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Prosthetic joint infections

Laura Prieto-Borja, Graciela Rodriguez-Sevilla, Alvaro Auñon, Concepción Pérez-Jorge, Enrique Sandoval, Joaquín Garcia-Cañete, Ignacio Gadea, Ricardo Fernandez-Roblas, Antonio Blanco, Jaime Esteban
BACKGROUND: The development of sonication protocols over the last few years has improved the sensitivity of conventional cultures for the diagnosis of prosthetic-joint infection (PJI). However, the development of a new, specifically designed kit for the molecular diagnosis of PJI could provide a major improvement in this field. METHODS: Prostheses retrieved from patients who underwent implant removal from May 2014 to May 2015 were sent for culture, and processed according to a previously defined protocol that included sonication...
October 18, 2016: Enfermedades Infecciosas y Microbiología Clínica
Michael Maceroli, Lucas E Nikkel, Bilal Mahmood, John P Ketz, Xing Qiu, Joseph Ciminelli, Susan Messing, John C Elfar
OBJECTIVES: To determine if hospital arthroplasty volume affects patient outcomes after undergoing total hip arthroplasty (THA) for displaced femoral neck fractures. METHODS: The Statewide Planning and Research Cooperative System database from the New York State Department of Health was used to group hospitals into quartiles based on overall THA volume from 2000 to 2010. The database was then queried to identify all patients undergoing THA specifically for femoral neck fracture during this time period...
November 2016: Journal of Orthopaedic Trauma
Mareike Klinger-Strobel, Oliwia Makarewicz, Mathias W Pletz, Andreas Stallmach, Christian Lautenschläger
Biofilm formation, also known as microfouling, on indwelling medical devices such as catheters or prosthetic joints causes difficult to treat and recurrent infections. It is also the initial step for biocorrosion of surfaces in aquatic environment. An efficient prevention of microfouling is preferable but the development of antibiofilm surfaces is enormously challenging. Therefore, soda-lime, aluminosilicate, and three borosilicate glasses with different TiO2 and ZnO compositions were investigated on their feasibility to prevent biofilm formation by standardized in vitro biofilm assays using different pathogenic bacteria...
December 2016: Journal of Materials Science. Materials in Medicine
Sara C Keller, Sara E Cosgrove, Yvonne Higgins, Damani A Piggott, Greg Osgood, Paul G Auwaerter
Background.  The use of suppressive antibiotics in treatment of orthopedic hardware infections (OHIs), including spinal hardware infections, prosthetic joint infections, and infections of internal fixation devices, is controversial. Methods.  Over a 4-year period at 2 academic medical centers, patients with OHI who were treated with debridement and retention of hardware components, with single-stage exchange, or without surgery were studied to determine whether use of oral antibiotics for at least 6 months after diagnosis impacts successful treatment of the infection at 1 year after diagnosis...
October 2016: Open Forum Infectious Diseases
Daniel Pérez-Prieto, María E Portillo, Lluís Puig-Verdié, Albert Alier, Carlo Gamba, Pau Guirro, Santos Martínez-Díaz, Juan P Horcajada, Andrej Trampuz, Joan C Monllau
BACKGROUND: Culture negative prosthetic joint infections (PJI) still remain an issue even with the advantages of the new diagnostic tools for PJI. This is why some orthopedic surgeons have reservations relative to the use of preoperative antibiotic prophylaxis when a PJI is suspected. The purpose of the present study was to evaluate the influence of preoperative antibiotic prophylaxis on intraoperative cultures. MATERIAL AND METHODS: An enhanced diagnostic protocol for PJI (Zimmerli criteria) was used for the inclusion criteria in order to collect all PJI that were seen in a university hospital...
September 23, 2016: Diagnostic Microbiology and Infectious Disease
E Fiaux, M Titecat, O Robineau, J Lora-Tamayo, Y El Samad, M Etienne, N Frebourg, N Blondiaux, B Brunschweiler, F Dujardin, E Beltrand, C Loiez, V Cattoir, J P Canarelli, C Hulet, M Valette, S Nguyen, F Caron, H Migaud, E Senneville
BACKGROUND: Outcome of patients with streptococcal prosthetic joint infections (PJIs) is not well known. METHODS: We performed a retrospective multicenter cohort study that involved patients with total hip/knee prosthetic joint (THP/TKP) infections due to Streptococcus spp. from 2001 through 2009. RESULTS: Ninety-five streptococcal PJI episodes (50 THP and 45 TKP) in 87 patients of mean age 69.1 ± 13.7 years met the inclusion criteria...
October 13, 2016: BMC Infectious Diseases
Shin Xu, Dustin K Baker, Justin C Woods, Eugene W Brabston, Brent A Ponce
Hospital readmissions are costly for patients and institutions. We conducted a study to evaluate rates of readmission within 30 days after anatomical total shoulder arthroplasty (ATSA) and reverse total shoulder arthroplasty (RTSA) and to determine independent risk factors for readmission. We queried the National Surgical Quality Improvement Program database for ATSAs and RTSAs performed between 2011 and 2013 and found a combined total of 3501 cases and an overall readmission rate of 2.7%. Of the readmissions, 67% were for medical complications, and 33% were for surgical complications...
September 2016: American Journal of Orthopedics
Arianna Barbara Lovati, Marta Bottagisio, Elena de Vecchi, Enrico Gallazzi, Lorenzo Drago
The demand for joint replacement and surgical treatment is continuously increasing, thus representing a clinical burden and a cost for the healthcare system. Among several pathogens involved in implant-related infections, staphylococci account for the two-thirds of clinically isolated bacteria. Despite most of them are highly virulent microorganisms (Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa), low virulent bacteria (Staphylococcus epidermidis, Propionibacterium acnes) are responsible for delayed, low-grade infections without specific clinical signs and hardly distinguishable from aseptic prosthetic failure...
October 9, 2016: Advances in Experimental Medicine and Biology
Oddvar Oppegaard, Steinar Skrede, Haima Mylvaganam, Bård Reiakvam Kittang
BACKGROUND: Beta-haemolytic streptococci are important contributors to the global burden of osteoarticular infections (OAI). Knowledge on the disease traits specific for streptococcal OAI, however, remains scarce. We wished to explore temporal trends of OAI caused by Group A Streptococci (GAS), Group B Streptococci (GBS) and Group C and G Streptococci (GCGS), and furthermore, to describe the associated host and pathogen characteristics. METHODS: All cases of microbiologically verified β-haemolytic streptococcal OAI in Health Region Bergen, Norway, in the period 1999-2013 were retrospectively identified...
October 4, 2016: BMC Infectious Diseases
R Pushkin, Maria Iglesias-Ussel, Keedy Kara, C MacLauchlin, D R Mould, R Berkowitz, S Kreuzer, R Darouiche, D Oldach, P Fernandes
BACKGROUND:  Fusidic acid (FA) has been used for decades for bone infection, including prosthetic joint infection (PJI), often in combination with rifampin (RIF). An FA/RIF pharmacokinetic interaction has not previously been described. METHODS:  In a phase 2 open-label randomized study, we evaluated oral FA/RIF versus standard of care (SOC) IV antibiotics for treatment of hip or knee PJI. Outcome assessment occurred at re-implantation (week 12) for subjects with 2-stage exchange; and after 3 or 6 months of treatment for subjects with hip or knee debride and retain strategies, respectively...
September 28, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
S Tevell, B Hellmark, Å Nilsdotter-Augustinsson, B Söderquist
Further knowledge about the clinical and microbiological characteristics of prosthetic joint infections (PJIs) caused by different coagulase-negative staphylococci (CoNS) may facilitate interpretation of microbiological findings and improve treatment algorithms. Staphylococcus capitis is a CoNS with documented potential for both human disease and nosocomial spread. As data on orthopaedic infections are scarce, our aim was to describe the clinical and microbiological characteristics of PJIs caused by S. capitis...
September 29, 2016: European Journal of Clinical Microbiology & Infectious Diseases
James P Lisik, Michelle M Dowsey, Joshua Petterwood, Peter F M Choong
BACKGROUND: Arthroscopic knee surgery has been a topic of significant controversy in recent orthopaedic literature. Multiple studies have used administrative (Victorian Admitted Episodes Dataset and Centre for Health Record Linkage) data to identify trends in practice. This study explored the usage and reporting of arthroscopic knee surgery by conducting a detailed audit at a major Victorian public hospital. METHODS: A database of orthopaedic procedures at St Vincent's Hospital Melbourne was used to retrospectively identify cases of knee arthroscopy from 1 December 2011 to 1 April 2014...
September 27, 2016: ANZ Journal of Surgery
Alban Fouasson-Chailloux, Benoit Metayer, Pierre Menu, Lydie Khatchatourian, Joelle Glemarec, Marc Dauty
OBJECTIVE: The loosening of total joint replacement is a frequent complication after total hip arthroplasty (THA). Septic osteolysis should always be feared. We report here a rare case of hip arthroplasty infection due to Mycobacterium bovis after Bacillus Calmette-Guerin (BCG) therapy in a context of bladder cancer. OBSERVATIONS: A 70-year-old man was referred to the department of rheumatology in September 2015, because of a total functional disability of the left lower limb...
September 2016: Annals of Physical and Rehabilitation Medicine
Christina G Zaccarini, Xiaoli Dong
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Heather C Yun, Clinton K Murray, Kenneth J Nelson, Michael J Bosse
Trauma to the extremities is disproportionately represented in casualties of recent conflicts, accounting for >50% of injuries sustained during operations in Iraq and Afghanistan. Infectious complications have been reported in >25% of those evacuated for trauma, and 50% of such patients were treated in the intensive care unit (ICU). Osteomyelitis has been reported in 9% (14% of intensive care unit patients), and deep-wound infection in 27% of type III open-tibia fractures. Infections complicating extremity trauma are frequently caused by multidrug-resistant bacteria and have been demonstrated to lead to failure of limb salvage, unplanned operative take-backs, late amputations, and decreased likelihood of returning to duty...
October 2016: Journal of Orthopaedic Trauma
Christopher J Palestro
No abstract text is available yet for this article.
September 22, 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Eythor Orn Jonsson, Hera Johannesdottir, Anna Stefansdottir
: An 80-year old male presented with an infected knee replacement following repeated joint aspirations. They were carried out due to recurrent hemarthrosis resulting from an initially missed quadriceps tendon injury. The infection was eradicated first after arthrodesis. This case highlights that prosthetic joints are sensitive to infection, which once established can be difficult to eradicate. Careful consideration is necessary before aspirating prosthetic joints. Diagnosing quadriceps tendon injuries can be difficult and they must be included in the differential diagnosis of traumatic hemarthrosis...
September 2016: Læknablađiđ
W J Metsemakers, R Kuehl, T F Moriarty, R G Richards, M H J Verhofstad, O Borens, S Kates, M Morgenstern
One of the most challenging complications in trauma surgery is infection after fracture fixation (IAFF). IAFF may result in permanent functional loss or even amputation of the affected limb in patients who may otherwise be expected to achieve complete, uneventful healing. Over the past decades, the problem of implant related bone infections has garnered increasing attention both in the clinical as well as preclinical arenas; however this has primarily been focused upon prosthetic joint infection (PJI), rather than on IAFF...
September 11, 2016: Injury
Stefan Salminger, Andreas Gradischar, Richard Skiera, Aidan D Roche, Agnes Sturma, Christian Hofer, Oskar C Aszmann
BACKGROUND: The stump-socket interface is of utmost importance for prosthetic function in transhumeral amputees. Stability of this connection may be improved using a newly designed subcutaneous implant. OBJECTIVES: The purpose was to determine the effect of the implant together with customized socket designs on the range of motion of the shoulder and the prosthetic function compared to conventional fitting. STUDY DESIGN: Case series. METHODS: The range of motion was measured with scaled metrics and the prosthetic function evaluated with the Southampton Hand Assessment Procedure and the Box and Block Test...
September 16, 2016: Prosthetics and Orthotics International
Sufian S Ahmad, Roland Becker, Antonia F Chen, Sandro Kohl
PURPOSE: Due to the juvenility of research in the field of periprosthetic joint infection (PJI), approaches employed for diagnosis of PJI vary amongst surgeons in different geographic regions. The aim of this study was to determine common diagnostic approaches utilized by European knee arthroplasty surgeons for the diagnosis of PJI. METHODS: A task force was established for questionnaire development, consisting of surgeons and clinical researchers who each had a record of publishing in the field of PJI...
October 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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