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Arthroplasty infection

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https://www.readbyqxmd.com/read/28331279/unplanned-90-day-readmissions-in-a-specialty-orthopaedic-unit-a-prospective-analysis-of-consecutive-12729-admissions
#1
Mahender Avinash, S Rajasekaran, Siddharth N Aiyer
INTRODUCTION: Unplanned readmissions are an undesirable and expensive outcome of clinical practice. Previous reported literature is limited by retrospective study designs and 30 day study intervals. We analyzed causes for 90-day unplanned readmission, temporal occurrence of major causes, possible predisposing factors, bed days lost and economic impact. MATERIALS & METHODS: A prospective analysis of 12729 admissions was performed over 1 year in an Orthopaedic unit...
June 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28326424/total-knee-arthroplasty-in-a-patient-with-hypofibrinogenemia
#2
Christopher R Nacca, Kalpit N Shah, Jeremy N Truntzer, Lee E Rubin
Patients with afibrinogenemia or hypofibrinogenemia present a unique challenge to the arthroplasty surgeon as fibrinogen is a key contributor to hemostasis. Patients with these disorders are known to have a higher risk for postsurgical bleeding complications. We present the case of a patient with hypofibrinogenemia who underwent an elective total knee arthroplasty. Our colleagues in hematology-oncology guided us initially to achieve and maintain appropriate fibrinogen levels in the early perioperative period...
December 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326423/removing-a-well-fixed-femoral-sleeve-during-revision-total-knee-arthroplasty
#3
J Ryan Martin, Tyler S Watters, Daniel L Levy, Jason M Jennings, Douglas A Dennis
The following surgical technique describes a case of a 51-year-old man with severe juvenile rheumatoid arthritis that required a 2-stage revision of an infected revision total knee implant. The patient had previously been implanted with a revision rotating platform, constrained condylar device which gained excellent fixation through the use of diaphyseal-engaging stems, and a well-ingrown, fully porous-coated femoral metaphyseal sleeve. To avoid intraoperative complications while removing the femoral sleeve, a novel technique for femoral sleeve extraction was used...
December 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326402/total-joint-arthroplasty-in-patients-with-chronic-infectious-liver%C3%A2-disease
#4
Jeremy N Truntzer, Kalpit N Shah, Derek R Jenkins, Lee E Rubin
The opportunity for total joint arthroplasty (TJA) in patients with chronic infectious liver disease is rapidly expanding. This is the product of both superior survival of chronic hepatitis patients, evolving implant technologies, and improvement of techniques in TJA. Unfortunately, treating this group of patients is not without significant challenges that can stem from both intrahepatic and extrahepatic clinical manifestations. Moreover, many subclinical changes occur in this cohort that can alter hemostasis, wound healing, and infection risk even in the asymptomatic patient...
June 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326209/neisseria-meningitidis-infecting-a-prosthetic-knee-joint-a-new-case-of-an-unusual-disease
#5
Berta Becerril Carral, Elvira Alarcón Manoja, Salvador López Cárdenas, Jesús Canueto Quintero
Primary meningococcal meningitis is an infrequent but known disease. However, the infection of a prosthetic joint with Neisseria meningitidis is rare. We hereby describe the second case of an arthroplasty infected with Neisseria meningitidis that responded favourably to prosthesis retention with surgical debridement, in combination with antibiotics treatment.
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28324232/reducing-surgical-site-infections-following-total-hip-and-knee-arthroplasty-an-israeli-experience
#6
R Finkelstein, O Eluk, T Mashiach, D Levin, B Peskin, G Nirenberg, S Karkabi, M Soudri
PURPOSE: To assess the changes observed in surgical site infection (SSI) rates following total joint arthroplasty (TJA) after the introduction of an infection control programme and evaluate the risk factors for the development of these infections. DESIGN: Prospective cohort study. SETTING: Large tertiary medical centre in Israel. METHODS: Data about SSIs and potential prophylaxis-, patient-, and procedure-related risk factors were collected for all patients who underwent elective total hip and total knee arthroplasty during the study period...
March 21, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28321829/prosthetic-joint-infections-and-cost-analysis
#7
F S Haddad, A Ngu, J J Negus
Prosthetic joint infection is a devastating complication of arthroplasty surgery that can lead to debilitating morbidity for the patient and significant expense for the healthcare system. With the continual rise of arthroplasty cases worldwide every year, the revision load for infection is becoming a greater financial burden on healthcare budgets. Prevention of infection has to be the key to reducing this burden. For treatment, it is critical for us to collect quality data that can guide future management strategies to minimise healthcare costs and morbidity / mortality for patients...
March 21, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28318868/management-of-periprosthetic-joint-infection-the-more-we-learn-the-less-we-know
#8
Robert A Henderson, Matthew S Austin
BACKGROUND: Despite the tremendous and long-standing success of total hip arthroplasty and total knee arthroplasty as treatments for end-stage arthritis, periprosthetic joint infection (PJI) remains a rare but feared complication of these procedures. METHODS: This review highlights some of the difficulties inherent to studying PJI. These include the difficulty in powering studies to capture this relatively uncommon complication, as well as the heterogeneity in clinical presentation and manifestations associated with the diagnosis and treatment of PJI...
February 23, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28318862/have-periprosthetic-hip-infection-rates-plateaued
#9
Dean C Perfetti, Matthew R Boylan, Qais Naziri, Carl B Paulino, Steven M Kurtz, Michael A Mont
BACKGROUND: Periprosthetic joint infection (PJI) is a serious complication of total hip arthroplasty (THA). Although the number of revision cases is increasing, the prevalence of PJI as an indication for revision surgery, and the variability of this indication among surgeons and hospitals, is unclear. METHODS: The New York Statewide Planning and Research Cooperative System was used to identify 33,582 patients undergoing revision THA between 2000 and 2013. PJI was identified using International Classification of Diseases, Ninth Revision diagnosis codes...
February 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28316961/acute-delayed-or-late-infection-of-revision-total-hip-arthroplasty-treated-with-debridement-antibiotic-loaded-cement-beads-and-retention-of-the-prosthesis
#10
Jun-Dong Chang, In-Sung Kim, Sang-Soo Lee, Je-Hyun Yoo
PURPOSE: The treatment of infected revision total hip arthroplasty (THA) is very challenging due to retained revision prosthesis, poor bone stock and soft tissue condition derived from previous revision surgeries, and comorbidities. The purpose of this study was to investigate the effectiveness and short-term outcomes of aggressive debridement and use of antibiotic-loaded cement beads with retention of the prosthesis for acute delayed or late infection of revision THAs. MATERIALS AND METHODS: Ten consecutive patients with symptoms or signs of less than one-week evolution and well-fixed prostheses, were treated with this procedure and a postoperative course of organism-specific antibiotics for a minimum of 6 weeks...
March 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/28316960/lower-urinary-tract-infection-and-periprosthetic-joint-infection-after-elective-primary-total-hip-arthroplasty
#11
Chan Ho Park, Young-Kyun Lee, Kyung-Hoi Koo
PURPOSE: Periprosthetic joint infection (PJI) after total hip arthroplasty (THA) is a grave complication. Urinary tract infection (UTI) as a source for PJI is controversial. Our purposes were, (1) to evaluate the incidence of PJI after elective primary THA and (2) to determine whether UTI was associated with a risk of PJI after elective primary THA. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 527 patients who underwent elective primary THA by using universal aseptic technique from May 2003 to October 2007...
March 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/28316959/comparative-study-of-peripheral-rim-fixation-using-jumbo-cup-in-revisional-hip-arthroplasty
#12
Woo-Lam Jo, Young-Wook Lim, Jin-Hyung Im, Seung-Chan Kim, Soon-Yong Kwon, Yong-Sik Kim
PURPOSE: It is challenging procedure to revise acetabular component in acetabulum with severe bone defect or deformity. The jumbo cup is good option for revisional arthroplasty in large bone defect. The purpose of this study is to compare the prognosis of revisional total hip arthroplasty using jumbo cup with peripheral rim fixation and no rim fixation. MATERIALS AND METHODS: We included the patients who had performed acetabular revisional total hip arthroplasty from January 2002 to March 2015 in our institute...
March 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/28314891/revision-total-knee-arthroplasty-with-porous-coated-metaphyseal-sleeves-provides-radiographic-ingrowth-and-stable-fixation
#13
Catherine J Fedorka, Antonia F Chen, Michael R Pagnotto, Lawrence S Crossett, Brian A Klatt
PURPOSE: Porous-coated metaphyseal sleeves are designed to fill bone defects and facilitate osseointegration when bone loss in encountered during revision total knee arthroplasty (TKA). The purpose of this study is to evaluate short-term results of porous-coated metaphyseal sleeves with regards to implant fixation and clinical outcomes. METHODS: A retrospective review was conducted on 50 patients (79 sleeves-49 tibial and 30 femoral) who had a press-fit metaphyseal sleeve with revision TKA...
March 17, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28306737/alcohol-consumption-and-the-risk-of-postoperative-mortality-and-morbidity-after-primary-hip-or-knee-arthroplasty-a-register-based-cohort-study
#14
Torill A Rotevatn, Henrik Bøggild, Christinna R Olesen, Christian Torp-Pedersen, Rikke N Mortensen, Per F Jensen, Charlotte Overgaard
OBJECTIVE: To investigate the implications of low and moderate preoperative alcohol consumption on postoperative mortality and morbidity after primary hip and knee arthroplasty. METHODS: A total of 30,799 patients who underwent primary hip or knee arthroplasty between January 1st, 2005 and October 8th, 2011 with information on preoperative alcohol consumption (0 grams of pure alcohol/week, >0-168 g/week, >168-252 g/week, and >252 g/week) were identified through the Danish Anesthesia Database...
2017: PloS One
https://www.readbyqxmd.com/read/28303585/the-effect-of-depth-of-centrifuged-synovial-fluid-on-leukocyte-esterase-test-for-periprosthetic-joint-infection
#15
Pakpoom Ruangsomboon, Sriprapa Chinprasertsuk, Varanya Khejonnit, Keerati Chareancholvanich
Centrifugation of aspirated synovial fluid before leukocytes esterase (LE) testing for diagnosing periprosthetic joint infection (PJI) may make blood tinged specimens interpretable. We aimed to establish the proper sampling depth of centrifuged specimens for LE testing as one diagnostic criterion and also AS-D chloroacetate esterase (CAE) staining testing as an adjunctive tool. A definite PJI knee joint group and an aseptic primary total knee arthroplasty control group were studied quasi-experimentally (N = 46)...
March 17, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28302460/one-stage-exchange-arthroplasty-a-surgical-technique-update
#16
David A George, Fares S Haddad
BACKGROUND: Standard surgical treatment for a periprosthetic knee infection has been based on a staged surgical technique, in order to assure infection eradication prior to implantation of a new prosthesis. METHODS: In this article, we discuss our surgical technique in undertaking a single-stage exchange of a chronic knee periprosthetic infection. RESULTS: This technique, which is based on the fundamental principles of controlling infection, preventing recurrence, and restoring function, has been shown to deliver high success rates...
February 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28299718/have-the-causes-of-revision-for-total-and-unicompartmental-knee-arthroplasties-changed-during-the-past-two-decades
#17
Gro S Dyrhovden, Stein Håkon L Lygre, Mona Badawy, Øystein Gøthesen, Ove Furnes
BACKGROUND: Revisions after knee arthroplasty are expected to increase, and the epidemiology of failure mechanisms is changing as new implants, technology, and surgical techniques evolve. QUESTIONS/PURPOSES: (1) Was there improvement in survival for TKA and unicompartmental knee arthroplasty (UKA) when comparing two consecutive 11-year periods with similar followups in a national registry? (2) Were there changes in the causes of revision during the two times? (3) Could the changes in revision causes be attributed to patient or implant characteristics? METHODS: A total of 60,623 TKAs (2426 revisions) and 7648 UKAs (725 revisions) were selected from the Norwegian Arthroplasty Register and analyzed based on year of primary surgery: 1994 to 2004 (Period 1) and 2005 to 2015 (Period 2)...
March 15, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28296531/risk-factors-associated-with-acute-kidney-injury-in-a-cohort-of-20-575-arthroplasty-patients
#18
Pyry Jämsä, Esa Jämsen, Leo-Pekka Lyytikäinen, Jarkko Kalliovalkama, Antti Eskelinen, Niku Oksala
Background and purpose - Patients developing postoperative acute kidney injury (AKI) are at risk of higher morbidity and mortality. In arthroplasty patients, many pre- and perioperative factors are associated with AKI but some of the risk factors are unclear. We report the incidence of postoperative AKI, the conditions associated with it, and survival rates in AKI patients. Patients and methods - We obtained data from 20,575 consecutive hip or knee arthroplasties. Postoperative AKI, occurring within 7 days after the operation, was defined using the risk, injury, failure, loss, and end-stage (RIFLE) criteria...
March 15, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28295126/gluteus-maximus-advancement-flap-procedure-for-reconstruction-of-posterior-soft-tissue-deficiency-in-revision-total-hip-arthroplasty
#19
Benjamin F Ricciardi, Peter W Henderson, Alexander S McLawhorn, Geoffrey H Westrich, Mathias P Bostrom, Lloyd B Gayle
The current study describes the surgical technique and early outcomes of a gluteus maximus advancement flap procedure for the treatment of posterior soft tissue insufficiency among patients with complex revision total hip arthroplasty. This retrospective case series was conducted with a prospective, single-institution arthroplasty registry. Patients who underwent a gluteus maximus advancement flap procedure in the setting of revision total hip arthroplasty between January 2012 and January 2016 were eligible for inclusion (N=7)...
March 14, 2017: Orthopedics
https://www.readbyqxmd.com/read/28292539/prevention-of-infection-in-orthopedic-prosthetic-surgery
#20
REVIEW
Ioana Chirca, Camelia Marculescu
Total joint arthroplasty is a generally safe orthopedic procedure; however, infection is a potentially devastating complication. Multiple risk factors have been identified for development of prosthetic joint infections. Identification of patients at risk and preoperative correction of known risk factors, such as smoking, diabetes mellitus, anemia, malnutrition, and decolonization of Staphylococcus carriers, represent well-established actions to decrease the infection risk. Careful operative technique, proper draping and skin preparation, and appropriate selection and dosing of antimicrobials for perioperative prophylaxis are also very important in prevention of infection...
March 11, 2017: Infectious Disease Clinics of North America
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