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Periprosthetic joint infection

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https://www.readbyqxmd.com/read/28228047/visible-glove-perforation-in-total-knee-arthroplasty
#1
Lee Qunn Jid, Mak Wai Ping, Wong Yiu Chung, Wai Yuk Leung
PURPOSE: The risk of superficial surgical site infection (SSI) and periprosthetic joint infection (PJI) after glove perforation is not evident. This study was to identify risk factors for glove perforation in primary TKR (total knee replacement) and the risk of subsequent superficial SSI and PJI. METHODS AND MATERIALS: Results of visible glove perforation of both inner and outer gloves during TKR were reviewed. A case-control analysis was performed on the preoperative and operative variables to identify predictive risk factors for glove perforation...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28215967/leukocyte-esterase-strip-test-can-predict-subsequent-failure-following-reimplantation-in-patients-with-periprosthetic-joint-infection
#2
Michael M Kheir, Colin T Ackerman, Timothy L Tan, Andrea Benazzo, Eric H Tischler, Javad Parvizi
BACKGROUND: Leukocyte esterase (LE) strip test is an accurate marker for diagnosing periprosthetic joint infection (PJI). This study aims to determine if LE is a good predictor of persistent infection and/or subsequent failure in patients undergoing reimplantation. METHODS: This single-institution study prospectively recruited and retrospectively analyzed 109 patients who underwent two-stage exchange treatment of PJI, from 2009-2016, and had an LE test performed at time of reimplantation...
January 26, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28214257/a-comparison-of-two-dosing-regimens-of-asa-following-total-hip-and-knee-arthroplasties
#3
Michael J Feldstein, Sara L Low, Antonia F Chen, Laura A Woodward, William J Hozack
BACKGROUND: The purpose of this study was to compare short-term side effects of aspirin (ASA) 325 mg vs ASA 81 mg orally twice daily (PO BID) when used as thromboembolic prophylaxis following primary total joint arthroplasty. METHODS: A 1-year prospective cohort study was performed on 643 primary unilateral total joint arthroplasty patients operated on by a single surgeon. Two hundred eighty-two patients were administered ASA 325 mg PO BID and 361 patients were administered ASA 81 mg PO BID for 1 month...
January 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28214256/is-there-a-threshold-value-of-hemoglobin-a1c-that-predicts-risk-of-infection-following-primary-total-hip-arthroplasty
#4
Jourdan M Cancienne, Brian C Werner, James A Browne
BACKGROUND: There remains little evidence to support a perioperative hemoglobin A1c (HbA1c) level that could serve as a threshold for a significantly increased risk of deep postoperative infection in patients with diabetes mellitus (DM) following total hip arthroplasty (THA). METHODS: A national administrative database was queried for patients who underwent primary THA with DM. Patients with an HbA1c level within 3 months of surgery were identified and were stratified based on HbA1c level in 0...
January 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28195606/use-of-articulating-spacer-technique-in-revision-total-knee-arthroplasty-complicated-by-sepsis-a-systematic-meta-analysis
#5
John C Spivey, George N Guild, Giles R Scuderi
Periprosthetic infection after total knee arthroplasty is a devastating complication, and 2-stage exchange is the standard of care in North America. Articulating spacers are effective in treating periprosthetic joint infections, but the optimal articulating spacer construct has yet to be identified. The authors performed a systematic review using MEDLINE, MEDLINE In-Process, EMBASE, BIOSIS, ClinicalTrials.gov, and Cochrane Database of Systematic Reviews. They identified 34 articles meeting inclusion criteria, producing 1016 spacers for comparison...
February 13, 2017: Orthopedics
https://www.readbyqxmd.com/read/28185753/predicting-the-incremental-hospital-cost-of-adverse-events-among-medicare-beneficiaries-in-the-comprehensive-joint-replacement-program-during-fiscal-year-2014
#6
Steven D Culler, David S Jevsevar, Kevin J McGuire, Kevin G Shea, Kenneth M Little, Michael J Schlosser
BACKGROUND: The Medicare program's Comprehensive Care for Joint Replacement (CJR) payment model places hospitals at financial risk for the treatment cost of Medicare beneficiaries (MBs) undergoing lower extremity joint replacement (LEJR). METHODS: This study uses Medicare Provider Analysis and Review File and identified 674,777 MBs with LEJR procedure during fiscal year 2014. Adverse events (death, acute myocardial infarction, pneumonia, sepsis or shock, surgical site bleeding, pulmonary embolism, mechanical complications, and periprosthetic joint infection) were studied...
January 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28167881/poor-prognosis-of-patients-treated-for-periprosthetic-joint-infection
#7
REVIEW
Cynthia A Kahlenberg, Alexia Hernandez-Soria, Michael B Cross
The study by Gomez et al., "The Fate of Spacers in the Treatment of Periprosthetic Joint Infection," evaluates the clinical course and success rate of treatment of periprosthetic joint infection with two-stage revision with spacer placement in the interim period. The current review critically analyzes the findings of this study and examines how these findings may influence patient care in the field of hip and knee replacement. Gomez et al. report sobering results of two-stage revision with spacer placement for periprosthetic joint infection...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28165600/early-periprosthetic-joint-infection-and-debridement-antibiotics-and-implant-retention-in-arthroplasty-for-femoral-neck-fracture
#8
Carl Mellner, Thomas Eisler, Björn Knutsson, Sebastian Mukka
INTRODUCTION: Periprosthetic joint infection (PJI) is a severe complication of hip arthroplasty for femoral neck fractures (FNF). Debridement, antibiotics and implant retention (DAIR) is recommended in early PJI in association with stable implants. Few studies have evaluated the outcome of DAIR in this fragile population.The purpose of this study was to analyse risk factors for PJI and the short-term outcome of DAIR in FNF patients treated with a hip arthroplasty. METHODS: A consecutive series of 736 patients (median age 81 years, 490 women, 246 men) had been treated with either a total hip arthroplasty or a hemi hip arthroplasty for a displaced FNF at our institution...
January 31, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28162880/surgical-management-of-periprosthetic-shoulder-infections
#9
Geoffrey P Stone, Rachel E Clark, Kathleen C O'Brien, Lisa Vaccaro, Peter Simon, Adam J Lorenzetti, Brent C Stephens, Mark A Frankle
BACKGROUND: The treatment of periprosthetic joint infection is a difficult challenge in shoulder arthroplasty. This study investigated 1-stage modular component exchange vs. 1-stage complete removal and reimplantation (CRR) vs. 2-stage revision arthroplasty for periprosthetic joint infection. METHODS: Between January 1, 2004, and December 31, 2012, 79 patients received a component exchange (n = 15), CRR (n = 45), or a 2-stage (n = 19) revision for infection. A binary logistic regression analysis was performed to determine factors presenting the greatest risk of reinfection...
February 2, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28160020/diagnosis-of-periprosthetic-joint-infection-using-alpha-defensin-test-or-multiplex-pcr-ideal-diagnostic-test-still-not-found
#10
Arnold J Suda, Marco Tinelli, Nils D Beisemann, Yoram Weil, Amal Khoury, Oliver E Bischel
PURPOSE: Diagnosing periprosthetic infection remains a challenge. Multiplex-PCR and biomarkers such as alpha-defensin are potentially useful and fast methods for detecting periprosthetic infection. This study compared these new methods with clinical assessment, conventional microbiological methods and histo-pathological examination. METHODS: Twenty-eight consecutive patients with 30 joints and a mean age of 67.7 years (range 39 to 88) with removal of total hip arthroplasty (THA) or total knee replacement (TKR) were included in this study...
February 4, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28145954/intra-articular-vancomycin-powder-eliminates-methicillin-resistant-s-aureus-in-a-rat-model-of-a-contaminated-intra-articular-implant
#11
Adam I Edelstein, Joseph A Weiner, Ralph W Cook, Danielle S Chun, Emily Monroe, Sean M Mitchell, Abhishek Kannan, Wellington K Hsu, S David Stulberg, Erin L Hsu
BACKGROUND: Periprosthetic joint infection following hip and knee arthroplasty leads to poor outcomes and exorbitant costs. Topical vancomycin powder has been shown to decrease infection in many procedures such as spine surgery. The role of vancomycin powder in the setting of total joint arthroplasty remains undefined. Our aim was to evaluate the efficacy of intra-articular vancomycin powder in preventing infection in a rat model of a contaminated intra-articular implant. METHODS: Thirty-two female Sprague-Dawley rats underwent knee arthrotomy and implantation of a femoral intramedullary wire with 1 mm of intra-articular communication...
February 1, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28145953/vancomycin-and-ceftazidime-in-bone-cement-as-a-potentially-effective-treatment-for-knee-periprosthetic-joint-infection
#12
Yung-Heng Hsu, Chih-Chien Hu, Pang-Hsin Hsieh, Hsin-Nung Shih, Steve W N Ueng, Yuhan Chang
BACKGROUND: The aim of this study was to determine the optimal formulation of antibiotic-loaded bone cement for knee periprosthetic joint infection. We used both in vitro and in vivo models incorporating various broad-spectrum antibiotics and tested their efficacy against gram-positive and gram-negative bacteria. METHODS: Bone cement specimens loaded with 4 g of either vancomycin or teicoplanin and 4 g of ceftazidime, imipenem, or aztreonam were studied to measure their in vitro antibiotic release characteristics and antibacterial capacities against methicillin-susceptible Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, and Escherichia coli...
February 1, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28145948/total-knee-arthroplasty-after-anterior-cruciate-ligament-reconstruction-not-just-a-routine-primary-arthroplasty
#13
Tyler Steven Watters, Yuan Zhen, J Ryan Martin, Daniel L Levy, Jason M Jennings, Douglas A Dennis
BACKGROUND: Despite the success of restoring joint stability and improving early functional outcomes after anterior cruciate ligament (ACL) reconstruction, the long-term risk of developing symptomatic osteoarthritis requiring total knee arthroplasty is higher than that in the uninjured population. The purpose of this study was to compare operative characteristics and early outcomes of patients undergoing total knee arthroplasty after ACL reconstruction with those of a matched cohort of control subjects with primary osteoarthritis and no history of ligament reconstruction...
February 1, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28134047/effectiveness-of-leucocyte-esterase-as-a-diagnostic-test-for-acute-septic-arthritis
#14
V K Gautam, Rishabh Saini, Siddharth Sharma
BACKGROUND: We hypothesized that leucocyte esterase strip test can aid in diagnosing septic arthritis in native synovial fluid because leucocyte esterase concentrations would be elevated at the infection site because of secretion by recruited neutrophils. METHOD: The cohort included 27 patients (suspected septic arthritis and normal subjects). A standard chemical test strip (graded as negative, trace, +, ++ or +++) was used to detect the presence of leucocyte esterase...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28109195/fungal-periprosthetic-joint-infection-following-total-elbow-arthroplasty-a-case-report-and-review-of-the-literature
#15
Cory A Kwong, Shannon K T Puloski, Kevin A Hildebrand
BACKGROUND: With improving surgical techniques for total elbow arthroplasty clinical outcomes have improved and its utilization continues to increase. Despite these advances, complication rates remain as high as 24%. Of these complications periprosthetic joint infection is one of the most common and morbid. The rheumatoid elbow remains a leading indication for total elbow arthroplasty. Patients with this condition frequently require immunosuppressive therapy, which places them at higher risk of both typical and atypical infections...
January 21, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28108823/which-clinical-and-patient-factors-influence-the-national-economic-burden-of-hospital-readmissions-after-total-joint-arthroplasty
#16
Steven M Kurtz, Edmund C Lau, Kevin L Ong, Edward M Adler, Frank R Kolisek, Michael T Manley
BACKGROUND: The Affordable Care Act of 2010 advanced the economic model of bundled payments for total joint arthroplasty (TJA), in which hospitals will be financially responsible for readmissions, typically at 90 days after surgery. However, little is known about the financial burden of readmissions and what patient, clinical, and hospital factors drive readmission costs. QUESTIONS/PURPOSES: (1) What is the incidence, payer mix, and demographics of THA and TKA readmissions in the United States? (2) What patient, clinical, and hospital factors are associated with the cost of 30- and 90-day readmissions after primary THA and TKA? (3) Are there any differences in the economic burden of THA and TKA readmissions between payers? (4) What types of THA and TKA readmissions are most costly to the US hospital system? METHODS: The recently developed Nationwide Readmissions Database from the Healthcare Cost and Utilization Project (2006 hospitals from 21 states) was used to identify 719,394 primary TJAs and 62,493 90-day readmissions in the first 9 months of 2013 based on International Classification of Diseases, 9th Revision, Clinical Modification codes...
January 20, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28108745/leukocyte-esterase-as-a-biomarker-in-the-diagnosis-of-periprosthetic-joint-infection
#17
Chi Wang, Rui Li, Qi Wang, Jinyan Duan, Chengbin Wang
BACKGROUND Total joint arthroplasty (TJA) has been one of the most rewarding interventions for treating patients suffering from joint disorders. However, periprosthetic joint infection (PJI) is a serious complication that frequently accompanies TJA. Our study aimed to investigate the application of the leukocyte esterase (LE) strip in the diagnosis of PJI. MATERIAL AND METHODS From October 2014 to July 2015, 72 patients who had undergone joint puncture after arthroplasty in our hospital were enrolled in this trial...
January 21, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28099298/low-dose-aspirin-is-effective-chemoprophylaxis-against-clinically-important-venous-thromboembolism-following-total-joint-arthroplasty-a-preliminary-analysis
#18
Javad Parvizi, Ronald Huang, Camilo Restrepo, Antonia F Chen, Matthew S Austin, William J Hozack, Jess H Lonner
BACKGROUND: Aspirin is a safe and effective prophylaxis for the prevention of venous thromboembolism following total joint arthroplasty. The optimal dose of aspirin prophylaxis is unknown. Our hypothesis was that lower-dose aspirin is as effective as higher-dose aspirin for the prevention of venous thromboembolism and is associated with fewer gastrointestinal side effects. METHODS: In a prospective, crossover study, we analyzed 4,651 primary total joint arthroplasty cases performed from July 2013 to June 2015...
January 18, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28097116/kikuchi-fujimoto-disease-misdiagnosed-as-relapse-of-the-infection-after-treatment-of-periprosthetic-hip-joint-infection
#19
Kyung-Keun Min, Byung-Woo Min, Kyung-Jae Lee, Jung-Hoon Choi
Periprosthetic joint infection (PJI) of the hip can be difficult to treat and can lead to a number of problems including: i) severe functional decline of the hip joint and ii) increasing financial burden for patients due to long treatment periods and the need for repeated surgical interventions. Because there is risk of inadequate control of infection or relapse of a preexisting infection following the treatment of PJI through surgery, it is important to closely observe clinical symptoms such as systemic fever...
December 2016: Hip & Pelvis
https://www.readbyqxmd.com/read/28094191/functional-results-of-bilateral-reverse-total-shoulder-arthroplasty
#20
Chris R Mellano, Noam Kupfer, Robert Thorsness, Peter N Chalmers, Terrence F Feldheim, Patrick O'Donnell, Brian J Cole, Nikhil N Verma, Anthony A Romeo, Gregory P Nicholson
BACKGROUND: The purpose of this study was to analyze a population of patients with bilateral reverse total shoulder arthroplasty (RTSA) to evaluate their ability to perform activities of daily living and personal hygiene tasks. METHODS: At a minimum 2-year follow-up, we retrospectively reviewed 50 patients (100 shoulders) with a mean age of 72 years who underwent staged bilateral RTSA. The average follow-up period was 61 months (range, 24-121 months), with a minimum 2-year follow-up after the second surgical procedure...
January 13, 2017: Journal of Shoulder and Elbow Surgery
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