various definitions of success have been used. This study aimed at analyzing the difference in outcome following 2-stage exchange arthroplasty using different definitions for success. METHODS: A retrospective study of 703 patients with PJI who underwent resection arthroplasty and spacer insertion between January 1999 and June 2015 was performed...
November 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30100135/patients-with-infected-total-hip-arthroplasty-undergoing-2-stage-exchange-arthroplasty-experience-massive-blood-loss
#7
Rahul Goel, Patrick Buckley, Emily Sterbis, Javad Parvizi
BACKGROUND: Two-stage exchange arthroplasty is the preferred treatment for chronic periprosthetic joint infection following total hip arthroplasty (THA). These patients are at high risk of substantial blood loss and perioperative blood transfusion. Our study aimed at determining risk factors for blood transfusion during a 2-stage exchange for infected THA. METHODS: Medical records of 297 patients with infected THA who underwent 2-stage exchange arthroplasty from 1997 to 2016 were reviewed...
November 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30100134/diagnosing-periprosthetic-joint-infection-in-inflammatory-arthritis-assumption-is-the-enemy-of-true-understanding
#8
Noam Shohat, Karan Goswami, Yale Fillingham, Timothy L Tan, Tyler Calkins, Craig J Della Valle, Jaiben George, Carlos Higuera, Javad Parvizi
BACKGROUND: Despite concern over the interpretation of serum and synovial fluid tests to screen and diagnose periprosthetic joint infection (PJI) in patients with inflammatory arthritis, only a single study has investigated this area. We aimed to assess accuracy of clinical and laboratory markers for PJI diagnosis in the context of underlying inflammatory arthritis. METHODS: This multicenter study was conducted on total joint arthroplasty patients at 3 different centers between 2001 and 2016...
November 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30093266/cefazolin-prophylaxis-for-total-joint-arthroplasty-obese-patients-are-frequently-underdosed-and-at-increased-risk-of-periprosthetic-joint-infection
#9
Alexander J Rondon, Michael M Kheir, Timothy L Tan, Noam Shohat, Max R Greenky, Javad Parvizi
BACKGROUND: One of the most effective prophylactic strategies against periprosthetic joint infection (PJI) is administration of perioperative antibiotics. Many orthopedic surgeons are unaware of the weight-based dosing protocol for cefazolin. This study aimed at elucidating what proportion of patients receiving cefazolin prophylaxis are underdosed and whether this increases the risk of PJI. METHODS: A retrospective study of 17,393 primary total joint arthroplasties receiving cefazolin as perioperative prophylaxis from 2005 to 2017 was performed...
November 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30093264/culturing-periprosthetic-joint-infection-number-of-samples-growth-duration-and-organisms
#10
Michael M Kheir, Timothy L Tan, Colin T Ackerman, Ronuk Modi, Carol Foltz, Javad Parvizi
BACKGROUND: Owing to the difficulty isolating microorganisms in periprosthetic joint infection (PJI), current guidelines recommend that 3-5 intraoperative samples be cultured and maintained for 3-14 days. We investigated (1) the optimal number of culture samples and growth duration to diagnose PJI and (2) the microbiology profile at our institution. METHODS: A retrospective review of 711 patients (329 hips, 382 knees) with PJI that met Musculoskeletal Infection Society criteria from 2000 to 2014 was performed...
November 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30092305/clinical-outcome-and-risk-factors-for-failure-in-late-acute-prosthetic-joint-infections-treated-with-debridement-and-implant-retention
#11
Marjan Wouthuyzen-Bakker, Marine Sebillotte, Jose Lomas, Adrian Taylor, Eva Benavent Palomares, Oscar Murillo, Javad Parvizi, Noam Shohat, Javier Cobo Reinoso, Rosa Escudero Sánchez, Marta Fernandez-Sampedro, Eric Senneville, Kaisa Huotari, José Maria Barbero Allende, Joaquín Garcia-Cañete, Jaime Lora-Tamayo, Matteo Carlo Ferrari, Danguole Vaznaisiene, Erlangga Yusuf, Craig Aboltins, Rihard Trebse, Mauro José Salles, Natividad Benito, Andrea Vila, Maria Dolores Del Toro, Tobias Siegfried Kramer, Sabine Petersdorf, Vicens Diaz-Brito, Zeliha Kocak Tufan, Marisa Sanchez, Cédric Arvieux, Alex Soriano
OBJECTIVES: Debridement, antibiotics and implant retention (DAIR) is the recommended treatment for all acute prosthetic joint infections (PJI), but its efficacy in patients with late acute (LA) PJI is not well described. METHODS: Patients diagnosed with LA PJI between 2005 and 2015 were retrospectively evaluated. LA PJI was defined as the development of acute symptoms (≤ 3 weeks) occurring ≥ 3 months after arthroplasty. Failure was defined as: (i) the need for implant removal, (ii) infection related death, (iii) the need for suppressive antibiotic therapy and/or (iv) relapse or reinfection during follow-up...
August 7, 2018: Journal of Infection
https://www.readbyqxmd.com/read/30072185/red-cell-distribution-width-an-unacknowledged-predictor-of-mortality-and-adverse-outcomes-following-revision-arthroplasty
#12
Arash Aali-Rezaie, Pouya Alijanipour, Noam Shohat, Hamed Vahedi, Carol Foltz, Javad Parvizi
BACKGROUND: Revision total joint arthroplasties (TJAs) have been empirically associated with significant postoperative morbidity and mortality. Red blood cell distribution width (RDW), a frequently measured hematological parameter, has been shown to predict mortality in hip fracture patients. However, its utility in risk-stratifying patients before revision TJA remains unknown. The aim of this study was to investigate the possible relationship between preoperative RDW levels and outcome of revision arthroplasty in terms of mortality, adverse outcomes, and length of hospital stay...
November 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30062484/current-recommendations-for-the-diagnosis-of-acute-and-chronic-pji-for-hip-and-knee-cell-counts-alpha-defensin-leukocyte-esterase-next-generation-sequencing
#13
REVIEW
Karan Goswami, Javad Parvizi, P Maxwell Courtney
PURPOSE OF REVIEW: Despite significant progress in recent years, the diagnosis of periprosthetic joint infection (PJI) remains a challenge and no gold standard test exists. A combination of serological, synovial, microbiological, histological, and radiological investigations is performed that are expensive, often invasive, and imperfect. Novel biomarkers and molecular methods have shown promise in recent years. The purpose of this review is to provide an update about the diagnostic recommendations for PJI and cover a selection of emerging diagnostic tools...
September 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/30054211/preoperative-opioids-increase-the-risk-of-periprosthetic-joint-infection-after-total-joint-arthroplasty
#14
Kerri L Bell, Noam Shohat, Karan Goswami, Timothy L Tan, Irene Kalbian, Javad Parvizi
BACKGROUND: Opioids have well-known immunosuppressive properties and preoperative opioid consumption is relatively common among patients undergoing total joint arthroplasty (TJA). The hypothesis of this study was that utilization of opioids preoperatively would increase the incidence of subsequent periprosthetic joint infection (PJI) in patients undergoing primary TJA. METHODS: A comparative cohort study design was set up that used a cohort of 23,754 TJA patients at a single institution...
October 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30029928/the-role-of-perioperative-surveillance-in-90-day-total-joint-arthroplasty-care
#15
Andrew J Luzzi, Meredith P Crizer, Andrew N Fleischman, Carol Foltz, Javad Parvizi
BACKGROUND: With the recent implementation of a bundled payment model for total joint arthroplasty, healthcare providers are financially responsible for management of complications throughout the 90-day perioperative period. Our aim was to assess the effectiveness of a surveillance system that was implemented to enhance communication during this period. METHODS: A retrospective study was conducted using a prospectively collected database of patients who underwent primary total joint arthroplasty from January 2015 to April 2016...
June 20, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30017220/differences-in-reported-outcomes-in-industry-funded-vs-nonfunded-studies-assessing-thromboprophylaxis-after-total-joint-arthroplasty
#16
Hannah Groff, Ibrahim Azboy, Javad Parvizi
BACKGROUND: There are numerous studies discussing thromboprophylaxis after total joint arthroplasty (TJA), with varying conclusions. Patient inclusion criteria may be different for each study, which may lead to selection bias and misrepresentation of data. This study aimed to investigate if industry funding impacted patient demographics and overall reported outcomes of studies analyzing venous thromboembolism (VTE) prevention after TJA. METHODS: Electronic searches were completed using Ovid, PubMed, and Embase databases...
November 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29975266/increased-postoperative-glucose-variability-is-associated-with-adverse-outcomes-following-total-joint-arthroplasty
#17
Noam Shohat, Camilo Restrepo, Arash Allierezaie, Majd Tarabichi, Rahul Goel, Javad Parvizi
BACKGROUND: Increased glucose variability during hospitalization has been associated with a longer length of stay in the hospital and a higher mortality rate following non-orthopaedic surgical procedures. Our aim was to investigate the association between glucose variability and postoperative complications following total joint arthroplasty. METHODS: We analyzed data on 21,487 patients who had undergone total hip arthroplasty (THA) or total knee arthroplasty (TKA) at a single center from 2001 to 2017...
July 5, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29914821/are-we-winning-or-losing-the-battle-with-periprosthetic-joint-infection-trends-in-periprosthetic-joint-infection-and-mortality-risk-for-the-medicare-population
#18
Steven M Kurtz, Edmund C Lau, Min-Sun Son, Ellen T Chang, Werner Zimmerli, Javad Parvizi
BACKGROUND: Periprosthetic joint infection (PJI) is a potentially deadly complication of total joint arthroplasty. This study was designed to address how the incidence of PJI and outcome of treatment, including mortality, are changing in the population over time. METHODS: Primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients with PJI from the 100% Medicare inpatient data set (2005-2015) were identified. Cox proportional hazards regression models for risk of PJI after THA/TKA (accounting for competing risks) or risk of all-cause mortality after PJI were adjusted for patient and clinical factors, with year included as a covariate to test for time trends...
June 1, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29903458/the-bundle-busters-incidence-and-costs-of-postacute-complications-following-total-joint-arthroplasty
#19
Andrew J Luzzi, Andrew N Fleischman, Christopher N Matthews, Meredith P Crizer, John Wilsman, Javad Parvizi
BACKGROUND: Recently, a bundled payment model was implemented in the United States to improve quality and reduce costs. While hospitals may be rewarded for lowering costs, they may be financially exposed by high cost complications, the so-called bundle busters. We aimed at determining the incidence, etiology, and costs of postacute complications after total joint arthroplasty (TJA). METHODS: A retrospective study was conducted using a prospectively collected database of patients who underwent primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) from January 2015 to April 2016...
September 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29885971/development-and-evaluation-of-a-prognostic-calculator-for-the-surgical-treatment-of-periprosthetic-joint-infection
#20
Michael M Kheir, Timothy L Tan, Jaiben George, Carlos A Higuera, Mitchell G Maltenfort, Javad Parvizi
BACKGROUND: Preoperative identification of patients at risk of failing surgical treatment for periprosthetic joint infection (PJI) is imperative to allow medical optimization and targeted prevention. The purpose of this study was to create a preoperative prognostic calculator for PJI treatment by assessing a patient's individual risk for treatment failure based on many preoperative variables. METHODS: A retrospective review was performed of 1438 PJIs, treated at 2 institutions from 2000 to 2014...
September 2018: Journal of Arthroplasty
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