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Prosthetic AND Joint AND infection

Jacob M Babu, Saisanjana Kalagara, Wesley Durand, Valentin Antoci, Matthew E Deren, Eric Cohen
BACKGROUND: Sarcopenia, an age-related loss of muscle mass and function, has been previously linked to an increased risk of morbidity, mortality, and infection after a variety of surgical procedures. This study is the first to evaluate the impact of the psoas-lumbar vertebral index (PLVI), a validated marker for central sarcopenia, on determining post-arthroplasty infection status. METHODS: This is a case-control, retrospective review of 30 patients with prosthetic joint infection (PJI) diagnosed by the Musculoskeletal Infection Society criteria compared to 69 control patients who underwent a total hip or knee arthroplasty...
September 20, 2018: Journal of Arthroplasty
Stefan J Gelderman, Paul C Jutte, Ronald Boellaard, Joris J W Ploegmakers, David Vállez García, Greetje A Kampinga, Andor W J M Glaudemans, Marjan Wouthuyzen-Bakker
Background and purpose - 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) can be used in the diagnostic work-up of a patient with suspected periprosthetic joint infection (PJI) but, due to a lack of accurate interpretation criteria, this technique is not routinely applied. Since the physiological uptake pattern of FDG around a joint prosthesis is not fully elucidated, we determined the physiological FDG uptake in non-infected total hip prostheses. Patients and methods - Patients treated with primary total hip arthroplasty (1995-2016) who underwent a FDG-PET/CT for an indication other than a suspected PJI were retrospectively evaluated...
October 18, 2018: Acta Orthopaedica
Shawn Vasoo
With the increasing number of prosthetic joints replaced annually worldwide, orthopedic implant-associated infections (OIAIs) present a considerable burden. Accurate diagnostics are required to optimize surgical and antimicrobial therapy. Sonication fluid cultures have been shown in multiple studies to improve the microbiologic yield OIAIs, but uptake of sonication has not been widespread in many routine clinical microbiology laboratories. In this issue M. Dudareva and colleagues (J Clin Microbiol 56:e00688-18, 2018, https://doi...
October 17, 2018: Journal of Clinical Microbiology
Jun-Zhe Lang, Cong-Cong Wu, Jian-Feng Jin, Peng Wu, Lei Hen
OBJECTIVE: To determine the association of sarcopenia with short-term postoperative function after hip replacement for femoral neck fractures. METHODS: A prospective study of 181 consecutive patients with femoral neck fractures who underwent hip replacement from May 2014 to January 2017 were performed, including 58 males and 123 females aging from 53 to 92 years old. The general conditions were collected before surgery, skeletal muscle index(ASMI), handgrip strength were measured...
September 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Pierre Sautet, Thibaut Mékidèche, Romain Guilhaumou, Matthew P Abdel, Jean-Noël Argenson, Sébastien Parratte, Matthieu Ollivier
Revisions TKAs are being completed with uncemented constructs more frequently. We hypothesized that tantalum cones could be an efficient carrier of antibiotics in uncemented procedures. We aimed to compare the release of vancomycin between 1) tantalum and smooth stainless cylinders, 2) different concentrations of vancomycin and 3) different durations of bathing. Specifically designed tantalum cylinders were bathed in a vancomycin solution with various durations of baths. We investigated rinses between each interval as well as the dose of vancomycin...
October 16, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Abdullah Al-Zaghal, William Raynor, Mohsen Khosravi, Ali Guermazi, Thomas J Werner, Abass Alavi
Medical imaging plays a particularly important role in the care of elderly patients, in whom complex symptomatology and a high prevalence of musculoskeletal diseases necessitate sensitive imaging modalities. MRI is the most commonly used imaging modality in the evaluation of various musculoskeletal disorders. The integration of positron emission technique and computed tomography as well as magnetic resonance imaging allows for generating complimentary data for accurate and quantitative diagnosis. This article highlights the implementations of molecular imaging probes in the assessment of prevalent musculoskeletal disorders among geriatric population with emphasis on osteoarthritis, osteoporosis, diabetic foot, and prosthetic joint infections...
November 2018: Seminars in Nuclear Medicine
E Carlos Rodriguez-Merchan
Background: Periprosthetic infection is the most serious joint replacement complication, occurring in 0.8-1.9% of total knee arthroplasties (TKAs).This review aims to define the role of preoperative aspiration culture (PAC) for diagnosis of TKA infection. Methods: A PubMed (MEDLINE) search related to TKA infection and PAC was analyzed. The main criteria for selection were that the articles were focused in the aforementioned question. Results: Twenty articles were found, but only fourteen were selected and reviewed because they were deeply focused on the topic...
September 2018: Archives of Bone and Joint Surgery
L G Mercuri
Prosthetic joint infections are not only distressing complications for patients and surgeons, but also have an enormous financial impact on healthcare systems. The reported incidence of prosthetic joint infection is likely underestimated due to difficulties in their diagnosis. This unfortunate complication has challenged joint replacement surgeons for years, despite all the advances made in this surgical discipline. Since eradication of these infections can be very difficult, prevention remains the primary objective...
October 10, 2018: International Journal of Oral and Maxillofacial Surgery
F-C Kuo, Y-D Lu, C-T Wu, H-L You, G-B Lee, M S Lee
AIMS: The aim of this study was to compare the results of 16S/28S rRNA sequencing with the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, and synovial fluid analysis in the diagnosis of prosthetic joint infection (PJI). PATIENTS AND METHODS: Between September 2015 and August 2016, 214 consecutive patients were enrolled. In the study population, there were 25 patients with a PJI and 189 controls. Of the PJI patients, 14 (56%) were women, and the mean age at the time of diagnosis was 65 years (38 to 83)...
October 2018: Bone & Joint Journal
Roger Erivan, Thibault Chaput, Guillaume Villatte, Matthieu Ollivier, Stéphane Descamps, Stéphane Boisgard
BACKGROUND: Current trends in patient management include decreasing hospital stay lengths and reductions in available material and human resources. A shortening of hospital stays in university hospitals has been documented over the last decade. However, to our knowledge, no study has assessed possible relationships linking shorter stays to staffing levels or complication rates. The objectives of this study were: 1) to assess changes in case volume in a university orthopaedics and trauma surgery department between 2006 and 2016, 2) and to look for correlations linking these changes to staffing levels and the rates of significant complications, including the number of hip dislocations after total hip arthroplasty (THA) and the number of infections and complications resulting in malpractice litigation after hip, knee, or shoulder arthroplasty...
October 2, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Kyle H Cichos, Eva J Lehtonen, Gerald McGwin, Brent A Ponce, Elie S Ghanem
INTRODUCTION: Orthopaedic surgeons are wary of patients with neuromuscular (NM) diseases as a result of perceived poor outcomes and lack of data regarding complication risks. We determined the prevalence of patients with NM disease undergoing total joint arthroplasty (TJA) and characterized its relationship with in-hospital complications, prolonged length of stay, and total charges. METHODS: Data from the Nationwide Inpatient Sample from 2005 to 2014 was used for this retrospective cohort study to identify 8,028,435 discharges with total joint arthroplasty...
October 2, 2018: Journal of the American Academy of Orthopaedic Surgeons
Kyung Hwa Park, Robin Patel
Prosthetic joint infection (PJI) poses a burden on patients and health care resources. PJI diagnosis can be challenging, owing to imperfect definition, alongside inadequate diagnostic techniques. In this review, we describe consensus definitions of PJI, approaches to diagnosis using methods available in Korea, and novel diagnostic methods.
September 2018: Infection & Chemotherapy
Vanina Meyssonnier, Valérie Zeller, Stéphanie Malbos, Beate Heym, Luc Lhotellier, Nicole Desplaces, Simon Marmor, Jean-Marc Ziza
OBJECTIVE: Tuberculous prosthetic joint infection (PJI) is uncommon and often diagnosed late. The objective here is to describe the management of tuberculous PJI at an osteoarticular infection referral center. METHODS: A single-center retrospective study of patients managed between 1987 and 2016 was performed. RESULTS: We identified 9 patients with a median age of 80 years. The hip was involved in all 9 patients. A known history of tuberculosis was noted in 2 patients and tuberculosis was present at other sites in 4 patients (lung, n = 3; urinary tract and scrotum, n = 1; and spine, n = 1)...
September 26, 2018: Joint, Bone, Spine: Revue du Rhumatisme
Nicholas D Sanderson, Teresa L Street, Dona Foster, Jeremy Swann, Bridget L Atkins, Andrew J Brent, Martin A McNally, Sarah Oakley, Adrian Taylor, Tim E A Peto, Derrick W Crook, David W Eyre
BACKGROUND: Prosthetic joint infections are clinically difficult to diagnose and treat. Previously, we demonstrated metagenomic sequencing on an Illumina MiSeq replicates the findings of current gold standard microbiological diagnostic techniques. Nanopore sequencing offers advantages in speed of detection over MiSeq. Here, we report a real-time analytical pathway for Nanopore sequence data, designed for detecting bacterial composition of prosthetic joint infections but potentially useful for any microbial sequencing, and compare detection by direct-from-clinical-sample metagenomic nanopore sequencing with Illumina sequencing and standard microbiological diagnostic techniques...
September 27, 2018: BMC Genomics
Elina Huerfano, Alejandro Gonzalez Della Valle, Kate Shanaghan, Federico Girardi, Stavros Memtsoudis, Jiabin Liu
Background: Acute care events including emergency department (ED) visits and unscheduled inpatient re-admissions following lower-extremity arthroplasty are not fully understood. Question/Purposes: The purpose of this study was to characterize acute care events occurring after discharge in patients who received a lower-extremity arthroplasty: the incidence, timing, and risk factors of inpatient admission and ED visits within 90 days of discharge. Methods: The New York State Inpatient and Emergency Department Databases were used to identify patients who underwent elective total knee arthroplasty (TKA) or total hip arthroplasty (THA) from 2009 to 2013 (124,234 and 76,411 patients, respectively)...
October 2018: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Chan-Yuan Chang, Wu-Chien Chien, Chi-Hsiang Chung, Chang-Huei Tsao, Fu-Huang Lin, Feng-Yee Chang, Shih-Ta Shang, Yung-Chih Wang
PURPOSE: This nationwide population-based retrospective cohort study evaluated the protective effect of N-acetylcysteine against prosthetic joint infection after hip or knee joint replacement. METHODS: Patients receiving N-acetylcysteine after hip or knee joint replacement between 2000 and 2015 were identified from the Taiwan National Health Insurance Research Database. Each patient receiving N-acetylcysteine was matched to four controls based on age, sex, and index year...
September 12, 2018: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
Elena Beam, Douglas Osmon
Prosthetic joint infection occurs in a minority of arthroplasties performed; however, it brings a large burden to both the individual and society in terms of morbidity, mortality, and health care expenditure. Although prevention of prosthetic joint infection is becoming more effective, the number of total arthroplasties in patients with increasing comorbidities continues to rise, and the total number of diagnosed and managed prosthetic joint infections is expected to rise accordingly. Management is complex and involves a multispecialty approach...
September 18, 2018: Infectious Disease Clinics of North America
Pablo A Slullitel, José I Oñativia, Martin A Buttaro, Marisa L Sánchez, Fernando Comba, Gerardo Zanotti, Francisco Piccaluga
Acute peri-prosthetic joint infection (PJI) following total hip arthroplasty (THA) is a potentially devastating and undesired complication, with a prevalence of 0.3% to 2.9%. Its suspicion begins with a meticulous physical examination and anamnesis. Diagnosis should be made on the basis of the Musculoskeletal Infection Society criteria. Serum and synovial biomarkers are very useful tools when major criteria are absent.Although sometimes not possible due to medical conditions, surgery is usually the first line of treatment...
July 2018: EFORT Open Reviews
Markku A Vuorinen, Riku A Palanne, Tatu J Mäkinen, Jarkko T Leskinen, Heini Huhtala, Kaisa A Huotari
PURPOSE: Dexamethasone has been shown to prevent post-operative nausea and vomiting (PONV) and seems to reduce post-operative pain. Both factors, which can extend the hospital stay, delay rehabilitation, and impact patient satisfaction. Because of the immunosuppressive and glucose-rising effects of dexamethasone, there has been concern of its safety in arthroplasty surgery. The purpose of our study was to examine infection safety of dexamethasone in arthroplasty surgery with enough large study material to reliably detect a possible, even small, difference in infection incidence...
September 19, 2018: International Orthopaedics
Yu-Ping Wang, Cheng-Fong Chen, Hsin-Pai Chen, Fu-Der Wang
BACKGROUND/PURPOSE: Total knee arthroplasty (TKA) improves the patient's quality of life by relieving pain, correcting the deformity, and helping the patient resume normal activities. However, post-TKA prosthetic joint infection leads to implant failure, is difficult to treat, and causes a significant burden both economically and health-wise. Therefore, an understanding of the current trends in this infection and microbiology data is essential for preventing and treating it. METHODS: A retrospective study was conducted on 10,768 patients who underwent primary TKA at Taipei Veterans General Hospital, Taiwan, from 2002 to 2014...
September 5, 2018: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
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