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Periprosthetic joint infection

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https://www.readbyqxmd.com/read/27919578/is-the-commercial-antibiotic-loaded-bone-cement-useful-in-prophylactic-and-cost-saving-after-knee-and-hip-joint-arthroplasty-the-transatlantic-paradox
#1
Pablo Sanz-Ruiz, Jose Antonio Matas-Diez, Mar Sanchez-Somolinos, Manuel Villanueva-Martinez, Javier Vaquero-Martín
BACKGROUND: The use of antibiotic-loaded bone cement (ALBC) has proven to be effective in preventing periprosthetic infection (PPI) after total hip (THA) and knee arthroplasty (TKA). However, the economic benefit of using ALBC routinely remains controversial. METHODS: A total of 2518 patients subjected to THA, partial hip arthroplasty, and TKA between 2009 and 2012 were identified in our prospectively collected registry. Two groups were defined: before (2009-2010) and after the introduction of ALBC (2011-2012)...
November 15, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27911455/functional-outcomes-of-infected-hip-arthroplasty-a-comparison-of-different-surgical-treatment-options
#2
Benjamin V Herman, Mark Nyland, Lyndsay Somerville, Steven J MacDonald, Brent A Lanting, James L Howard
BACKGROUND: Periprosthetic joint infection (PJI) following total hip arthroplasty (THA) can be treated with irrigation and debridement with head and polyethylene exchange (IDHPE) or 2-stage revision (2SR). Few studies have compared patient-reported outcome measures (PROMs) in patients managed with these treatments. METHODS: A retrospective review identified 137 patients who had an infected primary THA between 1986-2013. Control cohorts were matched according to age and Charlton Comorbidity Index (CCI)...
November 28, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27909122/femoral-impaction-bone-grafting-in-revision-hip-arthroplasty-705-cases-from-the-originating-centre
#3
M J Wilson, S Hook, S L Whitehouse, A J Timperley, G A Gie
AIMS: Femoral impaction bone grafting was first developed in 1987 using morselised cancellous bone graft impacted into the femoral canal in combination with a cemented, tapered, polished stem. We describe the evolution of this technique and instrumentation since that time. PATIENTS AND METHODS: Between 1987 and 2005, 705 revision total hip arthroplasties (56 bilateral) were performed with femoral impaction grafting using a cemented femoral stem. All surviving patients were prospectively followed for a mean of 14...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27890730/cathodic-voltage-controlled-electrical-stimulation-of-titanium-for-prevention-of-methicillin-resistant-staphylococcus-aureus-and-acinetobacter-baumannii-biofilm-infections
#4
Mary Canty, Nicole Luke-Marshall, Anthony Campagnari, Mark Ehrensberger
: Antibiotic resistance of bacterial biofilms limits available treatment methods for implant-associated orthopaedic infections. This study evaluated the effects of applying cathodic voltage-controlled electrical stimulations (CVCES) of -1.5V and -1.8V (vs. Ag/AgCl) to coupons of commercially pure titanium (cpTi) incubated in cultures of methicillin-resistant Staphylococcus aureus (MRSA) and Acinetobacter baumannii (A. baumannii) as a method of preventing bacterial attachment. Stimulations were applied for 2, 4, and 8 hours and coupon-associated and planktonic colony-forming units (CFU) were enumerated following stimulation...
November 24, 2016: Acta Biomaterialia
https://www.readbyqxmd.com/read/27876465/is-there-still-a-role-for-irrigation-and-debridement-with-liner-exchange-in-acute-periprosthetic-total-knee-infection
#5
Andrés F Duque, Zachary D Post, Rex W Lutz, Fabio R Orozco, Sergio H Pulido, Alvin C Ong
BACKGROUND: Periprosthetic joint infection (PJI) is an important cause of failure in total knee arthroplasty. Irrigation and debridement including liner exchange (I&D/L) success rates have varied for acute PJI. The purpose of this study is to present results of a specific protocol for I&D/L with retention of total knee arthroplasty components. METHODS: Sixty-seven consecutive I&D/L patients were retrospectively evaluated. Inclusion criteria for I&D/L were as follows: fewer than 3 weeks of symptoms, no immunologic compromise, intact soft tissue sleeve, and well-fixed components...
November 1, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27855056/-mixed-knee-arthrodesis-a-rescue-alternative-in-knee-periprosthetic-joint-infection
#6
Roberto Enrique López-Cervantes, Adrián Huematzin Rivera-Villa, Adrián Miguel-Pérez, René Morales-de Los Santos, Rubén Torres-González, José Manuel Pérez-Atanasio
BACKGROUND: Knee arthrodesis is a rescue procedure for patients with knee periprosthetic joint infection who are not candidates for a revision surgery. The actual methods present a high complication rate with only moderate efectivity. METHODS: We retrospectively analyzed 17 cases, of patients with knee periprosthetic joint infection and bone loss treated by intramedular expandable nail and monoplanar external fixator with a mínimum evolution of 1 year, evaluating the medical records and digitalized X-rays by 2 sub specialized doctors in osteoarticular rescue surgery...
2016: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/27842584/risk-of-infection-in-primary-elective-total-hip-arthroplasty-with-direct-anterior-approach-or-lateral-transgluteal-approach-a-prospective-cohort-study-of-1104-hips
#7
Thomas Ilchmann, Werner Zimmerli, Lilianna Bolliger, Peter Graber, Martin Clauss
BACKGROUND: The direct anterior approach (DAA) is increasingly popular for hip replacement. However, the small incision and the location near to the groin might increase the risk of periprosthetic joint infection (PJI). We asked the questions (i) whether there is an increased risk of infection for this approach, and (ii) whether the spectrum of microorganisms differs between patients with DAA and those with lateral transgluteal approach (LAT). METHODS: All patients operated between 08/2006 and 12/2013 were followed prospectively in an in house register...
November 14, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27834161/periprosthetic-infection-following-primary-hip-and-knee-arthroplasty-the-impact-of-limiting-the-postoperative-surveillance-period
#8
Virginia R Roth, Robyn Mitchell, Julie Vachon, Stéphanie Alexandre, Kanchana Amaratunga, Stephanie Smith, Mary Vearncombe, Ian Davis, Dominik Mertz, Elizabeth Henderson, Michael John, Lynn Johnston, Camille Lemieux, Linda Pelude, Denise Gravel
BACKGROUND Hip and knee arthroplasty infections are associated with considerable healthcare costs. The merits of reducing the postoperative surveillance period from 1 year to 90 days have been debated. OBJECTIVES To report the first pan-Canadian hip and knee periprosthetic joint infection (PJI) rates and to describe the implications of a shorter (90-day) postoperative surveillance period. METHODS Prospective surveillance for infection following hip and knee arthroplasty was conducted by hospitals participating in the Canadian Nosocomial Infection Surveillance Program (CNISP) using standard surveillance definitions...
November 11, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27833769/first-case-report-of-a-late-onset-knee-periprosthetic-joint-infection-caused-by-lactococcus-garvieae
#9
V-I Neagoe, S Zytoun, H-J Neuhaus
Lactococcus garvieae is known as a Gram-positive, catalase-negative, and facultatively anaerobic fish pathogen. The association between Lactococcus spp. and human infectious diseases is described as being mainly associated with lumbar osteomyelitis, hepatic abscess, and infective endocarditis. In the literature of orthopedic post-prosthetic infections, L. garvieae was associated with a case of hip prosthetic infection in a fishmonger woman. We present the case of a 79-year-old male patient with multiple comorbidities, who is admitted to our center with a 5-day history of pain, swelling, and motility disorder of the right knee by the presence of a bicondylar knee replacement surgery, which was performed due to gonarthrosis 17 years ago...
2016: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/27830274/silver-coated-endoprosthetic-replacement-of-the-proximal-humerus-in-case-of-tumour-is-there-an-increased-risk-of-periprosthetic-infection-by-using-a-trevira-tube
#10
Jan Schmolders, Sebastian Koob, Paul Schepers, Michael Kehrer, Sönke Percy Frey, Dieter Christian Wirtz, Peter Heinrich Pennekamp, Andreas Christian Strauss
BACKGROUND AND OBJECTIVES: The aim of our study was to evaluate if there is an increased risk of periprosthetic infection (PJI) in patients following replacement of the proximal humerus by using a modular tumour prosthesis in combination with a trevira tube. METHODS: Thirty patients were treated by using a modular tumour endoprosthesis (MUTARS®) following intra-articular resection of the proximal humerus. Fifteen patients received treatment by using a trevira tube...
November 9, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27822001/osteomyelitis-recent-advances-in-pathophysiology-and-therapeutic-strategies
#11
REVIEW
Mitchell C Birt, David W Anderson, E Bruce Toby, Jinxi Wang
This review article summarizes the recent advances in pathogenic mechanisms and novel therapeutic strategies for osteomyelitis, covering both periprosthetic joint infections and fracture-associated bone infections. A better understanding of the pathophysiology including the mechanisms for biofilm formation has led to new therapeutic strategies for this devastating disease. Research on novel local delivery materials with appropriate mechanical properties, lower exothermicity, controlled release of antibiotics, and absorbable scaffolding for bone regeneration is progressing rapidly...
March 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/27818657/is-penicillin-plus-gentamicin-synergistic-against-clinical-group-b-streptococcus-isolates-an-in-vitro-study
#12
Corinne Ruppen, Agnese Lupo, Laurent Decosterd, Parham Sendi
Group B Streptococcus (GBS) is increasingly causing invasive infections in non-pregnant adults. Elderly patients and those with comorbidities are at increased risk. On the basis of previous studies focusing on neonatal infections, penicillin plus gentamicin is recommended for infective endocarditis (IE) and periprosthetic joint infections (PJI) in adults. The purpose of this study was to investigate whether a synergism with penicillin and gentamicin is present in GBS isolates that caused IE and PJI. We used 5 GBS isolates, two clinical strains and three control strains, including one displaying high-level gentamicin resistance (HLGR)...
2016: Frontiers in Microbiology
https://www.readbyqxmd.com/read/27817992/procalcitonin-and-%C3%AE-defensin-for-diagnosis-of-periprosthetic-joint%C3%A2-infections
#13
Kai Xie, Xinhua Qu, Mengning Yan
BACKGROUND: Current methods to diagnose periprosthetic joint infection (PJI) before revision surgery have limited diagnostic accuracy. This meta-analysis was performed to estimate the accuracy of procalcitonin (PCT) and α-defensin for the diagnosis of PJI. METHODS: Articles on the diagnostic value of PCT or α-defensin for PJI diagnosis were searched in the PubMed database. Sensitivity, specificity, diagnostic odds ratio, the area under the curve of summary receiver operating characteristic curves (AUC), the positive likelihood ratio, and the negative likelihood ratio were calculated to evaluate the diagnostic ability of PCT and the α-defensin test for the diagnosis of PJI...
October 13, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27816369/in-hospital-mortality-in-patients-with-periprosthetic-joint-infection
#14
Alisina Shahi, Timothy L Tan, Antonia F Chen, Mitchell G Maltenfort, Javad Parvizi
BACKGROUND: While periprosthetic joint infection (PJI) has a huge impact on patient function and health, only a few studies have investigated its impact on mortality. The purpose of this large-scale study was to (1) determine the rate and trends of in-hospital mortality for PJI and (2) compare the in-hospital mortality rate of patients with PJI and those undergoing revision arthroplasty for aseptic failure and patients undergoing other nonorthopedic major surgical procedures. METHODS: Data from the Nationwide Inpatient Sample from 2002 to 2010 were analyzed to determine the risk of in-hospital mortality for PJI patients compared with aseptic revision arthroplasty...
September 30, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27807152/optimal-periprosthetic-tissue-specimen-number-for-diagnosis-of-prosthetic-joint-infection
#15
Trisha N Peel, Tim Spelman, Brenda L Dylla, John G Hughes, Kerryl E Greenwood-Quaintance, Allen C Cheng, Jayawant N Mandrekar, Robin Patel
We recently demonstrated improved sensitivity of prosthetic joint infection (PJI) diagnosis using an automated blood culture bottle system for periprosthetic tissue culture (mBio 7 (1):e01776-157, 2016, doi: 10.1128/mBio.01776-15). This study builds on the prior research, by examining the optimal number of periprosthetic tissue specimens required for accurate PJI diagnosis. Current guidelines recommend five to six, which is impractical. We applied Bayesian latent class modeling techniques for estimating diagnostic test properties of conventional culture techniques (aerobic and anaerobic agars and thioglycollate broth) compared to inoculation into blood culture bottles...
November 2, 2016: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/27803221/five-year-outcome-of-proximal-femoral-endoprosthetic-arthroplasty-for-non-tumour-indications
#16
G Grammatopoulos, A Alvand, H Martin, D Whitwell, A Taylor, C L M H Gibbons
OBJECTIVES: A possible solution for the management of proximal femoral bone loss is a modular femoral endoprosthesis (EPR). Although the outcome of EPRs in tumour surgery has been well described, the outcome of their use in revision hip surgery has received less attention. The aim of this study was to describe the outcome of using EPR for non-neoplastic indications. METHODS: A retrospective review of 79 patients who underwent 80 EPRs for non-neoplastic indications was performed, including the rates of complication and survival and the mean Oxford Hip Scores (OHS), at a mean of five years post-operatively...
November 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27789094/periprosthetic-joint-infections-caused-by-enterococci-have-poor-outcomes
#17
Michael M Kheir, Timothy L Tan, Carlos Higuera, Jaiben George, Craig J Della Valle, Mary Shen, Javad Parvizi
BACKGROUND: The definitive treatment and outcome of periprosthetic joint infection (PJI) caused by Enterococcus species is unknown. We performed a multi-institutional study to analyze the characteristics and treatment outcomes of patients with enterococcal PJI and to define an effective treatment protocol. METHODS: We retrospectively reviewed all PJIs at 3 institutions between 1999 and 2014 using an electronic query followed by manual chart review. We included patients who met the Musculoskeletal Infection Society's criteria for PJI and had at least 1 positive intraoperative culture for any Enterococcus species...
September 28, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27783140/lower-limb-reconstruction-in-tumor-patients-using-modular-silver-coated-megaprostheses-with-regard-to-perimegaprosthetic-joint-infection-a-case-series-including-100-patients-and-review-of-the-literature
#18
J Schmolders, S Koob, P Schepers, P H Pennekamp, S Gravius, D C Wirtz, R Placzek, A C Strauss
PURPOSE AND OBJECTIVE: Bone resection regarding adequate surgical margins is the treatment of choice for malignant bone tumors. In the case of metastasis-related complications, so-called skeletal-related events, it is highly important to achieve pain relief and a stable joint situation to re-mobilize the patients immediately following surgery. To bridge the often large osseous defect zones after tumor resection, both cemented and uncemented modular endoprosthetic systems are widely used...
October 25, 2016: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/27776905/silver-impregnated-occlusive-dressing-reduces-rates-of-acute-periprosthetic-joint-infection-after-total-joint-arthroplasty
#19
Matthew J Grosso, Ari Berg, Samuel LaRussa, Taylor Murtaugh, David P Trofa, Jeffrey A Geller
BACKGROUND: Commercial silver-impregnated occlusive dressings (such as Aquacel Ag Surgical wound dressing) have been touted as antimicrobial dressings to be used following total joint arthroplasty. Given the increased cost of an Aquacel dressing over a standard dressing for total joint arthroplasty, the objective of this study was to determine whether Aquacel surgical dressing is effective in reducing the rates of acute periprosthetic joint infection (PJI) compared to standard sterile dressing...
September 28, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27757937/algorithm-to-diagnose-delayed-and-late-pji-role-of-joint-aspiration
#20
Olivier Borens, Pablo S Corona, Lars Frommelt, Stergios Lazarinis, Michael Richard Reed, Carlo Luca Romano
Total Joint Arthroplasty (TJA) continues to gain acceptance as the standard of care for the treatment of severe degenerative joint disease, and is considered one of the most successful surgical interventions in the history of medicine. A devastating complication after TJA is infection. Periprosthetic joint infection (PJI), represents one of the major causes of failure and remains a significant challenge facing orthopaedics today. PJI usually requires additional surgery including revision of the implants, fusion or amputations causing tremendous patient suffering but also a heavy health economics burden...
October 19, 2016: Advances in Experimental Medicine and Biology
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