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Prosthetic joint infections

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https://www.readbyqxmd.com/read/29151012/the-role-and-timing-of-treatment-strategies-during-two-stage-revision-for-periprosthetic-joint-infections
#1
Shobhit Minhas, Russell Odono, Kristopher Collins, Jonathan Vigdorchik, Ran Schwarzkopf
INTRODUCTION: Prosthetic joint infection continues to be a source of significant morbidity to patients and an economic burden to society as a whole. Two-stage revision is the current gold standard for treatment of periprosthetic joint infection in North America. Despite this, much discussion persists about treatment strategies surrounding the interim of the two-stage revision and treatment beyond reimplantation. The aim of this review is to answer some of these questions, specifically: are C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) helpful prior to reimplantation, is aspiration helpful, what is the role and timing for systemic antibiotics, and is there a role for oral suppression following second-stage reimplantation? METHODS: A literature review was completed in an attempt to address unanswered questions associated with two-stage reimplantation...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29147744/consistency-in-patient-reported-outcome-measures-after-total-knee-arthroplasty-using-patient-specific-instrumentation-a-5-year-follow-up-of-200-consecutive-cases
#2
Daphne A L Schoenmakers, Martijn G M Schotanus, Bert Boonen, Nanne P Kort
PURPOSE: The purpose of this study was to evaluate the 5-year follow-up results of the first 200 total knee arthroplasties (TKA) performed by one high-volume surgeon, using patient-specific information (PSI). To date, there has been no other research into the mid-term follow-up of TKA performed using PSI. MATERIALS AND METHODS: A total of 184 consecutive patients (200 TKA) were evaluated. Outcome measures included implant survival rate, adverse events, and the following patient-reported outcome measures (PROMs); Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oxford Knee Score (OKS), Pain Visual Analogue Score (VAS) and EuroQol-5D Score (EQ-5D)...
November 17, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29141925/unusual-salmonella-typhi-periprosthetic-joint-infection-involving-bilateral-knees-management-options-and-literature-review
#3
Ashok Rajgopal, Inayat Panda, Anu Gupta
A 70-year-old Indian woman, who had undergone primary bilateral total knee arthroplasty (TKA) for rheumatoid arthritis 10 months prior, presented with 10 days history of pain, swelling and erythema over both knees with pus discharging from the right knee. She had type 2 diabetes mellitus and was on long-term steroid, leflunomide and antitumour necrosis factor therapy for rheumatoid arthritis. Her clinical and laboratory features were suggestive of a haematogenous periprosthetic joint infection (PJI). The final diagnosis of bilateral Salmonella typhi PJI was made based on culture reports...
November 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29139579/topical-adjuvants-incompletely-remove-adherent-staphylococcus-aureus-from-implant-materials
#4
Emily P Ernest, Anthony S Machi, Brock A Karolcik, P Rocco LaSala, Matthew J Dietz
Adjuvant treatments including Betadine, Dakin's solution (sodium hypochlorite), or hydrogen peroxide (H2O2) have been attempted to eradicate prosthetic joint infection caused by biofilm or intracellular bacteria. The purpose of this study was to evaluate the in vitro abilities of chemical adjuvants to decrease Staphylococcus aureus (S. aureus) biofilm presence on orthopaedic implant grade materials, including titanium, stainless steel, and cobalt chrome. S. aureus biofilms were grown for 48 hours and evaluated for baseline colony forming units/centimeter squared (CFU/cm(2) ) and compared to treatments with Betadine, Dakin's solution, H2 O2 , or 1% chlorine dioxide (ClO2 )...
November 15, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29139571/human-prosthetic-joint-infections-are-associated-with-myeloid-derived-suppressor-cells-mdscs-implications-for-infection-persistence
#5
Cortney E Heim, Debbie Vidlak, Jessica Odvody, Curtis W Hartman, Kevin L Garvin, Tammy Kielian
Prosthetic joint infection (PJI) is a devastating complication of joint arthroplasty surgery typified by biofilm formation. Currently, mechanisms whereby biofilms persist and evade immune-mediated clearance in immune competent patients remain largely ill-defined. Therefore, the current study characterized leukocyte infiltrates and inflammatory mediator expression in tissues from patients with PJI compared to aseptic loosening. CD33(+) HLA-DR(-) CD66b(+) CD14(-/low) granulocytic myeloid-derived suppressor cells (G-MDSCs) were the predominant leukocyte population at sites of human PJI compared to aseptic tissues...
November 15, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29137718/telavancin-for-the-treatment-of-methicillin-resistant-staphylococcus-aureus-bone-and-joint-infections
#6
Julie Harting, Francisco Fernandez, Rob Kelley, Tim Wiemken, Paula Peyrani, Julio Ramirez
This retrospective, case series describes our experience with the use of telavancin in patients with methicillin-resistant Staphylococcus aureus (MRSA) osteomyelitis and prosthetic joint infection. The primary objectives were clinical outcomes and adverse events (AEs), and a secondary outcome described microbiological susceptibility. Fourteen patients were enrolled. Median duration of therapy was 58 days, and four patients had concurrent bacteremia. End-of-treatment outcomes were available in 78% of patients, with a clinical success rate of 91%...
December 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/29129616/risk-of-periprosthetic-joint-infection-in-patients-with-multiple-arthroplasties
#7
W Parker Abblitt, Emily W Chan, Andrew A Shinar
BACKGROUND: Risk of subsequent periprosthetic joint infection (PJI) in a second prosthetic joint following initial PJI has been shown to be 19%-20%. We sought to identify (1) the risk of developing a second PJI for our patients with multiple prosthetic joints and (2) the effect of bacteremia on development of a subsequent PJI. METHODS: We retrospectively reviewed all patients treated surgically for PJI by a single surgeon from 2003 to 2014. Time between initial and subsequent infection, bacteremia, and risk factors for PJI were identified...
November 9, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29122410/non-compliance-with-idsa-guidelines-for-patients-presenting-with-methicillin-susceptible-staphylococcus-aureus-prosthetic-joint-infection-is-a-risk-factor-for-treatment-failure
#8
A Bouaziz, I Uçkay, S Lustig, A Boibieux, D Lew, P Hoffmeyer, P Neyret, C Chidiac, T Ferry
OBJECTIVE: The long-term impact of treatment strategies proposed by the IDSA guidelines for patients presenting with methicillin-susceptible S. aureus (MSSA) prosthetic joint infection (PJI) is not well-known. PATIENTS AND METHODS: Retrospective (2000-2010) cohort study including patients presenting with MSSA hip or knee PJI. A univariate Cox analysis was performed to determine if the non-compliance with IDSA surgical guidelines was a risk factor for treatment failure...
November 6, 2017: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/29119076/are-there-benefits-in-early-diagnosis-of-prosthetic-joint-infection-with-multiplex-polymerase-chain-reaction
#9
Christian Lausmann, Akos Zahar, Mustafa Citak, Julian Brañes, Stefan Schmidl, Lars Frommelt, Thorsten Gehrke, Matthias Gebauer
Purpose Identification of bacteria and susceptibility are fundamental in periprosthetic joint infection (PJI). Especially in the case of systemic inflammatory response syndrome (SIRS) rapid detection of pathogens is essential for proper therapy. Bacterial cultures are time consuming. The polymerase chain reaction (PCR) is a non-culture molecular method and is able to rapidly identify pathogens and their resistance genes. Multiplex PCR (mPCR) can amplify several different DNA sequences simultaneously. The aim of this study was to show the value of mPCR for early diagnosis of PJI...
2017: Journal of bone and joint infection
https://www.readbyqxmd.com/read/29103074/diagnostic-accuracy-of-synovial-fluid-blood-markers-and-microbiological-testing-in-chronic-knee-prosthetic-infections
#10
Giovanni Balato, Vincenzo Franceschini, Tiziana Ascione, Alfredo Lamberti, Fiamma Balboni, Andrea Baldini
INTRODUCTION: This retrospective study was undertaken to define cut-off values for synovial fluid (SF) leukocyte count and neutrophil percentage for differentiating aseptic failure and periprosthetic joint infection (PJI) and to evaluate the diagnostic accuracy of blood inflammatory markers, and microbiological testing according to the criteria proposed by the International Consensus Meeting (ICM) of Philadelphia. METHODS: All patients who underwent revision total knee arthroplasty from January 2010 to July 2015 were included: we identified and classified 31 PJIs and 136 aseptic joints...
November 4, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29103060/use-of-antibiotic-impregnated-bone-grafts-in-a-rabbit-osteomyelitis-model
#11
Akos Zahar, György Kocsis, Mustafa Citak, Gábor Puskás, Mónika Domahidy, Mária Hajdú, István Antal, Miklós Szendrői
BACKGROUND: Both osteomyelitis and prosthetic joint infection can be treated surgically with the use of antibiotic loaded bone grafts, as part of local antimicrobial therapy. OBJECTIVE: The purpose of the study was to evaluate and to report on a novel, biodegradable, long-acting (4-6 weeks) antibiotic-impregnated bone graft (AIBG). A novel drug delivery system, containing vancomycin, was utilized in a rabbit osteomyelitis model in order to evaluate the antimicrobial efficacy of the antibiotic bone graft...
October 23, 2017: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/29099342/synovial-fluid-leukocyte-esterase-in-the-diagnosis-of-peri-prosthetic-joint-infection-a-systematic-review-and-meta-analysis
#12
Chi Wang, Rui Li, Qi Wang, Chengbin Wang
BACKGROUND: Peri-prosthetic joint infection (PJI) is a serious and frequent complication of total joint arthroplasty (TJA). Recently, synovial fluid leukocyte esterase (LE), measurement of which is convenient and fast, has been examined as a marker of PJI. We summarized the articles describing synovial fluid LE as a biomarker for the diagnosis of PJI and assessed its diagnostic value in patients suspected of having PJI. METHODS: We searched with appropriate key words in PubMed, Embase, Web of Science, the Cochrane database, and Science Direct...
November 3, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29097373/predictors-of-revision-prosthetic-joint-infection-and-mortality-following-total-hip-or-total-knee-arthroplasty-in-patients-with-rheumatoid-arthritis-a-nationwide-cohort-study-using-danish-healthcare-registers
#13
Rene Lindholm Cordtz, Kristian Zobbe, Pil Højgaard, Lars Erik Kristensen, Søren Overgaard, Anders Odgaard, Hanne Lindegaard, Lene Dreyer
OBJECTIVES: To investigate predictors of 10-year risk of revision and 1-year risk of prosthetic joint infection (PJI) and death following total hip/total knee arthroplasty (THA/TKA) in (1) patients with rheumatoid arthritis (RA) compared with patients with osteoarthritis (OA); and (2) patients with RA treated with biological disease-modifying antirheumatic drugs (bDMARD) within 90 days preceding surgery compared with non-treated. METHODS: Register-based cohort study using the Danish National Patient Register, the DANBIO rheumatology register (RA-specific confounders and treatment episodes) and the Danish Hip and Knee Arthroplasty Registers...
November 2, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/29092997/the-orthopaedic-manifestation-and-outcomes-of-methicillin-sensitive-staphylococcus-aureus-septicaemia
#14
D Makki, T Elgamal, P Evans, D Harvey, G Jackson, S Platt
AIMS: The aim of this paper was to present the clinical features of patients with musculoskeletal sources of methicillin-sensitive Staphylococcus aureus (MSSA) septicaemia. PATIENTS AND METHODS: A total of 137 patients presented with MSSA septicaemia between 2012 and 2015. The primary source of infection was musculoskeletal in 48 patients (35%). Musculoskeletal infection was considered the primary source of septicaemia when endocarditis and other obvious sources were excluded...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092987/the-unsuspected-prosthetic-joint-infection-incidence-and-consequences-of-positive-intra-operative-cultures-in-presumed-aseptic-knee-and-hip-revisions
#15
A M E Jacobs, M Bénard, J F Meis, G van Hellemondt, J H M Goosen
AIMS: Positive cultures are not uncommon in cases of revision total knee and hip arthroplasty (TKA and THA) for presumed aseptic causes. The purpose of this study was to assess the incidence of positive intra-operative cultures in presumed aseptic revision of TKA and THA, and to determine whether the presence of intra-operative positive cultures results in inferior survival in such cases. PATIENTS AND METHODS: A retrospective cohort study was assembled with 679 patients undergoing revision knee (340 cases) or hip arthroplasty (339 cases) for presumed aseptic causes...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29079156/septic-arthritis-and-prosthetic-joint-infections-in-older-adults
#16
REVIEW
Rajeshwari Nair, Marin L Schweizer, Namrata Singh
Older adults are at increased risk for septic arthritis and prosthetic joint infections (PJI), owing at least in part to comorbid conditions and frailty. An increasing number of older adults undergo total joint arthroplasty to improve their quality of life. Infections in older adults differ from younger populations by the causative organisms, a great proportion of which are Staphylococcal infections. Targeting important modifiable and nonmodifiable risk factors may prevent or reduce the burden of joint infections in older adults...
December 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/29075808/the-kidney-liver-index-surgery-and-c-reactive-protein-score-is-a-predictor-of-treatment-response-in-acute-prosthetic-joint-infection
#17
C Jiménez-Garrido, J M Gómez-Palomo, I Rodriguez-Delourne, F J Durán-Garrido, E Nuño-Álvarez, E Montañez-Heredia
PURPOSE: This work seeks to verify the utility of the KLIC score as a predictor of treatment success or failure in patients with knee and hip acute prosthetic joint infections (APJI). These patients were treated in our centre, which is not a prosthetic joint infection reference centre. The KLIC score assesses factors such as chronic kidney failure (2 points) (Kidney), liver disease (1.5 points) (Liver), revision surgery or femoral neck fracture (1.5 points)and cemented prosthesis (2 points) (Index surgery) and a C-reactive protein level (CRP) greater than 11...
October 26, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29067042/a-clinical-study-on-arthroplasty-for-failed-internal-fixation-of-hip-fractures-and-review-of-literature
#18
Feng Mingli, Shen Huiliang, Cao Guanglei, Li Zheng, Lu Shibao, Liu Limin, An Shuai
BACKGROUND & OBJECTIVE: Hip fracture is common osteoporotic fracture associated sometimes with failed internal fixation. Joint replacement is commonly used to salvage failed internal fixation of hip fractures (FIFHF). Our objective was to present the outcome of Arthroplasty after FIFHF in our patients. METHODS: A prospective analysis was made on consecutive patients who underwent prosthetic replacements for FIFHF in Orthopaedics Department of Xuanwu Hospital between June 2012 and January 2015...
July 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29064220/the-management-of-infections-and-the-use-of-antibiotic-prophylaxis-by-dentists-a-review-of-the-evidence
#19
George Maranon
Dentistry plays an important role in managing the antibiotic resistance problem. Guidelines for the use of antibiotics for prevention of endocarditis, prosthetic joint infections and other medical conditions have changed frequently. Unfortunately, the original guidelines and subsequent changes were often made through consensus opinions and not evidence based. Clinical decisions on the use of antibiotics must be made on the basis of the scientific evidence with knowledge of the most current guidelines and indications...
March 2017: Journal of the California Dental Association
https://www.readbyqxmd.com/read/29054948/gentamicin-vancomycin-colistin-local-antibiotherapy-in-a-cement-spacer-in-a-54-year-old-haemophilic-patient-with-relapsing-plurimicrobial-severe-prosthetic-joint-infection
#20
Tristan Ferry, Romain Desmarchelier, Sophie Magréault, Florent Valour
No abstract text is available yet for this article.
October 19, 2017: BMJ Case Reports
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