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Periprosthetic joint infection

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https://www.readbyqxmd.com/read/29141925/unusual-salmonella-typhi-periprosthetic-joint-infection-involving-bilateral-knees-management-options-and-literature-review
#1
Ashok Rajgopal, Inayat Panda, Anu Gupta
A 70-year-old Indian woman, who had undergone primary bilateral total knee arthroplasty (TKA) for rheumatoid arthritis 10 months prior, presented with 10 days history of pain, swelling and erythema over both knees with pus discharging from the right knee. She had type 2 diabetes mellitus and was on long-term steroid, leflunomide and antitumour necrosis factor therapy for rheumatoid arthritis. Her clinical and laboratory features were suggestive of a haematogenous periprosthetic joint infection (PJI). The final diagnosis of bilateral Salmonella typhi PJI was made based on culture reports...
November 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29137901/impact-of-femoral-stem-design-on-failure-after-anterior-approach-total-hip-arthroplasty
#2
Krishna R Cidambi, Steven L Barnett, Paige R Mallette, Jay J Patel, Nader A Nassif, Robert S Gorab
BACKGROUND: An increased rate of complications related to femoral component failure has been described with less invasive total hip arthroplasty (THA). This study evaluated the incidence of femoral complications associated with the direct anterior approach for THA. METHODS: Retrospective review was performed of the initial 1120 consecutive patients who underwent direct anterior THA by 2 surgeons. RESULTS: A total of 899 patients (80.3%) had a 2-year follow-up (range, 2-8 years)...
November 11, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29130112/infection-risk-assessment-in-patients-undergoing-primary-total-knee-arthroplasty
#3
Lazaros A Poultsides, Georgios K Triantafyllopoulos, Vasileios I Sakellariou, Stavros G Memtsoudis, Thomas P Sculco
PURPOSE: To determine the incidence and to identify potential risk factors for in-hospital and late infections, as well as for deep periprosthetic joint infection (PJI) following TKA. METHODS: We identified 17,959 patients treated with primary TKA between 2000 and 2009. We recorded patient demographics, comorbidities and in-hospital complications. The rates of in-hospital, late, and deep PJIs were determined. Different logistic regression models were built to identify risk factors for each of the above types of infection...
November 12, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29129618/rotating-hinge-implants-for-complex-primary-and-revision-total-knee-arthroplasty
#4
Sean M Kearns, Brian M Culp, Daniel D Bohl, Scott M Sporer, Craig J Della Valle, Brett R Levine
BACKGROUND: Contemporary rotating hinge knee (RHK) prosthesis has shown improved survival rates over earlier generations. However, reports of high complication and mechanical failure rates highlight the need for more clinical outcome data in the complex primary and revision setting. The purpose of this study is to report our results of using a contemporary rotating hinge for complex primary and revision total knee arthroplasty. METHODS: Using a prospectively maintained surgical database, 79 knees in 76 patients who underwent an RHK of a single design for either a complex primary (14 knees) or revision total knee arthroplasty (65 knees) were identified...
October 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29129616/risk-of-periprosthetic-joint-infection-in-patients-with-multiple-arthroplasties
#5
W Parker Abblitt, Emily W Chan, Andrew A Shinar
BACKGROUND: Risk of subsequent periprosthetic joint infection (PJI) in a second prosthetic joint following initial PJI has been shown to be 19%-20%. We sought to identify (1) the risk of developing a second PJI for our patients with multiple prosthetic joints and (2) the effect of bacteremia on development of a subsequent PJI. METHODS: We retrospectively reviewed all patients treated surgically for PJI by a single surgeon from 2003 to 2014. Time between initial and subsequent infection, bacteremia, and risk factors for PJI were identified...
November 9, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29119076/are-there-benefits-in-early-diagnosis-of-prosthetic-joint-infection-with-multiplex-polymerase-chain-reaction
#6
Christian Lausmann, Akos Zahar, Mustafa Citak, Julian Brañes, Stefan Schmidl, Lars Frommelt, Thorsten Gehrke, Matthias Gebauer
Purpose Identification of bacteria and susceptibility are fundamental in periprosthetic joint infection (PJI). Especially in the case of systemic inflammatory response syndrome (SIRS) rapid detection of pathogens is essential for proper therapy. Bacterial cultures are time consuming. The polymerase chain reaction (PCR) is a non-culture molecular method and is able to rapidly identify pathogens and their resistance genes. Multiplex PCR (mPCR) can amplify several different DNA sequences simultaneously. The aim of this study was to show the value of mPCR for early diagnosis of PJI...
2017: Journal of bone and joint infection
https://www.readbyqxmd.com/read/29116327/the-effect-of-a-door-alarm-on-operating-room-traffic-during-total-joint-arthroplasty
#7
Scott M Eskildsen, Peter T Moskal, Jeffrey Laux, Daniel J Del Gaizo
Operating room traffic has been implicated in several studies to contribute to the risk of surgical site infections and periprosthetic joint infections. The purpose of this study was to evaluate the effect of a door alarm on operating room traffic during total joint arthroplasty. This prospective cohort study evaluated 100 consecutive primary total hip and knee arthroplasty surgeries performed by a single surgeon. An inconspicuous electronic door counter was placed on the substerile operating room door. Door openings and time left ajar were recorded...
November 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/29114643/analytical-evaluation-of-a-vancomycin-immunoassay-in-synovial-fluid
#8
REVIEW
Francesca Luceri, Fiamma Balboni, Giovanni Balato, Paola Pezzati, Nicoletta Cini, Gianni Virgili, Andrea Baldini
In clinical laboratories performing routine activities, the need to answer the burning clinical question in emerging field may be limited by lack of technology support or assays accessibility. Commercially available methods, although originally validated for specific biological matrices, may be employed for other matrices, following appropriate guidelines such as Clinical and Laboratory Standards Institute (CLSI) EP 19. We investigated the use of a vancomycin assay with synovial fluid samples, in view of a possible employment in vancomycin release study...
June 2017: Joints
https://www.readbyqxmd.com/read/29107499/clinical-outcome-of-massive-endoprostheses-used-for-managing-periprosthetic-joint-infections-of-the-hip-and-knee
#9
Abtin Alvand, George Grammatopoulos, Floris de Vos, Matthew Scarborough, Ben Kendrick, Andrew Price, Roger Gundle, Duncan Whitwell, William Jackson, Adrian Taylor, Christopher L M H Gibbons
BACKGROUND: Endoprosthetic replacement (EPR) is an option for management of massive bone loss resulting from infection around failed lower limb implants. The aim of this study is to determine the mid-term outcome of EPRs performed in the treatment of periprosthetic joint infection (PJI) and infected failed osteosyntheses around the hip and knee joint and identify factors that influence it. METHODS: We retrospectively reviewed all hip and knee EPRs performed between 2007 and 2014 for the management of chronic infection following complex arthroplasty or fracture fixation...
October 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29107493/association-between-body-mass-index-and-thirty-day-complications-after-total-knee-arthroplasty
#10
Jaiben George, Nicolas S Piuzzi, Mitchell Ng, Nipun Sodhi, Anton A Khlopas, Michael A Mont
BACKGROUND: Although previous studies have evaluated the effect of obesity on the outcomes of total knee arthroplasty (TKA), most considered obesity as a binary variable. It is important to compare different weight categories and consider body mass index (BMI) as a continuous variable to understand the effects of obesity across the entire range of BMI. Therefore, the objective of this study is to analyze the effect of BMI on 30-day readmissions and complications after TKA, considering BMI as both a categorical and a continuous variable...
October 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29103776/systemic-absorption-of-antibiotics-from-antibiotic-loaded-cement-spacers-for-the-treatment-of-periprosthetic-joint-infection
#11
Adam I Edelstein, Kamil T Okroj, Thea Rogers, Craig J Della Valle, Scott M Sporer
BACKGROUND: Two-stage treatment of periprosthetic joint infections involves placement of high-dose antibiotic-loaded cement spacers (ACSs). Reports of ACS-induced nephrotoxicity have raised concern regarding systemic absorption of antibiotics after ACS placement. We sought to characterize the serum concentrations of antibiotics that occur after ACS placement. METHODS: We performed a prospective study of patients with an infected primary total hip (THA) or knee arthroplasty (TKA) treated with standardized ACSs with vancomycin, gentamicin, and tobramycin...
October 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29103074/diagnostic-accuracy-of-synovial-fluid-blood-markers-and-microbiological-testing-in-chronic-knee-prosthetic-infections
#12
Giovanni Balato, Vincenzo Franceschini, Tiziana Ascione, Alfredo Lamberti, Fiamma Balboni, Andrea Baldini
INTRODUCTION: This retrospective study was undertaken to define cut-off values for synovial fluid (SF) leukocyte count and neutrophil percentage for differentiating aseptic failure and periprosthetic joint infection (PJI) and to evaluate the diagnostic accuracy of blood inflammatory markers, and microbiological testing according to the criteria proposed by the International Consensus Meeting (ICM) of Philadelphia. METHODS: All patients who underwent revision total knee arthroplasty from January 2010 to July 2015 were included: we identified and classified 31 PJIs and 136 aseptic joints...
November 4, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29101982/acr-appropriateness-criteria-%C3%A2-imaging-after%C3%A2-total%C3%A2-knee-arthroplasty
#13
Mary G Hochman, Yulia V Melenevsky, Darlene F Metter, Catherine C Roberts, Jenny T Bencardino, R Carter Cassidy, Michael G Fox, Mark J Kransdorf, Douglas N Mintz, Nehal A Shah, Kirstin M Small, Stacy E Smith, Kathy M Tynus, Barbara N Weissman
Total knee arthroplasty (TKA) is the most commonly performed joint replacement procedure in the United States and annual demand for primary TKA is expected to grow by 673% by 2030. The first part provides an overview of imaging modalities (radiographs, CT, MRI, ultrasound, and various nuclear medicine studies) and discusses their usefulness in the imaging evaluation of TKA. The second part focuses on evidence-based imaging and imaging-guided intervention algorithms for the workup of TKA and its complications, including routine follow-up, component wear, periprosthetic infection, aseptic loosening, granulomas/osteolysis, conventional and rotational instability, periprosthetic fracture, patellar complications, and a variety of periprosthetic soft tissue abnormalities...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29099890/the-role-of-synovial-cytokines-in-the-diagnosis-of-periprosthetic-joint-infections-current-concepts
#14
Jared M Newman, Jaiben George, Alison K Klika, Wael K Barsoum, Carlos A Higuera
Periprosthetic joint infection (PJI) is a serious and potentially devastating complication of total joint arthroplasty. Accurate diagnosis of PJI is of utmost importance, but differentiating septic from aseptic failed total joint arthroplasty is extremely challenging, and improper management can lead to significant morbidity. The gold standard for PJI diagnosis is based on standardized laboratory and clinical criteria but relies on preoperative and intraoperative findings, which can be unreliable. Given these limitations, research has focused on new methods for diagnosing PJI...
September 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29092988/a-positive-bacterial-culture-during-re-implantation-is-associated-with-a-poor-outcome-in-two-stage-exchange-arthroplasty-for-deep-infection
#15
D Akgün, M Müller, C Perka, T Winkler
AIMS: The aim of this study was to identify the incidence of positive cultures during the second stage of a two-stage revision arthroplasty and to analyse the association between positive cultures and an infection-free outcome. PATIENTS AND METHODS: This single-centre retrospective review of prospectively collected data included patients with a periprosthetic joint infection (PJI) of either the hip or the knee between 2013 and 2015, who were treated using a standardised diagnostic and therapeutic algorithm with two-stage exchange...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092984/outcomes-following-debridement-antibiotics-and-implant-retention-in-the-management-of-periprosthetic-infections-of-the-hip-a-review-of-cohort-studies
#16
S-T J Tsang, J Ting, A H R W Simpson, P Gaston
AIMS: The aims of the study were to review and analyse the reported series of debridement, antibiotics and implant retention (DAIR) in the management of infected total hip arthroplasties (THAs) to establish the overall success and the influencing factors. PATIENTS AND METHODS: Using a standardised recognised study protocol, meta-analysis of observational studies in epidemiology guidelines, a comprehensive review and analysis of the literature was performed. The primary outcome measure was the success of treatment...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29083362/periprosthetic-knee-infection-two-stage-revision-surgery
#17
Tommaso Bonanzinga, Giuseppe Tanzi, Francesco Iacono, Matteo Carlo Ferrari, Maurilio Marcacci
Periprosthetic joint infection (PJI) remains a serious complication following a total joint replacement.  Diagnosis and management of PJI is challenging for surgeons since there is no "gold standard". This challenging condition requires a coordinated management approach to achieve good patient outcomes. Further difficulties involve choosing the optimal method to treat the periprosthetic joint infection. In this article, it is stressed the role of the two-stage revision: implant removal, debridement and placement of an antibiotic spacer, and antibiotic therapy with cessation prior to reimplantation...
October 18, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29075518/usefulness-of-ultrasonography-in-the-diagnosis-of-hematoma-after-primary-hip-arthroplasty
#18
Jerzy Białecki, Paweł Bartosz, Wojciech Marczyński, Jan Zając
INTRODUCTION: To date, suction drainage has been routinely used after hip joint replacement. Currently, the validity of this practice is questioned in the literature. Hematoma is a risk factor of periprosthetic infection. Post-operative ultrasonography enables precise assessment of hip joint hematoma. AIM: The aim of the study was to evaluate the usefulness of hip joint ultrasonography with respect to the validity of using suction drainage after primary hip arthroplasty...
September 2017: Journal of Ultrasonography
https://www.readbyqxmd.com/read/29066250/corrigendum-to-silver-impregnated-occlusive-dressing-reduces-rates-of-acute-periprosthetic-joint-infection-after-total-joint-arthroplasty-journal-of-arthroplasty-32-2017-929-932
#19
Matthew J Grosso, Ari Berg, Samuel LaRussa, Taylor Murtaugh, David P Trofa, Jeffrey A Geller
No abstract text is available yet for this article.
October 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29059113/the-diagnostic-utility-of-synovial-fluid-markers-in-periprosthetic-joint-infection-a-systematic-review-and-meta-analysis
#20
Anas Saleh, Deepak Ramanathan, Marcelo Bogliolo P Siqueira, Alison K Klika, Wael K Barsoum, Carlos A Higuera Rueda
INTRODUCTION: This study is a systematic review of all reported synovial fluid markers for the diagnosis of periprosthetic joint infection and a meta-analysis of the most frequently reported markers to identify those of greatest diagnostic utility. METHODS: A search of six databases was conducted to identify all studies evaluating the utility of synovial fluid markers in the diagnosis of periprosthetic joint infection. Two observers assessed methodologic quality and extracted data independently...
November 2017: Journal of the American Academy of Orthopaedic Surgeons
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