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Prosthetic joint

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https://www.readbyqxmd.com/read/28341280/cost-effectiveness-of-staphylococcus-aureus-decolonization-strategies-in-high-risk-total-joint-arthroplasty-patients
#1
Devin M Williams, Andy O Miller, Michael W Henry, Geoffrey H Westrich, Hassan M K Ghomrawi
BACKGROUND: The risk of prosthetic joint infection increases with Staphylococcus aureus colonization. The cost-effectiveness of decolonization is controversial. We evaluated cost-effectiveness decolonization protocols in high-risk arthroplasty patients. METHODS: An analytical model evaluated risk under 3 protocols: 4 swabs, 2 swabs, and nasal swab alone. These were compared to no-screening and universal decolonization strategies. Cost-effectiveness was evaluated from the hospital, patient, and societal perspective...
February 7, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28339315/identification-of-asymptomatic-prosthetic-joint-infection-microbiologic-and-operative-treatment-outcomes
#2
Przemysław L Bereza, Alicja Ekiel, Aleksandra Auguściak-Duma, Małgorzata Aptekorz, Iwona Wilk, Piotr Wojciechowski, Damian J Kusz, Gayane Martirosian
BACKGROUND: This prospective study investigated the role of mechanical and biological factors in aseptic implant loosening or presumed silent prosthetic joint infection (PJI). METHODS: Thirty-seven patients were investigated. Microbiologic and molecular methods were used to detect bacteria on the surface of the failed implants removed during revision arthroplasty. Histopathologic analysis was performed. The influence of body mass index (BMI) and various co-morbidities on implant failure also was determined...
March 24, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28332761/a-uk-national-survey-of-care-pathways-and-support-offered-to-patients-receiving-revision-surgery-for-prosthetic-joint-infection-in-the-highest-volume-nhs-orthopaedic-centres
#3
Andrew J Moore, Michael R Whitehouse, Rachael Gooberman-Hill, Jason Heddington, Andrew D Beswick, Ashley W Blom, Tim J Peters
BACKGROUND: Deep prosthetic joint infection (PJI) is a devastating complication of joint replacement surgery. It is difficult to treat, and patients often require multiple major revision surgeries to eradicate the infection. Treatment can have negative and long-term impact on patients' quality of life. Understanding current service provision provides valuable information needed to design and evaluate support interventions for patients. AIM: This survey aimed to identify usual care pathways and support in UK National Health Service (NHS) orthopaedic centres for patients receiving revision surgery for PJI after hip or knee replacement...
March 23, 2017: Musculoskeletal Care
https://www.readbyqxmd.com/read/28330577/-custom-made-implant-for-complex-facial-reconstruction-a-case-of-total-replacement-of-temporo-mandibular-joint-zygomatic-arch-and-malar-bone
#4
D Guillier, V Moris, L-A See, M Girodon, B-L Wajszczak, N Zwetyenga
INTRODUCTION: Total prosthetic replacement of the temporo-mandibular joint (TMJ) has become a common procedure, but it is usually limited to the TMJ itself. We report about one case of complex prosthetic joint reconstruction extending to the neighbouring bony structures. CASE: A 57-year-old patient, operated several times for a cranio-facial fibrous dysplasia, presented with a recurring TMJ ankylosis and a complexe latero-facial bone loss on the right side. We performed a reconstruction procedure including the TMJ, the zygomatic arch and the malar bone by mean of custom made composite prosthesis (chrome-cobalt-molybdenum-titanium and polyethylene)...
February 2017: J Stomatol Oral Maxillofac Surg
https://www.readbyqxmd.com/read/28326447/in-vitro-activity-of-tedizolid-and-linezolid-against-staphylococcus-epidermidis-isolated-from-prosthetic-joint-infections
#5
C Littorin, B Hellmark, Å Nilsdotter-Augustinsson, B Söderquist
Prosthetic joint infections (PJIs) are rare but long-lasting and are serious complications without any spontaneous resolution, requiring additional surgery and long-term treatment with antibiotics. Staphylococci are the most important aetiological agents of PJIs, and among the coagulase-negative staphylococci Staphylococcus epidermidis is the most common. However, S. epidermidis often displays multidrug resistance (MDR), demanding additional treatment options. The objective was to examine the effectiveness of tedizolid and linezolid against S...
March 22, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28326413/antibiotic-prophylaxis-for-dental-treatment-after-prosthetic-joint-replacement-exploring-the-orthopaedic-surgeon-s-opinion
#6
Clare M McNally, Renuka Visvanathan, Sharon Liberali, Robert J Adams
BACKGROUND: Antibiotic prophylaxis before dental treatment is routinely recommended by orthopaedic surgeons to prevent prosthetic joint infection (PJI). This recommendation is at odds with current guidelines. METHODS: A postal survey of 9 checkbox or short-answer questions was completed by 633 orthopaedic surgeons. RESULTS: The majority of respondents (n = 186 of 260, 72%) believe that antibiotic prophylaxis is required indefinitely for dental treatment...
September 2016: Arthroplast Today
https://www.readbyqxmd.com/read/28326209/neisseria-meningitidis-infecting-a-prosthetic-knee-joint-a-new-case-of-an-unusual-disease
#7
Berta Becerril Carral, Elvira Alarcón Manoja, Salvador López Cárdenas, Jesús Canueto Quintero
Primary meningococcal meningitis is an infrequent but known disease. However, the infection of a prosthetic joint with Neisseria meningitidis is rare. We hereby describe the second case of an arthroplasty infected with Neisseria meningitidis that responded favourably to prosthesis retention with surgical debridement, in combination with antibiotics treatment.
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28324977/a-novel-method-to-assess-angle-sensor-performance-for-wearable-exoskeletal-joint-kinematics
#8
Nicholas B Bolus, Geza F Kogler, Omer T Inan
Full range of motion (ROM) at a joint is necessary for efficient and adaptive movement; as such, it is an essential clinical evaluation measure for assessing an individual's motor function, which can be affected by any number of musculoskeletal injuries and neuropathies. Measurement of joint ROM in the clinic has classically been accomplished statically through the use of a manual goniometer. More recent efforts in the fields of prosthetics and orthotics have demonstrated the potential utility of wearable systems (e...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28324232/reducing-surgical-site-infections-following-total-hip-and-knee-arthroplasty-an-israeli-experience
#9
R Finkelstein, O Eluk, T Mashiach, D Levin, B Peskin, G Nirenberg, S Karkabi, M Soudri
PURPOSE: To assess the changes observed in surgical site infection (SSI) rates following total joint arthroplasty (TJA) after the introduction of an infection control programme and evaluate the risk factors for the development of these infections. DESIGN: Prospective cohort study. SETTING: Large tertiary medical centre in Israel. METHODS: Data about SSIs and potential prophylaxis-, patient-, and procedure-related risk factors were collected for all patients who underwent elective total hip and total knee arthroplasty during the study period...
March 21, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28321991/atomic-layer-deposition-of-a-silver-nanolayer-on-advanced-titanium-orthopedic-implants-inhibits-bacterial-colonization-and-supports-vascularized-de-novo-bone-ingrowth
#10
Aine Devlin-Mullin, Naomi M Todd, Zahra Golrokhi, Hua Geng, Moritz A Konerding, Nigel G Ternan, John A Hunt, Richard J Potter, Chris Sutcliffe, Eric Jones, Peter D Lee, Christopher A Mitchell
Joint replacement surgery is associated with significant morbidity and mortality following infection with either methicillin-resistant Staphylococcus aureus (MRSA) or Staphylococcus epidermidis. These organisms have strong biofilm-forming capability in deep wounds and on prosthetic surfaces, with 10(3) -10(4) microbes resulting in clinically significant infections. To inhibit biofilm formation, we developed 3D titanium structures using selective laser melting and then coated them with a silver nanolayer using atomic layer deposition...
March 21, 2017: Advanced Healthcare Materials
https://www.readbyqxmd.com/read/28321829/prosthetic-joint-infections-and-cost-analysis
#11
F S Haddad, A Ngu, J J Negus
Prosthetic joint infection is a devastating complication of arthroplasty surgery that can lead to debilitating morbidity for the patient and significant expense for the healthcare system. With the continual rise of arthroplasty cases worldwide every year, the revision load for infection is becoming a greater financial burden on healthcare budgets. Prevention of infection has to be the key to reducing this burden. For treatment, it is critical for us to collect quality data that can guide future management strategies to minimise healthcare costs and morbidity / mortality for patients...
March 21, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28321490/c-reactive-protein-may-misdiagnose-prosthetic-joint-infections-particularly-chronic-and-low-grade-infections
#12
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/28318387/a-qualitative-study-of-the-challenges-of-providing-pre-prosthetic-rehabilitation-in-rural-south-africa
#13
Liezel Ennion, Anton Johannesson Johannesson
BACKGROUND: There is a known shortage of rehabilitation staff in rural settings and a sharp increase in the number of lower limb amputations being performed. A lack of adequate pre-prosthetic rehabilitation will result in worse physical and psychological outcomes for a person with a lower limb amputation, and they will not be eligible to be fitted with a prosthesis. OBJECTIVE: To explore therapists' experiences with providing pre-prosthetic rehabilitation in a rural setting...
March 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/28314986/false-positive-synovial-fluid-alpha-defensin-test-in-a-patient-with-acute-gout-affecting-a-prosthetic-knee
#14
D G Partridge, A Gordon, R Townsend
The alpha-defensin test has demonstrated promising results in studies evaluating it for the diagnosis of prosthetic joint infection. There are limited data in the literature regarding its use in patients with other inflammatory joint conditions, but a high specificity for infection has been reported. We describe a patient with a prosthetic knee joint, who had a positive alpha-defensin lateral flow assay but in whom subsequent results confirmed a diagnosis of acute gout with no evidence of infection.
March 17, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28292539/prevention-of-infection-in-orthopedic-prosthetic-surgery
#15
REVIEW
Ioana Chirca, Camelia Marculescu
Total joint arthroplasty is a generally safe orthopedic procedure; however, infection is a potentially devastating complication. Multiple risk factors have been identified for development of prosthetic joint infections. Identification of patients at risk and preoperative correction of known risk factors, such as smoking, diabetes mellitus, anemia, malnutrition, and decolonization of Staphylococcus carriers, represent well-established actions to decrease the infection risk. Careful operative technique, proper draping and skin preparation, and appropriate selection and dosing of antimicrobials for perioperative prophylaxis are also very important in prevention of infection...
March 11, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28290115/sonication-of-arthroplasty-implants-improves-accuracy-of-periprosthetic-joint-infection-cultures
#16
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
#17
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/28280845/-function-of-prosthesis-components-in-lower-limb-amputees-with-bone-anchored-percutaneous-implants-biomechanical-aspects
#18
S Blumentritt
BACKGROUND: Bone anchorage of an artificial limb has been proven to be an alternative intervention for amputees when prosthesis use is seriously reduced because of stump problems. Little is known about how prosthesis components interact with bone and joints and which potential the optimum use provides with respect to quality of treatment of leg amputees. OBJECTIVE: Does osseointegration influence the motor activity of residual limbs differently compared with socket prostheses? How should prosthesis components be aligned? What type of prosthetic knee joints should be preferred in transfemoral amputees? MATERIAL AND METHODS: Transfer of biomechanical knowledge of socket prosthetics to bone-anchored prostheses...
March 9, 2017: Der Unfallchirurg
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
#19
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/28279223/effect-of-a-standardized-treatment-regime-for-infection-after-osteosynthesis
#20
Pien Hellebrekers, Luke P H Leenen, Meriam Hoekstra, Falco Hietbrink
BACKGROUND: Infection after osteosynthesis is an important complication with significant morbidity and even mortality. These infections are often caused by biofilm-producing bacteria. Treatment algorithms dictate an aggressive approach with surgical debridement and antibiotic treatment. The aim of this study is to analyze the effect of such an aggressive standardized treatment regime with implant retention for acute, existing <3 weeks, infection after osteosynthesis. METHODS: We conducted a retrospective 2-year cohort in a single, level 1 trauma center on infection occurring within 12 months following any osteosynthesis surgery...
March 9, 2017: Journal of Orthopaedic Surgery and Research
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