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Arthroplasty infection

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https://www.readbyqxmd.com/read/28818359/environment-of-care-is-it-time-to-reassess-microbial-contamination-of-the-operating-room-air-as-a-risk-factor-for-surgical-site-infection-in-total-joint-arthroplasty
#1
REVIEW
Javad Parvizi, Sue Barnes, Noam Shohat, Charles E Edmiston
In the modern operating room (OR), traditional surgical mask, frequent air exchanges, and architectural barriers are viewed as effective in reducing airborne microbial populations. Intraoperative sampling of airborne particulates is rarely performed in the OR because of technical difficulties associated with sampling methodologies and a common belief that airborne contamination is infrequently associated with surgical site infections (SSIs). Recent studies suggest that viable airborne particulates are readily disseminated throughout the OR, placing patients at risk for postoperative SSI...
August 14, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28816895/ten-year-multicenter-clinical-and-mri-evaluation-of-isolated-supraspinatus-repairs
#2
Philippe Collin, Jean-François Kempf, Daniel Mole Combining Acute Accent, Nicolas Meyer, Charles Agout, Mo Saffarini, Arnaud Godene Combining Grave Accent Che
BACKGROUND: Early repair of isolated supraspinatus tears could prevent further deterioration of the rotator cuff; however, there is no consensus on the management of such tears because of a lack of long-term outcome studies. The purposes of this study were to report the 10-year outcomes of isolated supraspinatus repairs and to investigate the factors that favor healing and recovery. METHODS: We retrieved the records of all 511 patients who, in 2003, underwent repair of full-thickness isolated supraspinatus tears, performed by 15 surgeons at 15 centers...
August 16, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28811109/the-risk-of-acute-infection-following-intra-articular-corticosteroid-injection-into-a-pre-existing-total-knee-arthroplasty
#3
Emily S Mills, Michael B Elman, Jared R H Foran
BACKGROUND: No previous studies have investigated the risk of infection following intra-articular corticosteroid injection (IACI) into a pre-existing total knee arthroplasty (TKA). The aim of this study is to determine the risk of acute infection following IACI into a pre-existing TKA. METHODS: A retrospective chart review identified all patients at a single institution between October 2009 and May 2015 that had an ipsilateral knee injection subsequent to a TKA...
July 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28811108/methylene-blue-guided-debridement-as-an-intraoperative-adjunct-for-the-surgical-treatment-of-periprosthetic-joint-infection
#4
Jeremy D Shaw, Steve Miller, Anna Plourde, Daniel L Shaw, Rosanna Wustrack, Erik N Hansen
BACKGROUND: Current methods to identify infected tissue in periprosthetic joint infection (PJI) are inadequate. The purpose of this study was (1) to assess methylene blue-guided surgical debridement as a novel technique in PJI using quantitative microbiology and (2) to evaluate clinical success based on eradication of infection and infection-free survival. METHODS: Sixteen total knee arthroplasty patients meeting Musculoskeletal Infection Society criteria for PJI undergoing the first stage of 2-stage exchange arthroplasty were included in this prospective study...
July 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28807468/are-revision-hip-arthroplasty-patients-at-higher-risk-for-venous-thromboembolic-events-than-primary-hip-arthroplasty-patients
#5
P Maxwell Courtney, Anthony J Boniello, Brett R Levine, Neil P Sheth, Wayne G Paprosky
BACKGROUND: The purpose of this study is to determine whether revision total hip arthroplasty (THA) is associated with increased rates of deep vein thrombosis (DVT) and pulmonary embolism (PE) when compared to primary THA. METHODS: We queried the American College of Surgeons National Surgical Quality Improvement Program database for all primary and revision THA cases from 2011 to 2014. Demographic data, medical comorbidities, and venous thromboembolic rates within 30 days of surgery were compared between the primary and revision THA groups...
July 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28802851/does-hydroxyapatite-coating-of-uncemented-cups-improve-long-term-survival-an-analysis-of-28-605-primary-total-hip-arthroplasty-procedures-from-the-nordic-arthroplasty-register-association-nara
#6
Stergios Lazarinis, Keijo T Mäkelä, Antti Eskelinen, Leif Havelin, Geir Hallan, Søren Overgaard, Alma B Pedersen, Johan Kärrholm, Nils P Hailer
OBJECTIVE: It is unclear whether hydroxyapatite (HA) coating of uncemented cups used in primary total hip arthroplasty (THA) improves bone ingrowth and reduces the risk of aseptic loosening. We therefore investigated survival of different uncemented cups that were available with or without HA coating. METHOD: We investigated three different cup types used with or without HA coating registered in the Nordic Arthroplasty Register Association (NARA) database that were inserted due to osteoarthritis (n=28,605)...
August 9, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28802416/accuracy-of-valgus-osteotomy-using-dynamic-hip-screw
#7
Sunil G Kulkarni, G S Kulkarni, Sushrut Babhulkar, Milind G Kulkarni, Ruta M Kulkarni
BACKGROUND: Non-union of neck femur is a common but difficult situation to manage especially in young adults. There are two main options of arthroplasty or osteotomy. The aim of this study was to assess the results of intertrochanteric valgus osteotomy in non-union femoral neck fractures. PATIENTS AND METHODS: We present a study of 44 cases of neck femur non-union including untreated fractures, late presentations (more than 3 weeks), treated with compression screw, DHS...
August 2017: Injury
https://www.readbyqxmd.com/read/28800858/diagnostic-value-of-synovial-white-blood-cell-count-and-serum-c-reactive-protein-for-acute-periprosthetic-joint-infection-after-knee-arthroplasty
#8
Sang-Gyun Kim, Jae-Gyoon Kim, Ki-Mo Jang, Seung-Bum Han, Hong-Chul Lim, Ji-Hoon Bae
BACKGROUND: The diagnosis of periprosthetic joint infection (PJI) remains difficult, particularly in acute postoperative stage. The purpose of this study was to investigate the optimal cutoff value of synovial white blood cell (WBC) count, percentage of polymorphonuclear cells, erythrocyte sedimentation rate, and C-reactive protein (CRP) for diagnosing early postoperative infection after knee joint arthroplasty. METHODS: We retrospectively reviewed primary total knee arthroplasties and unicompartmental knee arthroplasties, with a knee aspiration within 3 weeks of surgery, from January 2006 to November 2016...
July 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28800854/up-to-seven-years-follow-up-of-short-cemented-stems-in-complex-primary-total-knee-arthroplasty-a-prospective-study
#9
Mathieu Angers-Goulet, Martin Bédard
BACKGROUND: Although primary total knee arthroplasty (TKA) shows good clinical, functional and radiological results, it can be complicated by certain conditions or pathologies. The main objective of this study was to evaluate the global performance of short cemented metaphyseal stem components in patients undergoing complex primary TKA. METHODS: This is a single-surgeon prospective case series of 91 patients who underwent complex primary TKA requiring short stem fixation between January 2009 and October 2014...
August 8, 2017: Knee
https://www.readbyqxmd.com/read/28797879/using-a-non-invasive-secure-skin-closure-following-total-knee-arthroplasty-leads-to-fewer-wound-complications-and-no-patient-home-care-visits-compared-to-surgical-staples
#10
Alberto V Carli, Sara Spiro, Brian T Barlow, Steven B Haas
BACKGROUND: Superficial wound complications occur in up to 10% of total knee arthroplasty (TKA) procedures and have been associated with periprosthetic joint infection. The ideal material for TKA closure should offer: 1) fast intraoperative application, 2) minimal wound complications and 3) removable by patients without assistance. We evaluated a novel, non-invasive, removable skin closure system for TKA to determine its effect on wound complications. METHODS: We prospectively evaluated 221 consecutive TKA patients who received skin closure using a non-invasive zipper-like system ('Zip'; Zip 16 Surgical Skin Closure System; Zipline Medical)...
August 7, 2017: Knee
https://www.readbyqxmd.com/read/28797875/success-rates-characteristics-and-costs-of-articulating-antibiotic-spacers-for-total-knee-periprosthetic-joint-infection
#11
Scott R Nodzo, Keely K Boyle, Sara Spiro, Allina A Nocon, Andy O Miller, Geoffrey H Westrich
BACKGROUND: The optimal type, characteristics, and success rates of articulating antibiotic spacers used during total knee arthroplasty (TKA) periprosthetic joint infection (PJI) have not been well defined in a single series. We sought to (1) determine the success rate for three unique spacer constructs and (2) evaluate any microbiological, surgical, or patient characteristics that would influence the success rate. METHODS: We retrospectively reviewed patients who underwent a two-stage exchange for a TKA PJI with a prefabricated spacer (PREFAB), home-made mold (MOLD), or autoclaved femoral component (AUTOCL)...
August 8, 2017: Knee
https://www.readbyqxmd.com/read/28793978/patellofemoral-arthroplasty-conversion-to-total-knee-arthroplasty-retrieval-analysis-and-clinical-correlation
#12
Alexander B Christ, Elexis Baral, Chelsea Koch, Beth E Shubin Stein, Alejandro Gonzalez Della Valle, Sabrina M Strickland
BACKGROUND: Patellofemoral arthroplasty (PFA) can be a successful, bone-sparing treatment for isolated patellofemoral arthritis. However, progression of tibio-femoral arthritis or incorrect indications may predispose patients to early conversion to total knee arthroplasty (TKA). The purpose of this study was to review the clinical cases and perform retrieval analysis of PFA conversions to TKA at our institution. METHODS: Twenty one patellofemoral arthroplasties in 18 patients that were converted to TKA were identified through our implant retrieval registry...
August 6, 2017: Knee
https://www.readbyqxmd.com/read/28790468/management-of-the-infected-total-hip-arthroplasty
#13
D'jon Lopez, Isabel Leach, Elinor Moore, Alan R Norrish
In the United Kingdom approximately 80,000 total hip arthroplasties are undertaken on an average each year. The popularity and demand for this operation are continually increasing. Our understanding of arthroplasty surgery and its complications has evolved greatly, and as a result infection rates are undeniably at an all-time low. The increasing volume of operations being performed does, however, mean that we still continue to see an increased number of cases of infection. There is no doubt that periprosthetic joint infection (PJI) poses a complex clinical and diagnostic predicament to clinicians...
July 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28781018/high-early-major-complication-rate-after-revision-for-mechanically-assisted-crevice-corrosion-in-metal-on-polyethylene-total-hip-arthroplasty
#14
Brian J McGrory, Anna H Jorgensen
BACKGROUND: Failed total hip arthroplasty caused by mechanically assisted crevice corrosion (MACC) has serious consequences such as adverse local tissue reaction. Revision is currently indicated for significant hip pain, stiffness, and dysfunction; hip instability; progressive bone loss; and soft tissue destruction. Outcomes of this revision surgery are not yet completely understood. METHODS: We examined the surgical outcomes at a minimum of 6 months (average, 25; range, 7-68 months) in a cohort of 27 consecutive patients who underwent revision total hip arthroplasty for MACC associated with a single implant vendor and taper type...
July 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28781015/incidence-and-risk-factors-for-postoperative-urinary-retention-in-total-hip-arthroplasty-performed-under-spinal-anesthesia
#15
Charles M Lawrie, Alvin C Ong, Victor H Hernandez, Samuel Rosas, Zachary D Post, Fabio R Orozco
BACKGROUND: The objective of this study is to determine the risk factors for postoperative urinary retention (POUR) following total hip arthroplasty (THA) under spinal anesthesia. METHODS: Consecutive patients who underwent a primary THA without preoperative catheterization under spinal anesthesia were identified in a prospectively collected institutional patient database. All patients were monitored postoperatively for urinary retention on the basis of symptoms and the use of bladder ultrasound scans performed by a hospital technician...
July 15, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28780223/modifiable-risk-factors-are-common-in-early-revision-hip-and-knee%C3%A2-arthroplasty
#16
James R Kee, Simon C Mears, Paul K Edwards, C Lowry Barnes
BACKGROUND: Obesity, smoking, uncontrolled diabetes, and poor dental health are modifiable risk factors for revision total joint arthroplasty. To protect patients from revision surgery while also reducing cost, some joint arthroplasty practices use these conditions as contraindications until they are improved. However, this practice is variable among joint arthroplasty surgeons. We hypothesize that a relatively high rate of revision arthroplasty patients had modifiable risk factors at the time of primary surgery...
July 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28773989/bacterial-infection-and-implant-loosening-in-hip-and-knee-arthroplasty-evaluation-of-209-cases
#17
Ulrike Dapunt, Stephanie Radzuweit-Mihaljevic, Burkhard Lehner, Gertrud Maria Haensch, Volker Ewerbeck
The aim of this study was to evaluate bacteria species detected in a large number of patients treated for prosthetic joint infection of the hip and knee at a single specialized center. Furthermore, the rate of implant loosening was investigated in a time-dependent manner for the most frequently detected bacteria species. A retrospective analysis of patients (n = 209) treated for prosthetic joint infection of the hip and knee was performed. The following parameters were evaluated: C-Reactive Protein (CRP) concentration, microbiological evaluation of tissue samples, loosening of the implant, the time that had elapsed since the primary prosthetic joint replacement, and the duration since the last surgical intervention...
October 26, 2016: Materials
https://www.readbyqxmd.com/read/28772331/-pre-operative-evaluation-of-patients-undergoing-total-joint-arthroplasty-what-is-essential
#18
Holger Haas, Christian D Weber
Background A thorough pre-operative evaluation is required prior to total joint arthroplasty (TJA). The objective of screening is to identify patient- and procedure-related risk constellations. Pre-operative diagnostic measures are vital in order to anticipate, reduce or even eliminate threats to patient safety. Furthermore, the clinical and radiographical workup may confirm the indication and type of surgical procedure, but this is not the subject of this article. Objective An overview of the current literature on pre-operative diagnostic principles is presented...
August 3, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28771057/excellent-long-term-results-of-the-m%C3%A3-ller-acetabular-reinforcement-ring-in-primary-cup-revision
#19
Pascal Mueller Greber, Isabella Manzoni, Peter E Ochsner, Thomas Ilchmann, Lukas Zwicky, Martin Clauss
Background and purpose - The original Müller acetabular reinforcement ring (ARR) was developed to be used for acetabular revisions with small cavitary and/or segmental defects or poor acetabular bone quality. Long-term data for this device are scarce. We therefore investigated long-term survival and radiographic outcome for revision total hip arthroplasty using the ARR. Patients and methods - Between October 1984 and December 2005, 259 primary acetabular revisions using an ARR were performed in 245 patients (259 hips)...
August 3, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28768787/factors-affecting-the-rate-of-surgical-site-infection-in-patients-after-hemiarthroplasty-of-the-hip-following-a-fracture-of-the-neck-of-the-femur
#20
L de Jong, T M A L Klem, T M Kuijper, G R Roukema
AIMS: Surgical site infection can be a devastating complication of hemiarthroplasty of the hip, when performed in elderly patients with a displaced fracture of the femoral neck. It results in a prolonged stay in hospital, a poor outcome and increased costs. Many studies have identified risk and prognostic factors for deep infection. However, most have combined the rates of infection following total hip arthroplasty and internal fixation as well as hemiarthroplasty, despite the fact that they are different entities...
August 2017: Bone & Joint Journal
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