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Prosthetic joint infection

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https://www.readbyqxmd.com/read/29791703/biological-intercalary-reconstruction-with-bone-grafts-after-joint-sparing-resection-of-the-lower-limb-is-this-an-effective-and-durable-solution-for-joint-preservation
#1
Francesco Muratori, Francesca Totti, Antonio D'Arienzo, Maurizio Scorianz, Guido Scoccianti, Giovanni Beltrami, Francesco Rosario Campo, Carmine Citarelli, Rodolfo Capanna, Domenico Andrea Campanacci
Due to advances in neoadjuvant therapies and preoperative imaging modalities, joint-sparing resections have become appealing in bone tumor surgery. However, the intercalary reconstruction of metadiaphyseal bone defects of the femur and the tibia after juxta-articular tumor resection remains challenging. Both biological and prosthetic reconstructions have been used for joint-sparing resections, but little is known about the long-term outcome of these procedures. The authors reviewed a consecutive series of 64 patients treated with joint-sparing intercalary resection and reconstruction with bone grafts...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29789958/prosthetic-joint-infections-an-update
#2
REVIEW
C L Abad, A Haleem
PURPOSE OF REVIEW: Prosthetic joint infection (PJI) is a rare but serious complication that is frequently misdiagnosed. We aimed to highlight the nuances of PJI diagnosis and antimicrobial therapies and provide clarity in key areas of management. RECENT FINDINGS: Current research in PJI centers on a potential role for diagnostic biomarkers, molecular techniques, and implant sonication to reduce culture-negativity rates. The optimal duration of antimicrobial therapy remains controversial...
May 22, 2018: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/29788680/two-sequential-free-flaps-for-coverage-of-a-total-knee-implant
#3
Siew Weng Ng, Hui Chai Fong, Bien-Keem Tan
Knee revision arthroplasty following peri-prosthetic joint infections is a formidable challenge. Patients are at a high risk of recurrent infection, and the soft tissue over the revised implant is often of questionable quality. Flap reconstruction has improved the salvage rates of infected arthroplasties, and should be considered in all cases of revision arthroplasty. We present a challenging case requiring staged reconstruction with two free latissimus dorsi flaps after the initial use of a medial gastrocnemius flap...
May 2018: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/29771856/vitamin-e-phosphate-coating-stimulates-bone-deposition-in-implant-related-infections-in-a-rat-model
#4
Arianna B Lovati, Marta Bottagisio, Susanna Maraldi, Martina B Violatto, Monica Bortolin, Elena De Vecchi, Paolo Bigini, Lorenzo Drago, Carlo L Romanò
BACKGROUND: Implant-related infections are associated with impaired bone healing and osseointegration. In vitro antiadhesive and antibacterial properties and in vivo antiinflammatory effects protecting against bone loss of various formulations of vitamin E have been demonstrated in animal models. However, to the best of our knowledge, no in vivo studies have demonstrated the synergistic activity of vitamin E in preventing bacterial adhesion to orthopaedic implants, thus supporting the bone-implant integration...
June 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29763476/drug-induced-linear-iga-bullous-dermatosis-in-a-patient-with-a-vancomycin-impregnated-cement-spacer
#5
Kelsie Riemenschneider, Daren A Diiorio, John A Zic, Matthew R Livingood, Jo-David Fine, Jennifer G Powers, Jeffrey P Zwerner, Eric Tkaczyk
Linear IgA bullous dermatosis (LABD) is an autoimmune blistering rash caused by IgA autoantibodies against the epidermal basement membrane zone. It commonly is drug induced, often in association with systemic vancomycin. We report a case of a previously healthy 77-year-old man who developed a diffuse macular rash and hemorrhagic bullae on the left leg 10 days after placement of a vancomycin-impregnated cement spacer (VICS) during a revision knee arthroplasty and initiation of postoperative treatment with intravenous (IV) vancomycin...
April 2018: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/29752197/panophthalmitis-caused-by-streptococcus-dysgalactiae-subsp-equisimilis-a-case-report-and-literature-review
#6
Hideharu Hagiya, Takuya Semba, Takeshi Morimoto, Norihisa Yamamoto, Hisao Yoshida, Kazunori Tomono
Lancefield group G β-hemolytic Streptococcus dysgalactiae subspecies equisimilis (SDSE) has become a leading causative pathogen of invasive streptococcal infection. In this report, we describe a case of disseminated SDSE infection complicated by endogenous endophthalmitis, resulting in panophthalmitis and blindness. A 65-year-old man who underwent mitral valve replacement surgery two months previously was hospitalized due to high fever and right visual loss. A systemic investigation revealed endophthalmitis complicated by mediastinal abscess, prosthetic infective endocarditis, cerebral emboli and hemorrhage, and multiple arthritis...
May 8, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29746579/remote-acoustic-sensing-as-a-safety-mechanism-during-exposure-of-metal-implants-to-alternating-magnetic-fields
#7
Bingbing Cheng, Yonatan Chatzinoff, Debby Szczepanski, Chenchen Bing, Sumbul Shaikh, Omar Wyman, Cameron E Perry, James A Richardson, Dennis K Burns, Bret M Evers, David E Greenberg, Rajiv Chopra
Treatment of prosthetic joint infections often involves multiple surgeries and prolonged antibiotic administration, resulting in a significant burden to patients and the healthcare system. We are exploring a non-invasive method to eradicate biofilm on metal implants utilizing high-frequency alternating magnetic fields (AMF) which can achieve surface induction heating. Although proof-of-concept studies demonstrate the ability of AMF to eradicate biofilm in vitro, there is a legitimate safety concern related to the potential for thermal damage to surrounding tissues when considering heating implanted metal objects...
2018: PloS One
https://www.readbyqxmd.com/read/29744425/preliminary-focus-on-the-mechanical-and-antibacterial-activity-of-a-pmma-based-bone-cement-loaded-with-gold-nanoparticles
#8
T Russo, A Gloria, R De Santis, U D'Amora, G Balato, A Vollaro, O Oliviero, G Improta, M Triassi, L Ambrosio
In total knee arthroplasty (TKA) and total hip replacement (THR) the restoration of the normal joint function represents a fundamental feature. A prosthetic joint must be able to provide motions and to transmit functional loads. As reported in the literature, the stress distribution may be altered in bones after the implantation of a total joint prosthesis. Some scientific works have also correlated uncemented TKA to a progressive decrease of bone density below the tibial component. Antibiotic-loaded bone cements are commonly employed in conjunction with systemic antibiotics to treat infections...
September 2017: Bioactive Materials
https://www.readbyqxmd.com/read/29715553/development-and-validation-of-baseline-perioperative-and-at-discharge-predictive-models-for-postsurgical-prosthetic-joint-infection
#9
María Dolores Del Toro, Cecilia Peñas, Ana Conde Albarracín, Julián Palomino, Francisco Brun, Santiago Sánchez, Jesús Rodríguez-Baño
OBJECTIVES: To develop and validate baseline, perioperative and at-discharge risk-scoring systems for postsurgical prosthetic joint infection (PJI) in patients undergoing arthroplasty. PATIENTS AND METHODS: A multicentre, prospective cohort study of patients undergoing hip and knee arthroplasty was performed. Patients were randomly assigned (2:1) to a derivation cohort (DC) or a validation cohort (VC). Multivariable predictive models of PJI were constructed at baseline (preoperative period), perioperative (adding perioperative variables), and at-discharge (adding wound state at-discharge)...
April 28, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29715222/alpha-defensin-lateral-flow-test-for-diagnosis-of-periprosthetic-joint-infection-not-a-screening-but-a-confirmatory-test
#10
Nora Renz, Katsiaryna Yermak, Carsten Perka, Andrej Trampuz
BACKGROUND: Determination of alpha defensin in synovial fluid has shown promising results for diagnosing periprosthetic joint infection (PJI). The purposes of our study were to assess the performance of alpha defensin lateral flow (ADLF) test for the diagnosis of acute and chronic PJI using 3 classification systems and to compare its performance with the synovial fluid leukocyte count. METHODS: Patients in whom aspiration of a prosthetic hip or knee joint was performed before revision arthroplasty were prospectively included...
May 2, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29707402/molecularly-specific-detection-of-bacterial-lipoteichoic-acid-for-diagnosis-of-prosthetic-joint-infection-of-the-bone
#11
Julie E Pickett, John M Thompson, Agnieszka Sadowska, Christine Tkaczyk, Bret R Sellman, Andrea Minola, Davide Corti, Antonio Lanzavecchia, Lloyd S Miller, Daniel Lj Thorek
Discriminating sterile inflammation from infection, especially in cases of aseptic loosening versus an actual prosthetic joint infection, is challenging and has significant treatment implications. Our goal was to evaluate a novel human monoclonal antibody (mAb) probe directed against the Gram-positive bacterial surface molecule lipoteichoic acid (LTA). Specificity and affinity were assessed in vitro. We then radiolabeled the anti-LTA mAb and evaluated its effectiveness as a diagnostic imaging tool for detecting infection via immunoPET imaging in an in vivo mouse model of prosthetic joint infection (PJI)...
2018: Bone Research
https://www.readbyqxmd.com/read/29702663/meta-analysis-of-sonication-prosthetic-fluid-pcr-for-diagnosing-periprosthetic-joint-infection
#12
Kan Liu, Jun Fu, Baozhan Yu, Wei Sun, Jiying Chen, Libo Hao
Periprosthetic joint infection (PJI) is a catastrophic complication following total joint arthroplasty. Until now, the diagnosis of PJI is still confronted with difficulties, which is characterized by technical limitations. The question of whether sonication fluid PCR can provide high value in the diagnosis of PJI remains unanswered. This meta-analysis included 9 studies that evaluated PCR assays of sonication fluid for the diagnosis of PJI. The pooled sensitivity, specificity, Positive likelihood ratio (PLR), Negative likelihood ratio (NLR) and Diagnostic odds ratio (DOR) were 0...
2018: PloS One
https://www.readbyqxmd.com/read/29698308/corr-insights%C3%A2-are-sonication-cultures-of-antibiotic-cement-spacers-useful-during-second-stage-reimplantation-surgery-for-prosthetic-joint-infection
#13
Carl A Deirmengian
No abstract text is available yet for this article.
April 23, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29695923/antibiotic-sensitivities-of-coagulase-negative-staphylococci-and-staphylococcus-aureus-in-hip-and-knee-periprosthetic-joint-infections-does-this-differ-if-patients-meet-the-international-consensus-meeting-criteria
#14
Elena De Vecchi, David A George, Carlo L Romanò, Fabrizio E Pregliasco, Roberto Mattina, Lorenzo Drago
Introduction: Coagulase-negative staphylococci (CoNS) are the main pathogens responsible for prosthetic joint infections (PJIs). As normal inhabitants of human skin, it is often difficult to define if they are contaminants, or if they have an active role in initiating infection. This study aims to evaluate differences in CoNS organisms ( Staphylococcus hominis, Staphylococcus capitis , Staphylococcus haemolyticus , Staphylococcus warneri) and Staphylococcus aureus in terms of isolation rate and antimicrobial susceptibility from patients who met the International Consensus Meeting (ICM) criteria for PJIs and those who did not...
2018: Infection and Drug Resistance
https://www.readbyqxmd.com/read/29691168/predicting-failure-in-early-acute-prosthetic-joint-infection-treated-with-debridement-antibiotics-and-implant-retention-external-validation-of-the-klic-score
#15
Claudia A M Löwik, Paul C Jutte, Eduard Tornero, Joris J W Ploegmakers, Bas A S Knobben, Astrid J de Vries, Wierd P Zijlstra, Baukje Dijkstra, Alex Soriano, Marjan Wouthuyzen-Bakker
BACKGROUND: Debridement, antibiotics, and implant retention (DAIR) is a widely used treatment modality for early acute prosthetic joint infection (PJI). A preoperative risk score was previously designed for predicting DAIR failure, consisting of chronic renal failure (K), liver cirrhosis (L), index surgery (I), cemented prosthesis (C), and C-reactive protein >115 mg/L (KLIC). The aim of this study was to validate the KLIC score in an external cohort. METHODS: We retrospectively evaluated patients with early acute PJI treated with DAIR between 2006 and 2016 in 3 Dutch hospitals...
March 27, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29688636/-critical-evaluation-of-the-ability-to-diagnose-periprosthetic-infection-in-a-medical-system-in-israel
#16
Raviv Allon, Nofar Ben Basat, Alexander Puhov, Yaron Zaulan, Ronit Wollstein
INTRODUCTION: Prosthetic joint infection is a dangerous complication of joint replacement arthroplasty. Besides its catastrophic consequences, differentiating a deep infection from other complications is not always trivial due to lack of clinical signs of infection, inaccurate tests, lab-dependent analysis, variable normal values and ongoing dispute in the literature regarding the recommended diagnosis algorithm. AIMS: The purpose of this study was to examine the diagnosis algorithm in our medical center...
April 2018: Harefuah
https://www.readbyqxmd.com/read/29684101/high-cure-rate-for-acute-streptococcal-prosthetic-joint-infections-treated-with-debridement-antimicrobials-and-implant-retention-in-a-specialized-tertiary-care-center
#17
Kaisa Huotari, Markku Vuorinen, Mikko Rantasalo
Streptococcal prosthetic joint infections (PJIs) treated with debridement, exchange of removable parts, antibiotics, and implant retention within 3 weeks from symptom onset had implant survival rate of 97.9% and implant survival rate without suppressive antimicrobials of 80.9%. Treatment centralization for acute streptococcal PJIs to specialized centers makes excellent cure-rates possible.
April 19, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29670791/self-resolution-of-a-draining-sinus-tract-in-a-patient-with-chronic-periprosthetic-hip-infection
#18
Trevor J Shelton, Alton W Skaggs, Gavin C Pereira
We report a novel case of a patient who had a draining sinus soon after a total hip arthroplasty that spontaneously resolved. The patient voluntarily discontinued antibiotic suppressive therapy (AST) after 10 years of treatment and paradoxically experienced full resolution of signs of chronic prosthetic joint infection (PJI), including recovery of his left-sided draining sinus tract. Now 8 years after discontinuing AST, the patient has no pain, good function, and no major or minor criteria of joint infection according to the Musculoskeletal Infection Society (MSIS) workgroup...
2018: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29660385/pre-operative-asymptomatic-bacteriuria-a-risk-factor-for-prosthetic-joint-infection
#19
R Weale, F El-Bakri, Kordo Saeed
BACKGROUND: Infection is a rare complication following implantation of prosthetic material into a joint. The impact of asymptomatic bacteriuria (ASB) before elective operations and the subsequent risk of prosthetic joint infection (PJI) are not well understood. AIMS: • Assess the prevalence of ASB amongst patients undergoing total arthroplasty of the hip and knee. • Determine the rates of PJI diagnosed within two years of the arthroplasty and if ASB is an independent risk factor for developing PJI...
April 13, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29656981/dual-agent-antibiotic-prophylaxis-using-a-single-preoperative-vancomycin-dose-effectively-reduces-prosthetic-joint-infection-rates-with-minimal-renal-toxicity-risk
#20
John R Burger, Benjamin J Hansen, Emily V Leary, Ajay Aggarwal, James A Keeney
BACKGROUND: We performed this study to compare prosthetic joint infection (PJI) and renal toxicity rates following hip and knee total joint arthroplasty (TJA) when a first-generation cephalosporin was administered either alone or in combination with a single preoperative vancomycin dose, whether vancomycin administration timing potentially influenced dual-antibiotic PJI prophylaxis approach effectiveness, and whether single-dose vancomycin use increased risk of renal impairment. METHODS: This was a retrospective study of 1977 consecutive primary TJAs (1871 patients) treated with cefazolin alone (1044 TJAs) or cefazolin with single-dose vancomycin (953 TJAs)...
March 14, 2018: Journal of Arthroplasty
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