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Periprosthetic joint infection

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https://www.readbyqxmd.com/read/29352435/outcome-of-hip-and-knee-periprosthetic-joint-infections-caused-by-pathogens-resistant-to-biofilm-active-antibiotics-results-from-a-prospective-cohort-study
#1
Doruk Akgün, Carsten Perka, Andrej Trampuz, Nora Renz
BACKGROUND: Periprosthetic joint infections (PJI) caused by pathogens, for which no biofilm-active antibiotics are available, are often referred to as difficult-to-treat (DTT). However, it is unclear whether the outcome of DTT PJI is worse than those of non-DTT PJI. We evaluated the outcome of DTT and non-DTT PJI in a prospective cohort treated with a two-stage exchange according to a standardized algorithm. METHODS: Patients with hip and knee PJI from 2013 to 2015 were prospectively included and followed up for ≥ 2 years...
January 19, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29349979/-capsular-enhanced-repair-with-suture-anchors-in-bipolar-hemiarthroplasty-for-the-treatment-of-femoral-neck-fractures-in-elderly-patients
#2
Bo Shi, Ming-Rui Xie, Zong-Yuan Li
OBJECTIVE: To evaluate the efficacy of capsular-enhanced repair with suture anchors in bipolar hemiarthroplasty for the treatment of femoral neck fractures in elderly patients. METHODS: A retrospective study was designed. From June 2009 to June 2016, 53 senile patients (54 hips)with femoral neck fracture were treated operatively in Mianyang central hospital (Sichuan, China). There were 21 males and 32 females, ranging in age from 80 to 97.5 years old (mean, 84.7 years old)...
April 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29344701/the-fate-of-immunocompromised-patients-in-the-treatment-of-chronic-periprosthetic-joint-infection-a-single-centre-experience
#3
Baochao Ji, Xiaogang Zhang, Boyong Xu, Jiangdong Ren, Wentao Guo, Wenbo Mu, Li Cao
PURPOSE: Immunocompromised patients with periprosthetic joint infection (PJI) are rare and currently there are no reliable guidelines according to which these infections can be successfully managed. The purpose of this study was to report the clinical course of different strategies for treatment of PJI in frail patients. METHODS: A retrospective analysis between 2004 and 2015 included 29 immunocompromised patients (13 hips and 16 knees) with chronic PJI who underwent one-stage revision or debridement, antibiotics and implant retention (DAIR)...
January 17, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29342496/-adverse-events-in-the-treatment-of-periprosthetic-fractures-around-the-knee-a-clinical-and-radiological-outcome-analysis
#4
Anna Janine Schreiner, Christoph Gonser, Christoph Ihle, Max Konstantin Zauleck, Tim Klopfer, Fabian Stuby, Ulrich Stöckle, Björn Gunnar Ochs
BACKGROUND: The incidence of periprosthetic fractures associated with total knee arthroplasty (PpFxK) has been reported to be 0.3 - 5.5%. 40% of all cases are related to revision TKA. The most common localisation is the distal femur. Classification is performed according to Rorabeck (RB). RB I - II fractures are usually treated with locked plating and retrograde intramedullary nailing, whereas RB III fractures are an indication for revision arthroplasty using a hinged endoprosthesis...
January 17, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29342065/diagnosis-of-periprosthetic-joint-infection-the-potential-of-next-generation-sequencing
#5
Majd Tarabichi, Noam Shohat, Karan Goswami, Abtin Alvand, Randi Silibovsky, Katherine Belden, Javad Parvizi
BACKGROUND: Next-generation sequencing is a well-established technique for sequencing of DNA and has recently gained attention in many fields of medicine. Our aim was to evaluate the accuracy of next-generation sequencing in identifying the causative organism(s) in patients with periprosthetic joint infection. METHODS: In this prospective study, samples were collected from 65 revision arthroplasties (39 knees and 26 hips) and 17 primary arthroplasties (9 hips and 8 knees)...
January 17, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29340736/risk-factors-for-early-infection-following-hemiarthroplasty-in-elderly-patients-with-a-femoral-neck-fracture
#6
Dirk Zajonz, Alexander Brand, Christian Lycke, Orkun Özkurtul, Jan Theopold, Ulrich J A Spiegl, Andreas Roth, Christoph Josten, Johannes K M Fakler
PURPOSE: Periprosthetic joint infections (PJI) after hemiarthroplasty for geriatric femoral neck fractures are a devastating complication that results in serious morbidity and increased mortality. Identifying risk factors associated with early infection after HA for hip fractures may offer an opportunity to address and prevent this complication in many patients. The aim of this study was to evaluate preoperative risk factors for early PJI after HA in hip fracture patients. METHODS: From January 2010 to December 2015, 312 femoral neck fractures (AO/OTA 31-B) in 305 patients were included in this single-center, retrospective study...
January 16, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29325835/synthetic-mesh-vs-allograft-extensor-mechanism-reconstruction-in-total-knee-arthroplasty-a-systematic-review-of-the-literature-and-meta-analysis
#7
REVIEW
David Shau, Ryan Patton, Suhag Patel, Laura Ward, George Guild
BACKGROUND: Extensor mechanism disruption after total knee arthroplasty (TKA) is a devastating complication. Reconstruction with allograft and synthetic mesh has been described. However, these reports have typically been small case series, and controversy exists with regard to which reconstruction technique is optimal. METHODS: The authors performed a systematic review using PUBMED, MEDLINE, EMBASE, BIOSIS, Clinicaltrials.gov, and Cochrane Database of Systematic Reviews identifying 14 articles meeting inclusion criteria and producing 204 knees for comparison...
January 8, 2018: Knee
https://www.readbyqxmd.com/read/29325724/rheumatoid-arthritis-disease-modifying-agents-and-periprosthetic-joint-infection-what-does-a-joint-surgeon-need-to-know
#8
REVIEW
Mehrnoush H Yeganeh, Michael M Kheir, Alisina Shahi, Javad Parvizi
The incidence of periprosthetic joint infection (PJI) among patients with rheumatoid arthritis (RA) is 1.6× greater than in patients undergoing the same procedure for osteoarthritis. This higher risk "may" be due to the immunosuppressive therapies for RA patients including corticosteroids, such as prednisone, and disease-modifying antirheumatic drugs (DMARDs), such as methotrexate. There is a debate about the role of DMARDs in increasing the incidence of subsequent PJI. Studies show conflicting results, with some demonstrating no significant increase in the rates of PJI and some finding otherwise...
November 23, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29316602/no-evidence-of-increased-infection-risk-with-forced-air-warming-devices-a-systematic-review
#9
Heather S Haeberle, Sergio M Navarro, Linsen T Samuel, Anton Khlopas, Assem A Sultan, Nipun Sodhi, Morad Chughtai, Michael A Mont, Prem N Ramkumar
INTRODUCTION: Forced-air warming devices have been reported to present a potential risk for surgical site infections (SSIs) and periprosthetic joint infections. Due to a lack of consensus, we reviewed the infection risk of forced-air warming devices. MATERIALS AND METHODS: A systematic literature review was performed, evaluating overall infection risk and bacterial load. A total of eight studies reporting outcomes from 1,965 subjects were included. RESULTS AND CONCLUSIONS: There is no current evidence in the orthopaedic literature that forced-air warming devices translate to increased SSIs...
December 22, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29312848/season-of-the-year-influences-infection-rates-following-total-hip-arthroplasty
#10
Samuel Rosas, Alvin C Ong, Leonard T Buller, Karim G Sabeh, Tsun Yee Law, Martin W Roche, Victor H Hernandez
AIM: To research the influence of season of the year on periprosthetic joint infections. METHODS: We conducted a retrospective review of the entire Medicare files from 2005 to 2014. Seasons were classified as spring, summer, fall or winter. Regional variations were accounted for by dividing patients into four geographic regions as per the United States Census Bureau (Northeast, Midwest, West and South). Acute postoperative infection and deep periprosthetic infections within 90 d after surgery were tracked...
December 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/29310922/are-all-periprosthetic-joint-infections-the-same-evaluating-major-vs-minor-criteria
#11
Mitchell R Klement, Ahmed Siddiqi, Justin M Rock, Thorsten M Seyler, Javad Parvizi, Antonia F Chen
BACKGROUND: The diagnosis of periprosthetic joint infection (PJI) can be made when 1 major criterion or 3 of 5 minor criteria are present. However, the outcomes of patients with a major vs minor criteria for diagnosis have not been studied. The objective of this study was to evaluate if a difference in outcome of surgical intervention existed between patients with PJI who were diagnosed with a major criterion or a combination of minor criteria. METHODS: A retrospective chart review identified 277 primary total hip or knee arthroplasty patients who had developed PJI based on the International Consensus Meeting definition...
December 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29309712/leukocyte-esterase-strip-test-a-rapid-and-reliable-method-for-the-diagnosis-of-infections-in-arthroplasty
#12
Xiang Li, Rui Li, Ming Ni, Wei Chai, Libo Hao, Yonggang Zhou, Jiying Chen
The reliability of the leukocyte esterase (LE) strip test needs further investigation. A total of 204 joints suspected of having periprosthetic joint infection were enrolled from July 2014 to June 2016. One drop of synovial fluid extracted by joint aspiration was applied to LE strips. The results were recorded after 2 to 3 minutes according to the 5 color grades on the color chart (-neg, 25, 27, 250, and 500). A centrifuge was used before the LE strip test when the synovial fluid was mixed with blood. Based on the Musculoskeletal Infection Society criteria, 88 joints were diagnosed as being infected and 116 as not infected...
January 8, 2018: Orthopedics
https://www.readbyqxmd.com/read/29307651/acute-periprosthetic-joint-infection-due-to-fusobacterium-nucleatum-in-a-non-immunocompromised-patient-failure-using-a-debridement-antibiotics-implant-retention-approach
#13
Pablo S Corona, Mayli Lung, Dolors Rodriguez-Pardo, Carles Pigrau, Francisco Soldado, Carles Amat, Luis Carrera
Fusobacterium nucleatum is an obligately anaerobic gram-negative rod, a component of the microbiome of the oropharynx and the gastrointestinal and urogenital tracts, causing an array of human infections which often include periodontal pathologies. As far as we know, there are no previous publications about acute periprosthetic joint infection due to Fusobacterium sp.; we report the first case in the medical literature of an aggressive, acute knee prosthetic infection due to F. nucleatum in a non-immunocompromised patient, unsuccessfully treated with a DAIR approach (Debridement + Antibiotics + Implant Retention)...
January 4, 2018: Anaerobe
https://www.readbyqxmd.com/read/29305453/synovasure-quick-test-is-not-as-accurate-as-the-laboratory-based-%C3%AE-defensin-immunoassay-a-systematic-review-and-meta-analysis
#14
K Suen, M Keeka, R Ailabouni, P Tran
AIMS: α-defensin is a biomarker which has been described as having a high degree of accuracy in the diagnosis of periprosthetic joint infection (PJI). Current meta-analyses are based on the α-defensin laboratory-based immunoassay rather than the quick on-table lateral flow test kit. This study is the first meta-analysis to compare the accuracy of the α-defensin laboratory-based immunoassay and the lateral flow test kit for the diagnosis of PJI. MATERIALS AND METHODS: A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...
January 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29305426/rapid-detection-of-periprosthetic-joint-infection-using-a-combination-of-16s-rdna-polymerase-chain-reaction-and-lateral-flow-immunoassay-a-pilot-study
#15
V Janz, J Schoon, C Morgenstern, B Preininger, S Reinke, G Duda, A Breitbach, C F Perka, S Geissler
OBJECTIVES: The objective of this study was to develop a test for the rapid (within 25 minutes) intraoperative detection of bacteria from synovial fluid to diagnose periprosthetic joint infection (PJI). METHODS: The 16s rDNA test combines a polymerase chain reaction (PCR) for amplification of 16s rDNA with a lateral flow immunoassay in one fully automated system. The synovial fluid of 77 patients undergoing joint aspiration or primary or revision total hip or knee surgery was prospectively collected...
January 2018: Bone & Joint Research
https://www.readbyqxmd.com/read/29305046/proinflammatory-biomarkers-level-and-functional-genetic-polymorphisms-in-periprosthetic-joint-infection
#16
Bülent Erdemli, Emre Anıl Özbek, Kerem Başarir, Zeynep Ceren Karahan, Duygu Öcal, Derya Biriken
OBJECTIVE: The aims of this study were 1) to identify the level of inflammatory biomarkers interleukin (IL)-1α, IL-1β, IL-6, IL-8, IL-17, C-reactive protein (CRP), granulocyte colony-stimulating factor (GCSF), ferritin, and tumor necrosis factor (TNF)-α in serum and synovial fluid samples of patients who underwent revision arthroplasty surgery; 2) to establish the relationship between serum and synovial fluid levels; 3) to determine if any of the 11 genetic polymorphisms of TNFα, IL-1, IL-6, IL-8, IL-17, and GCSF on the encoding genes was associated with periprosthetic joint infection (PJI)...
January 2, 2018: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/29302137/rethinking-pyogenic-flexor-tenosynovitis-biofilm-formation-treated-in-a-cadaveric-model
#17
Constantinos Ketonis, Noreen J Hickock, Asif M Ilyas
Introduction  Pyogenic flexor tenosynovitis (PFT) of the hand remains a challenging problem that often requires surgical irrigation and parenteral or oral antibiotics. The authors hypothesize that the pathophysiology and microenvironment of PFT can be likened to that of periprosthetic joint infections (PJIs), in which bacteria thrive in a closed synovial space with limited blood supply. As such, they postulate that PFT is also facilitated by bacterial attachment and biofilm formation rendering standard treatments less effective...
December 2017: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/29298271/high-fidelity-point-of-care-diagnostic-test-for-periprosthetic-joint-infection-commentary-on-an-article-by-thorsten-gehrke-md-et-al-the-accuracy-of-the-alpha-defensin-lateral-flow-device-for-diagnosis-of-periprosthetic-joint-infection-comparison-with-a-gold
#18
https://www.readbyqxmd.com/read/29298259/the-accuracy-of-the-alpha-defensin-lateral-flow-device-for-diagnosis-of-periprosthetic-joint-infection-comparison-with-a-gold-standard
#19
Thorsten Gehrke, Christian Lausmann, Mustafa Citak, Tommaso Bonanzinga, Lars Frommelt, Akos Zahar
BACKGROUND: Alpha defensin is a new biomarker that has been shown to have a very high accuracy to rule out periprosthetic joint infection. Recently, a new rapid lateral flow version of the alpha defensin test was developed and introduced to detect high levels of alpha defensin in synovial fluid quickly and with ease. We conducted a single-center prospective clinical study to compare the results of the Synovasure Alpha Defensin Test with those of the Musculoskeletal Infection Society (MSIS) criteria, which are considered to be the gold standard for diagnosing periprosthetic joint infection...
January 3, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29291158/antibiotic-prophylaxis-and-dair-treatment-in-primary-total-hip-and-knee-arthroplasty-a-national-survey-in-the-netherlands
#20
Ewout S Veltman, Dirk Jan F Moojen, Rob Ghh Nelissen, Rudolf W Poolman
BACKGROUND: To prevent postoperative infection the use of systemic antibiotic prophylaxis is common ground. Type of antibiotic used and duration of prophylaxis are subject to debate. In case of suspected early periprosthetic infection a debridement, antibiotics and implant retention (DAIR) procedure is treatment of first choice. This study evaluated the antibiotic prophylaxis and DAIR treatment protocols nationwide as well as reporting of these DAIR procedures to the national joint registry...
2018: Journal of Bone and Joint Infection
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