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Periprosthetic AND Infection

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https://www.readbyqxmd.com/read/30102651/usefulness-of-culturing-the-periprosthetic-membrane-or-neosynovium-for-the-diagnosis-of-infection-during-hip-and-knee-revision-arthroplasty
#1
Ernesto Muñoz-Mahamud, Ignacio Molinas, Luis Lozano, Jordi Bosch, Laura Morata, Andrés Combalia, Álex Soriano, Guillem Bori
INTRODUCTION: Identification of microorganisms is critical for correct management of an infected arthroplasty. Our hypothesis is that the culture yield depends on the location around the prosthesis from which samples are obtained. METHODS: This prospective study included 298 revisions of the hip (123) and knee (175). We compared the yield of the intraoperative samples obtained, which included synovial fluid (two), neosynovium (two), and periprosthetic membrane (two)...
August 10, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/30100137/defining-treatment-success-after-2-stage-exchange-arthroplasty-for-periprosthetic-joint-infection
#2
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...
June 20, 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
#3
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...
July 2, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30100134/diagnosing-periprosthetic-joint-infection-in-inflammatory-arthritis-assumption-is-the-enemy-of-true-understanding
#4
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...
July 24, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30099992/combination-of-conventional-culture-vial-culture-and-broad-range-pcr-of-sonication-fluid-for-the-diagnosis-of-prosthetic-joint-infection
#5
Antonios Stylianakis, Georgios Schinas, Pavlos C Thomaidis, Joseph Papaparaskevas, Dimitrios C Ziogas, Maria N Gamaletsou, George L Daikos, Spyros Pneumaticos, Nikolaos V Sipsas
We assessed the value of conventional culture, vial culture, and broad-range PCR of the sonication fluid (SF), individually or in combinations, for the diagnosis of prosthetic joint infection (PJI). We studied 114 consecutive patients (median age:72.5 years, males: 28.07%) undergoing removal of a total knee or hip prosthesis. By non-microbiologic criteria, 87 patients had aseptic failure, and 27 PJI. All patients had periprosthetic tissue culture, sonication of prosthesis, and study of SF by conventional and vial culture, and PCR...
September 2018: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/30099642/the-influence-of-bearing-surfaces-on-periprosthetic-hip-infections-analysis-of-thirty-nine-thousand-two-hundred-and-six-cementless-total-hip-arthroplasties
#6
Barbara Bordini, Susanna Stea, Francesco Castagnini, Luca Busanelli, Federico Giardina, Aldo Toni
PURPOSE: Periprosthetic hip infection (PHI) is a devastating complication. The association between PHI and bearing surfaces as well as patient-related factors has been recently investigated, with contradictive outcomes. The dataset of Emilia-Romagna region Registry for Orthopaedic Prosthetic Implants (RIPO) has been assessed to investigate, if the bearing choice influenced the risk of septic loosening occurrence. METHODS: RIPO data about 39,206 cementless total hip arthroplasties (THA), collected since 2003, were analysed...
August 11, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/30096121/breast-implant-mycobacterial-infections-an-epidemiological-review-and-outcome-analysis
#7
Becher Al-Halabi, Alex Viezel-Mathieu, Zachary Shulman, Marcel A Behr, Omar Fouda Neel
BACKGROUND: Epidemiological evidence of periprosthetic mycobacterial infections (PMIs) is limited. The recent boom in cosmetic surgery tourism has been associated with a rise of surgical site infections (SSIs) in returning patients. This review aims to explore available data, examine trends of documented PMIs and analyze outcomes of management techniques. METHODS: A search in Biosis, Embase, LILACS, Medline, and Web of Science databases from inception until December 2017 for "Breast Implants" and "Mycobacterial Infections" and equivalents was performed...
August 7, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/30096095/new-insights-into-breast-implant-associated-anaplastic-large-cell-lymphoma
#8
Camille Laurent, Corinne Haioun, Pierre Brousset, Philippe Gaulard
PURPOSE OF REVIEW: Breast implant-associated anaplastic large cell lymphoma (BI-ALCL) is a rare form of lymphoma arising adjacent to a breast implant. We aim to review the pathogenesis and clinico-biological features of BI-ALCL. RECENT FINDINGS: BI-ALCL is a new provisional entity in the 2017 updated WHO classification. Among several hypotheses, BI-ALCL development seems to be determined by the interaction of immune response related to implant products and additional genetic events...
September 2018: Current Opinion in Oncology
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...
July 5, 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...
July 11, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30092109/overlapping-lower-extremity-total-joint-arthroplasty-does-not-increase-the-risk-of-90-day-complications
#11
Jaiben George, Jared M Newman, Mhamad Faour, William Messner, Alison K Klika, Wael K Barsoum, Carlos A Higuera
Although total hip arthroplasty and total knee arthroplasty commonly overlap, there are concerns about the safety and quality of this scenario. The objectives of this study were to (1) compare the operative time and the incidence of 90-day complications between overlapping and nonoverlapping total joint arthroplasties; and (2) evaluate the effect of the duration of overlap on operative time and the incidence of 90-day complications. A total of 9192 patients who underwent primary total hip arthroplasty or total knee arthroplasty at a large academic hospital from 2005 to 2014 were identified...
August 9, 2018: Orthopedics
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...
July 4, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30062941/a-randomized-controlled-trial-of-cemented-versus-cementless-arthroplasty-in-patients-with-a-displaced-femoral-neck-fracture
#13
RANDOMIZED CONTROLLED TRIAL
B Barenius, C Inngul, Z Alagic, A Enocson
Aims: The aim of this study was to compare the functional and radiological outcomes in patients with a displaced fracture of the hip who were treated with a cemented or a cementless femoral stem. Patients and Methods: A four-year follow-up of a randomized controlled study included 141 patients who underwent surgery for a displaced femoral neck fracture. Patients were randomized to receive either a cemented (n = 67) or a cementless (n = 74) stem at hemiarthroplasty (HA; n = 83) or total hip arthroplasty (THA; n = 58)...
August 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/30062940/the-exeter-v40-cemented-femoral-component-at-a-minimum-10-year-follow-up
#14
R W Westerman, S L Whitehouse, M J W Hubble, A J Timperley, J R Howell, M J Wilson
Aims: The aim of this study was to report the initial results of the Exeter V40 stem, which became available in 2000. Patients and Methods: A total of 540 total hip arthroplasties (THAs) were performed in our unit using this stem between December 2000 and May 2002. Our routine protocol is to review patients postoperatively and at one, five, and ten years following surgery. Results: A total of 145 patients (26.9%) died before ten years and of the remaining 395 stems, 374 (94...
August 2018: Bone & Joint Journal
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
#15
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...
July 31, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/30058529/periprosthetic-stress-fracture-around-a-well-fixed-type-2b-short-uncemented-stem
#16
Pablo Ariel Slullitel, Jose Ignacio Oñativia, Lionel Llano, Fernando Comba, Gerardo Zanotti, Francisco Piccaluga, Martin Alejandro Buttaro
Despite the theoretical advantages of uncemented short stems, postoperative thigh pain is still matter of concern and can be attributed to different causes. We report a peculiar case of a stress fracture around a short cementless stem with cervico-metaphyseal fixation in an otherwise healthy patient. We implanted a MiniHipTM stem in a 43 year-old male professional golf player for the treatment of primary osteoarthritis using a ceramic on ceramic bearing. Against medical advice, the patient started to play soccer at the 4th postoperative month and was completely asymptomatic to that extent; but at 8 months follow-up and without a history of trauma he started complaining about progressive hip pain...
2018: SICOT-J
https://www.readbyqxmd.com/read/30054812/comparison-of-two-stage-revision-arthroplasty-and-intramedullary-arthrodesis-in-patients-with-failed-infected-knee-arthroplasty
#17
Martin Gathen, Matthias D Wimmer, Milena M Ploeger, Leonie Weinhold, Matthias Schmid, Dieter C Wirtz, Sascha Gravius, Max J Friedrich
BACKGROUND: Failed total knee arthroplasty (TKA) with significant bone loss and compromised soft-tissues is challenging and the final results are often inferior to patient's expectation. The objective of this study was to present a comparison of outcomes in patients with failed infected TKA treated with two-stage revision TKA or knee arthrodesis and to assess clinical and functional results, implant survival and infection recurrence. The hypothesis was that an arthrodesis may result in beneficial effects on patients' outcome...
July 27, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/30054644/-revision-surgery-in-acute-periprosthetic-knee-joint-infections
#18
REVIEW
T Hawellek, F T Beil, J Hubert
OBJECTIVE: Reduction of pathogens in the knee joint by removal of infected periprosthetic soft tissue, irrigation and modular implant exchange of the total knee arthroplasty (TKA) to eliminate the infection and long-term preservation of the TKA. INDICATIONS: Early infection of TKA (<4 weeks postoperatively); acute hematogenous TKA infection (symptom duration <3 weeks). CONTRAINDICATIONS: Delayed (>4 weeks postoperatively) or chronic TKA infection; TKA loosening; difficult-to-treat pathogens; critical soft tissue with draining sinus tract...
July 27, 2018: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/30054211/preoperative-opioids-increase-the-risk-of-periprosthetic-joint-infection-after-total-joint-arthroplasty
#19
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...
May 29, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30051105/tibial-tubercle-osteotomy-in-total-knee-arthroplasty-midterm-results-experience-of-a-monocentric-study
#20
Stefano Biggi, Stefano Divano, Riccardo Tedino, Andrea Capuzzo, Stefano Tornago, Andrea Camera
Purpose  Difficult primary total knee arthroplasty (TKA) and revision TKA may be high demanding, especially during joint exposure. Aim of this article is to evaluate the clinical and radiological outcomes of a series of patients, who underwent TKA and revision TKA, where tibial tubercle osteotomy (TTO) was performed. Methods  We retrospectively reviewed a cohort of 79 consecutives TKAs where TTO was performed. Patients were assessed clinically and radiographically at their last follow-up (mean, 7.4 ± 3...
June 2018: Joints
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