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Periprosthetic joint infection

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https://www.readbyqxmd.com/read/28343870/cd15-focus-score-infection-diagnosis-and-stratification-into-low-virulence-and-high-virulence-microbial-pathogens-in-periprosthetic-joint-infection
#1
V T Krenn, M Liebisch, B Kölbel, N Renz, T Gehrke, M Huber, M G Krukemeyer, A Trampuz, H Resch, V Krenn
INTRODUCTION: The aim of the work was to validate the CD15 focus score for the infection pathology of periprosthetic joint infection in a large group and to clarify whether a stratification into low-virulence and high-virulence microbial pathogens is possible by means of the CD15 focus score (quantification of CD15 positive granulocytes). METHODS: The histopathology of 275 synovial tissue samples taken intraoperatively during revision operations (n=127 hip, n=141 knee, n=2 shoulder, n=5 ankle) was evaluated according to the SLIM consensus classification (SLIM=synovial-like interface membrane)...
January 12, 2017: Pathology, Research and Practice
https://www.readbyqxmd.com/read/28343826/diagnosis-of-periprosthetic-joint-infection-an-algorithm-based-approach
#2
Nicholas T Ting, Craig J Della Valle
BACKGROUND: Periprosthetic joint infection (PJI) remains one of the most challenging and devastating modes of failure after total hip and knee arthroplasties. Despite the profound urgency and impact of PJI on an individual and societal basis, historically, there have not been standardized definitions of and diagnostic algorithms for infection after total joint arthroplasty. METHODS: In a recent symposium, the American Academy of Hip and Knee Surgeons put forth a standardized approach to the prevention, diagnosis, and management of the patient with a suspected PJI...
March 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28336247/surgical-case-order-has-an-effect-on-the-risk-of-subsequent-periprosthetic-joint-infection
#3
Antonia F Chen, Michael M Kheir, Joshua M Greenbaum, Camilo Restrepo, Mitchell G Maltenfort, Javad Parvizi
BACKGROUND: Periprosthetic joint infection (PJI) after total joint arthroplasty (TJA) is a serious complication with multiple etiologies. Prior spine literature has shown that later cases in the day were more likely to develop surgical site infection. However, the effect of case order on PJI after TJA is unknown. This study aims to determine the influence of case order, prior infected case, and terminal cleaning on the risk for a subsequent PJI. METHODS: A retrospective, single-institution study was conducted on 31,499 TJAs performed from 2000 to 2014...
February 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28335753/leuconostoc-mesenteroides-periprosthetic-knee-infection-an-unusual-fastidious-gram-positive-bacteria-a-case-report
#4
Rafael Franco-Cendejas, Claudia A Colín-Castro, Melissa Hernández-Durán, Luis E López-Jácome, Silvestre Ortega-Peña, Guillermo Cerón-González, Samuel Vanegas-Rodríguez, Jaime A Mondragón-Eguiluz, Eduardo Acosta-Rodríguez
BACKGROUND: Periprosthetic joint infections are mainly caused by Gram-positive cocci. Leuconostoc mesenteroides is a rare microorganism mainly causing bloodstream infections. At times, it might be confused with another type of cocci and give rise to misdiagnosed infections. Molecular diagnosis and biofilm production comprise important techniques to guide antibiotic treatment. CASE PRESENTATION: A 68-year-old Hispanic female with a previous history of bilateral knee arthroplasty presented with acute right-knee inflammation and gait impairment...
March 23, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28321490/c-reactive-protein-may-misdiagnose-prosthetic-joint-infections-particularly-chronic-and-low-grade-infections
#5
Daniel Pérez-Prieto, María E Portillo, Lluís Puig-Verdié, Albert Alier, Santos Martínez, Lluisa Sorlí, Juan P Horcajada, Joan C Monllau
BACKGROUND: Periprosthetic tissue cultures, sonication and synovial fluid cultures remain the gold standard for prosthetic joint infection (PJI) diagnosis. However, some 15-20% culture-negative PJI are still reported. Therefore, there is the need for other diagnostic criteria. One point of concern relative to the different definitions of PJI is as to the inclusion of the c-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR) as diagnostic criteria for PJI despite them being non-specific inflammatory blood tests...
March 21, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28318868/management-of-periprosthetic-joint-infection-the-more-we-learn-the-less-we-know
#6
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
#7
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/28316960/lower-urinary-tract-infection-and-periprosthetic-joint-infection-after-elective-primary-total-hip-arthroplasty
#8
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/28303585/the-effect-of-depth-of-centrifuged-synovial-fluid-on-leukocyte-esterase-test-for-periprosthetic-joint-infection
#9
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/28295126/gluteus-maximus-advancement-flap-procedure-for-reconstruction-of-posterior-soft-tissue-deficiency-in-revision-total-hip-arthroplasty
#10
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/28291188/quantification-of-peri-implant-bacterial-load-and-in-vivo-biofilm-formation-in-an-innovative-clinically-representative-mouse-model-of-periprosthetic-joint-infection
#11
Alberto V Carli, Samrath Bhimani, Xu Yang, Matthew B Shirley, Karen L de Mesy Bentley, F Patrick Ross, Mathias P G Bostrom
BACKGROUND: Periprosthetic joint infection (PJI) is a devastating complication following total joint arthroplasty. Current animal models of PJI are limited because of a lack of quantitative methods and failure to effectively recreate the periprosthetic space. We therefore developed a murine PJI model involving a 3-dimensionally printed Ti-6Al-4V implant capable of bearing weight and permitting quantitative analysis of periprosthetic bacterial load and evaluation of biofilm. METHODS: Twenty-five 12-week-old C57BL/6 mice received a unilateral proximal tibial implant and intra-articular injection of either 3 × 10 colony forming units (CFUs) of Staphylococcus aureus Xen 36 or saline solution...
March 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28290115/sonication-of-arthroplasty-implants-improves-accuracy-of-periprosthetic-joint-infection-cultures
#12
REVIEW
Adam C Rothenberg, Alan E Wilson, John P Hayes, Michael J O'Malley, Brian A Klatt
BACKGROUND: There is evidence that sonication of explanted prosthetic hip and knee arthroplasty components with culture of the sonication fluid may enhance diagnostic sensitivity. Previous studies on the use of implant sonicate cultures have evaluated diagnostic thresholds but did not elaborate on the clinical importance of positive implant sonicate cultures in the setting of presumed aseptic revisions and did not utilize consensus statements on periprosthetic joint infection (PJI) diagnosis when defining their gold standard for infection...
March 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28287012/low-sensitivity-of-implant-sonication-when-screening-for-infection-in-revision-surgery
#13
Floor M Van Diek, Christiaan G M Albers, Miranda L Van Hooff, Jacques F Meis, Jon H M Goosen
Background and purpose - Prosthetic-joint infection (PJI) is the most serious complication of arthroplasty, and accurate identification of a potentially responsible microorganism is essential for successful antibiotic treatment. We therefore determined the diagnostic accuracy of sonication and compared it with tissue culture as a screening tool in detecting prosthetic joint infection in revision arthroplasty. Patients and methods - 252 consecutive revision arthroplasty cases were enrolled. These cases were determined as being suspected or unsuspected of having infection according to standard criteria...
March 13, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28285096/periprosthetic-joint-infection-by-propionibacterium-acnes-clinical-differences-between-monomicrobial-versus-polymicrobial-infection
#14
Raúl Figa, David Muñetón, Lucía Gómez, A Matamala, Mayli Lung, Eva Cuchi, Pablo S Corona
OBJECTIVE: To compare a series of monomicrobial Propionibacterium acnes (P. acnes) knee and hip periprosthetic joint infection (PJI) cases with cases of polymicrobial PJI which included P. acnes. We hypothesized that the presence of a polymicrobial P. acnes infection would lead to worse outcomes than those in cases of monomicrobial P. acnes PJI. METHODS: Retrospective multicentre study. All patients with hip or knee PJIs including P. acnes diagnosed from August-2002 to July-2013 in two university hospitals were included...
March 8, 2017: Anaerobe
https://www.readbyqxmd.com/read/28283902/what-is-the-ideal-route-of-administration-of-tranexamic-acid-in-tka-a-randomized-controlled-trial
#15
Sung Yup Lee, Suri Chong, Dhanasekaraprabu Balasubramanian, Young Gon Na, Tae Kyun Kim
BACKGROUND: TKA commonly involves substantial blood loss and tranexamic acid has been used to reduce blood loss after TKA. Numerous clinical trials have documented the efficacy and safety of intravenous (IV) or intraarticular (IA) use of tranexamic acid. Combined administration of tranexamic acid also has been suggested; however, there is no consensus regarding the ideal route of tranexamic acid administration. QUESTIONS/PURPOSES: (1) To compare the efficacy of tranexamic acid in terms of total blood loss and the allogeneic transfusion rate among three routes of administration: IV alone, IA alone, and combined IV and IA...
March 10, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28280641/prosthetic-joint-infection-due-to-mycobacterium-avium-intracellulare-in-a-patient-with-rheumatoid-arthritis-a-case-report-and-review-of-the-literature
#16
Nicholas E Ingraham, Brenton Schneider, Jonathan D Alpern
Nontuberculous mycobacteria (NTM) are a rare cause of prosthetic joint infections (PJI). However, the prevalence of NTM infections may be increasing with the rise of newer immunosuppressive medications such as biologics. In this case report, we describe a rare complication of immunosuppressive therapies and highlight the complexity of diagnosing and treating PJI due to NTM. The patient is a 79-year-old Caucasian male with a history of severe destructive rheumatoid arthritis on several immunosuppressive agents and right hip osteoarthritis s/p total hip arthroplasty 15 years previously with several complex revisions, presenting with several weeks of worsening right hip and abdominal pain...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28271915/a-new-multiplex-real-time-polymerase-chain-reaction-assay-for-the-diagnosis-of-periprosthetic-joint-infection
#17
Masaki Kawamura, Naomi Kobayashi, Yutaka Inaba, Hyonmin Choe, Taro Tezuka, So Kubota, Tomoyuki Saito
OBJECTIVES: A new multiplex real-time polymerase chain reaction (PCR) assay was developed to detect methicillin-resistant Staphylococcus (MRS) and to distinguish between gram-positive and gram-negative bacteria. In this study, we validated the sensitivity and specificity of this assay with periprosthetic joint infections (PJIs) and evaluated the utility of PCR for culture-negative PJI. METHODS: Forty-five samples from 23 infectious PJI cases and 106 samples from 64 non-infectious control cases were analyzed by real-time PCR using a LightCycler Nano(®) system...
March 8, 2017: Modern Rheumatology
https://www.readbyqxmd.com/read/28271085/the-zeitgeist-of-challenging-the-evidence-a-perspective-on-the-international-consensus-meeting-on-periprosthetic-joint-infection
#18
Hangama C Fayaz, Jesse B Jupiter
BACKGROUND: The economic burden of the treatment of periprosthetic joint infection (PJI) is high and the treatment of PJI has a high degree of international controversy. Several papers have declared the International Consensus Meeting on Periprosthetic Joint Infection (ICMPJI) to be the "flawless pledge of international academics" to overcome the challenges of musculoskeletal infections. The purpose of this paper is to highlight for the first time some essential insights into the key dilemmas that are associated with this international consensus process...
January 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28267904/-treatment-of-the-infected-hip-replacement-3-surgical-times-in-one-hospital-stay-t-3-1
#19
F Gómez-García, R L Espinosa-Mendoza, A Nava-García
BACKGROUND: The impacts of chronic periprosthetic joint infection, variability in rates of recurrence and the lack of consensus as to what is the best way to treat it, require using alternatives. Does the alternative proposed here has a recurrence rate at least equal to or less than the methods used now? MATERIAL AND METHODS: We were retrospectively studied 15 adult patients and analyze variables related to the host, implant, germ, diagnosis and recurrence rate...
July 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28264756/systematic-review-of-risk-prediction-scores-for-surgical-site-infection-or-periprosthetic-joint-infection-following-joint-arthroplasty
#20
S K Kunutsor, M R Whitehouse, A W Blom, A D Beswick
Accurate identification of individuals at high risk of surgical site infections (SSIs) or periprosthetic joint infections (PJIs) influences clinical decisions and development of preventive strategies. We aimed to determine progress in the development and validation of risk prediction models for SSI or PJI using a systematic review. We searched for studies that have developed or validated a risk prediction tool for SSI or PJI following joint replacement in MEDLINE, EMBASE, Web of Science and Cochrane databases; trial registers and reference lists of studies up to September 2016...
March 7, 2017: Epidemiology and Infection
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