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Prosthetic joint infections

Sandrine Mariaux, Ulrika Furustrand Tafin, Olivier Borens
Introduction : When treating periprosthetic joint infection with a two-stage procedure, antibiotic-impregnated spacers can be used in the interval between prosthetic removal and reimplantation. In our experience, cultures of sonicated spacers are most often negative. The objective of the study was to assess whether that sonication causes an elution of antibiotics, leading to elevated antibiotic concentrations in the sonication fluid inhibiting bacterial growth and thus causing false-negative cultures. Methods : A prospective monocentric study was performed from September 2014 to March 2016...
2018: Journal of Bone and Joint Infection
Emeli Månsson, Berolla Sahdo, Åsa Nilsdotter-Augustinsson, Eva Särndahl, Bo Söderquist
Nosocomial sequence types of Staphylococcus epidermidis dominate in prosthetic joint infections. We examined caspase-1 activation in human neutrophils after incubation with Staphylococcus epidermidis isolated from prosthetic joint infections and normal skin flora. Active caspase-1 was lower after incubation with isolates from prosthetic joint infections than after incubation with commensal isolates. Both host and isolate dependent differences in active caspase-1 were noted. Our results indicate that there might be a host-dependent incapacity to elicit a strong caspase-1 response towards certain strains of S...
2018: Journal of Bone and Joint Infection
Valérie A Zeller, Valérie-Anne Letembet, Vanina A Meyssonnier, Beate Heym, Jean-Marc Ziza, Simon D Marmor
BACKGROUND: Cutibacterium spp. (formerly Propionibacterium) are slow-growing cutaneous anaerobic commensals, rarely reported in prosthetic joint infections (PJIs). We describe epidemiological, clinical, biological, and radiological characteristics of 15 Cutibacterium avidum PJIs, their treatments, and outcomes. METHODS: This study is an observational, monocenter study (January 2004 to April 2017), with comparison of C avidum vs Cutibacterium acnes (n = 40) PJI characteristics...
February 12, 2018: Journal of Arthroplasty
Anny Lam, Magnus Rasmussen, Olof Thompson
BACKGROUND/AIM: Streptococci cause approximately 10% of prosthetic joint infections (PJIs). The aim of this study was to identify the characteristics of patients with streptococcal PJIs and to describe the treatment and outcome of streptococcal PJIs in Skåne county between 2011 and 2015. METHODS: Patients with streptococcal PJIs with positive cultures or PCRs on samples from joint aspirate and/or periprosthetic tissue between 2011 and 2015 in Skåne county, were identified and medical records were studied...
March 13, 2018: Infectious Diseases
Karsten D Ottink, Marjan Wouthuyzen-Bakker, Greetje A Kampinga, Paul C Jutte, Joris J Ploegmakers
BACKGROUND: Diagnosing a chronic prosthetic joint infection (PJI) can be challenging. We hypothesized that obtaining preoperative tissue samples for culture in hip arthroplasty will increase the likelihood of diagnosing an infection before revision surgery. The aim of this cohort study was to determine the diagnostic accuracy of 2 tissue acquiring biopsy strategies to diagnose a PJI. METHODS: Patients with a painful hip arthroplasty, in which a chronic PJI was suspected, were included...
February 5, 2018: Journal of Arthroplasty
Kevin L Garvin, Ryan E Miller, Todd M Gilbert, Anthony M White, Elizabeth R Lyden
BACKGROUND: Two-stage reimplantation has consistently yielded high rates of success for patients with chronic prosthetic joint infection, although results more than 5 years after reimplantation are not commonly reported. Numerous factors may contribute to the risk of reinfection, although these factors-as well as the at-risk period after reimplantation-are not well characterized. QUESTIONS/PURPOSES: (1) What is the risk of reinfection after reimplantation for prosthetic joint infection at a minimum of 5 years? (2) Is the bacteriology of the index infection associated with late reinfection? (3) Is the presence of bacteria at the time of reimplantation associated with late reinfection? METHODS: Between 1995 and 2010, we performed 97 two-stage revisions in 93 patients for prosthetic joint infection of the hip or knee, and all are included in this retrospective study...
February 2018: Clinical Orthopaedics and related Research
Minxun Lu, Yongjiang Li, Yi Luo, Wenli Zhang, Yong Zhou, Chongqi Tu
BACKGROUND: Currently, it is challenging to treat massive bone defects of proximal tibia. Although numerous methods are available for reconstruction with epiphysis preservation, limitations in knee function and complications are noted with these methods. Our paper describes our attempt to reconstruct a marked defect in the proximal tibia with an uncemented three-dimensional (3D)-printed prosthesis and to evaluate the prosthesis design and short-term outcomes. CASE PRESENTATION: A 15-year-old boy with metaphyseal osteosarcoma of the tibia underwent intercalary allograft reconstruction following wide tumour resection with epiphysis preservation...
March 6, 2018: World Journal of Surgical Oncology
Ruben Scholten, Jetze Visser, Job L C Van Susante, Corné J M Van Loon
Background and purpose - The Synovasure lateral flow test was developed as a rapid test for the detection or exclusion of periprosthetic joint infection (PJI). 3 studies have reported promising results on its diagnostic value in total joint revision surgery. We aimed to assess the sensitivity and specificity of the Synovasure test to exclude infection in patients undergoing revision surgery for suspected early aseptic loosening of a total hip or knee arthroplasty. Patients and methods - In a prospective study design, 37 patients who underwent revision surgery for suspected early aseptic loosening (< 3 years after primary arthroplasty) were included...
March 6, 2018: Acta Orthopaedica
Will B J Rudge, Kelechi Eseonu, Matthew Brown, Simon Warren, Addie Majed, Ian L Bayley, Simon M Lambert, Deborah Higgs, Mark Falworth
BACKGROUND: Deep prosthetic infection is a potentially devastating complication after total elbow arthroplasty, with an incidence of up to 12%. This study examined the demographics, microbiologic profile, and outcomes of infected total elbow arthroplasty treated with 2-stage revision in a tertiary referral unit. METHODS: We identified 19 consecutive patients (mean age, 65 years) undergoing revision arthroplasty for deep prosthetic infection. All patients underwent a first-stage procedure with removal of implants, débridement, and insertion of an antibiotic-loaded cement spacer, followed by at least 6 weeks of intravenous antibiotics...
March 1, 2018: Journal of Shoulder and Elbow Surgery
Yoshinobu Saitoh, Takao Setoguchi, Takako Yoshioka, Junichiro Nishi, Akihide Tanimoto, Setsuro Komiya
OBJECTIVE: The aim of this study was to evaluate whether intraoperative histopathological examination could predict the risk of relapse of infection in periprosthetic joint infections (PJI). METHODS: The study included 25 patients (14 women and 11 men, with a mean age of 67.0 years (range, 37-83 years)), who had two-staged revision surgery for a PJI. Following prosthetic removal in the first stage, all patient underwent an intraoperative histopathological examination during the second stage...
March 1, 2018: Acta Orthopaedica et Traumatologica Turcica
Imalka Munaweera, Sumbul Shaikh, Danny Maples, Adane S Nigatu, Sri Nandhini Sethuraman, Ashish Ranjan, David E Greenberg, Rajiv Chopra
Implants are commonly used as a replacement for damaged tissue. Many implants, such as pacemakers, chronic electrode implants, bone screws, and prosthetic joints, are made of or contain metal. Infections are one of the difficult to treat complications associated with metal implants due to the formation of biofilm, a thick aggregate of extracellular polymeric substances (EPS) produced by the bacteria. In this study, we treated a metal prosthesis infection model using a combination of ciprofloxacin-loaded temperature-sensitive liposomes (TSL) and alternating magnetic fields (AMF)...
March 2018: International Journal of Hyperthermia
Paraskevi Vivian Papas, Dominick Congiusta, Giles R Scuderi, Fred D Cushner
Total knee arthroplasty (TKA) is recognized as one of the most successful surgical procedures performed today. One of the most common and dreaded complications of TKA is postoperative infection. To prevent infections, it is critical to identify patients at high risk through analyzing their risk factors, and help in addressing them prior to surgery. The effort to prevent infection must be carried through every step of the surgical process, from preoperative counseling to intraoperative measures and postoperative protocols...
February 28, 2018: Journal of Knee Surgery
Irasha Hettiarachchi, Scott Parker, Sanjit Singh
Capnocytophaga canimorsus is a commensal organism commonly found in the oral cavity of cats and dogs. Infections with this organism are rare and can affect both immunocompetent and immunocompromised individuals. The authors present a case of C canimorsus causing indolent prosthetic hip joint infection in a healthy 66-year-old woman following a history of being scratched by her pet dog. The patient had an atypical history of chronic, low-grade infection which is unusual, as this organism is more frequently associated with acute presentations and fulminant sepsis...
February 27, 2018: BMJ Case Reports
Ben Parkinson, Drew Armit, Peter McEwen, Michelle Lorimer, Ian A Harris
BACKGROUND: Climate factors have been shown to be associated with spontaneous musculoskeletal and some surgical site infections with increased rates of infection during warmer periods. To date, little research has been performed to determine if this phenomenon is associated with differences in the risk of revision for prosthetic joint infection (PJI) in primary TKA. QUESTIONS/PURPOSES: (1) Does the rate of revision for early PJI within the first year after primary TKA differ between tropical and nontropical regions? (2) Is there a seasonal variation in the rate of revision for PJI? (3) Is the geographic and seasonal variation (if present) associated with the sex, age, and/or American Society of Anesthesiologists (ASA) grade of the patient? METHODS: All 219,983 primary TKAs performed for osteoarthritis over a 5-year period (2011-2015) in the Australian Orthopaedic Association National Joint Replacement Registry were examined based on the month of the primary procedure to determine the rate of revision for PJI within 12 months...
February 21, 2018: Clinical Orthopaedics and related Research
Lone Heimann Larsen, Vesal Khalid, Yijuan Xu, Trine Rolighed Thomsen, Henrik C Schønheyder
Prosthetic joint failure is mainly caused by infection, aseptic failure (AF), and mechanical problems. Infection detection has been improved with modified culture methods and molecular diagnostics. However, comparisons between modified and conventional microbiology methods are difficult, due to variations in specimen sampling. In this prospective, multidisciplinary study of hip or knee prosthetic failures, we assessed the contributions of different specimen types, extended culture incubations, and 16S rRNA sequencing for diagnosing prosthetic joint infections (PJI)...
February 14, 2018: Journal of Clinical Microbiology
Qingyu Zhang, Lihua Liu, Wei Sun, Fuqiang Gao, Liming Cheng, Zirong Li
BACKGROUND: A high prevalence of asymptomatic bacteriuria exists in patients prior to arthroplasty, and urinary tract infection is considered to be a source of postoperative superficial wound and prosthetic joint infections. There is no consensus whether to screen for and treat asymptomatic bacteriuria before arthroplasty. OBJECTIVE: To summarize the association between asymptomatic bacteriuria and complications after arthroplasty and to evaluate the clinical benefits of treating asymptomatic bacteriuria prior to arthroplasty...
February 2018: Medicine (Baltimore)
Nicolas Benech, Sebastien Lustig, Christian Chidiac, Tristan Ferry
No abstract text is available yet for this article.
February 5, 2018: BMJ Case Reports
Hussein Abdelaziz, Akos Zahar, Christian Lausmann, Thorsten Gehrke, Helmut Fickenscher, Eduardo M Suero, Matthias Gebauer, Mustafa Citak
PURPOSE: The aim of the study was to quantify the bacterial contamination rate of electrocautery tips during primary total joint replacement (TJR), as well as during aseptic and septic revision TJR. METHODS: A total of 150 electrocautery tips were collected between April and July 2017. TJR surgeries were divided into three groups: (1) primary, (2) aseptic and (3) septic revisions. In each group, a total of 50 electrocautery tips were collected. A monopolar electrocautery with a reusable stainless-steel blade tip was used in all cases...
February 12, 2018: International Orthopaedics
M Morgenstern, T F Moriarty, R Kuehl, R G Richards, M A McNally, M H J Verhofstad, O Borens, C Zalavras, M Raschke, S L Kates, W J Metsemakers
INTRODUCTION: Fracture-related infection (FRI) is one of the most challenging musculoskeletal complications in orthopaedic-trauma surgery. Although the orthopaedic community has developed and adopted a consensus definition of prosthetic joint infections (PJI), it still remains unclear how the trauma surgery community defines FRI in daily clinical practice or in performing clinical research studies. The central aim of this study was to survey the opinions of a global network of trauma surgeons on the definitions and criteria they routinely use, and their opinion on the need for a unified definition of FRI...
February 6, 2018: Injury
Christophe Isnard, Anne Dhalluin, Damasie Malandain, Quentin Bruey, Michel Auzou, Jocelyn Michon, Jean-Christophe Giard, François Guérin, Vincent Cattoir
OBJECTIVES: Ceftaroline and ceftobiprole are new parenteral cephalosporins with potent activity against methicillin-resistant (MR) staphylococci, which are the leading cause of prosthetic joint infections (PJIs). The aim of the study was to determine and compare in vitro activities of both molecules against staphylococcal isolates recovered from clinically-documented PJIs. METHODS: A collection of 200 non-redundant clinical isolates (100 Staphylococcus aureus and 100 coagulase-negative staphylococci [CoNS], including 19 and 27 MR isolates, respectively) was studied...
February 5, 2018: Journal of Global Antimicrobial Resistance
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