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Periprosthetic joint infections

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https://www.readbyqxmd.com/read/28913404/esr-and-crp-are-useful-between-stages-of-2-stage-revision-for-periprosthetic-joint-infection
#1
Christopher P Lindsay, Christopher W Olcott, Daniel J Del Gaizo
BACKGROUND: Serum erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are important tests in the initial diagnosis of periprosthetic joint infection. Many surgeons also use these tests to determine if infection has resolved between stages of a 2-stage procedure, but little data exist regarding this practice. METHODS: A retrospective review of our institutional total joint databases was conducted to determine sensitivity, specificity, and predictive values of elevated ESR and/or CRP to diagnose persistent infection between stages...
September 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28912417/comparison-of-leukocyte-esterase-testing-of-synovial-fluid-with-synovial-histology-for-the-diagnosis-of-periprosthetic-joint-infection
#2
Rui Li, Xiang Li, Baozhan Yu, Xin Li, Xinggui Song, Heng Li, Chi Xu, Jiying Chen
BACKGROUND Periprosthetic joint infection (PJI) is a complication of total joint arthroplasty (TJA). The leukocyte esterase (LE) strip test and histology are diagnostic methods for PJI. The aims of this study were to determine the sensitivity and specificity of the LE strip test and to compare it with histology in the diagnosis of PJI. MATERIAL AND METHODS Between January and December 2015, 93 patients who underwent TJA with PJI were enrolled in the study. Synovial fluid samples were tested with an LE strip, and three synovial tissue samples from each patient underwent frozen section and formalin-fixed histology...
September 15, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28899592/the-american-college-of-surgeons-national-surgical-quality-improvement-program-surgical-risk-calculator-has-a-role-in-predicting-discharge-to-post-acute-care-in-total-joint-arthroplasty
#3
Daniel E Goltz, Billy T Baumgartner, Cary S Politzer, Marcus DiLallo, Michael P Bolognesi, Thorsten M Seyler
BACKGROUND: Patient demand and increasing cost awareness have led to the creation of surgical risk calculators that attempt to predict the likelihood of adverse events and to facilitate risk mitigation. The American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator is an online tool available for a wide variety of surgical procedures, and has not yet been fully evaluated in total joint arthroplasty. METHODS: A single-center, retrospective review was performed on 909 patients receiving a unilateral primary total knee (496) or hip (413) arthroplasty between January 2012 and December 2014...
August 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28894690/management-of-asymptomatic-bacteriuria-urinary-catheters-and-symptomatic-urinary-tract-infections-in-patients-undergoing-surgery-for-joint-replacement-a-position-paper-of-the-expert-group-infection-of-swissorthopaedics
#4
REVIEW
Parham Sendi, Olivier Borens, Peter Wahl, Martin Clauss, Ilker Uçkay
In this position paper, we review definitions related to this subject and the corresponding literature. Our recommendations include the following statements. Asymptomatic bacteriuria, asymptomatic leukocyturia, urine discolouration, odd smell or positive nitrite sediments are not an indication for antimicrobial treatment. Antimicrobial treatment of asymptomatic bacteriuria does not prevent periprosthetic joint infection, but is associated with adverse events, costs and antibiotic resistance development. Urine analyses or urine cultures in asymptomatic patients undergoing orthopaedic implants should be avoided...
2017: Journal of bone and joint infection
https://www.readbyqxmd.com/read/28875344/sweet-s-syndrome-a-clinical-entity-need-to-discriminate-against-acute-haematogenous-periprosthetic-joint-infection
#5
Ju Hong Lee, Ki Bum Kim, Ju Rang Lee, Myougn Ja Chung, Sung Il Wang
Sweet's syndrome (SS) or acute febrile neutrophilic dermatosis is an uncommon condition. It is characterized by fever, polymorphonuclear leukocytosis, painful erythematous cutaneous plaques, and dense dermal infiltrate of neutrophils without vasculitis at the site of skin lesions. Lesions in SS might enlarge and coalesce with increasing dermal oedema, resulting in pseudo-vesicular appearance mimicking joint infections. Here, a rare case of SS mimicking acute haematogenous periprosthetic infection in a 74-year-old woman with a history of total knee arthroplasty is reported...
September 5, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28872523/serum-d-dimer-test-is-promising-for-the-diagnosis-of-periprosthetic-joint-infection-and-timing-of-reimplantation
#6
Alisina Shahi, Michael M Kheir, Majd Tarabichi, Hamid R S Hosseinzadeh, Timothy L Tan, Javad Parvizi
BACKGROUND: Despite the availability of a battery of tests, the diagnosis of periprosthetic joint infection (PJI) continues to be challenging. Serum D-dimer assessment is a widely available test that detects fibrinolytic activities that occur during infection. We hypothesized that patients with PJI may have a high level of circulating D-dimer and that the presence of a high level of serum D-dimer may be a sign of persistent infection in patients awaiting reimplantation. METHODS: This prospective study was initiated to enroll patients undergoing primary and revision arthroplasty...
September 6, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28869114/multidrug-resistant-organisms-in-the-setting-of-periprosthetic-joint-infection-diagnosis-prevention-and-treatment
#7
REVIEW
Matthew P Siljander, Ali H Sobh, Kevin C Baker, Erin A Baker, Lige M Kaplan
BACKGROUND: Periprosthetic joint infection (PJI) is a rare yet challenging problem in total hip and knee arthroplasties. The management of PJI remains difficult primarily due to the evolution of resistance by the infecting organisms. METHODS: This review profiles acquired mechanisms of bacterial resistance and summarizes established and emerging techniques in PJI diagnosis, prevention, and treatment. RESULTS: New techniques in PJI diagnosis and prevention continue to be explored...
August 3, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28865964/routine-cultures-for-seemingly-aseptic-revision-shoulder-arthroplasty-are-they-necessary
#8
REVIEW
Tyler J Brolin, Daniel J Hackett, Joseph A Abboud, Jason E Hsu, Surena Namdari
Propionibacterium acnes has recently gained attention as the leading cause of periprosthetic joint infections (PJIs) after shoulder arthroplasty. Unlike PJIs in the lower extremity, PJIs after shoulder arthroplasty usually have an indolent course and are notoriously difficult to diagnose. Most of the time, the diagnosis is made after positive intraoperative cultures are taken at the time of revision surgery. Adding even more complexity to the diagnosis is the high rate of P acnes-positive cultures taken at the time of primary shoulder surgery...
August 30, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28865425/silver-coated-modular-megaendoprostheses-in-salvage-revision-arthroplasty-after-periimplant-infection-with-extensive-bone-loss-a-pilot-study-of-34-patients
#9
Dirk Zajonz, Undine Birke, Mohamed Ghanem, Torsten Prietzel, Christoph Josten, Andreas Roth, Johannes K M Fakler
BACKGROUND: Hip and knee replacements in patients with bone defects after infection correlates with high rates of reinfection. In this vulnerable patient population, the prevention of reinfection is to be considered superordinate to the functionality and defect bridging. The use of silver coating of aseptic implants as an infection prophylaxis is already proven; however, the significance of these coatings in septic reimplantation of large implants is still not sufficiently investigated...
September 2, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28859063/bmi-is-a-key-risk-factor-for-early-periprosthetic-joint-infection-following-total-hip-and-knee-arthroplasty
#10
Patrick Jung, Arthur J Morris, Mark Zhu, Sally A Roberts, Chris Frampton, Simon W Young
AIM: To identify patient and surgical risk factors that are associated with periprosthetic joint infection (PJI), especially whether obesity is a risk factor following total hip arthroplasty (THA) and total knee arthroplasty (TKA). METHODS: New Zealand Surgical Site Infection Improvement Programme data was analysed using deep infection within 90 days of the index procedure as the outcome. This was tested against surgical and patient factors for statistical associations in a multivariate model...
September 1, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28854762/efficacy-of-open-debridement-and-polyethylene-exchange-in-strictly-selected-patients-with-infection-after-total-knee-arthroplasty
#11
Whee Sung Son, Oog-Jin Shon, Dong-Chul Lee, Sang-Jin Park, Han Seok Yang
Purpose: To assess the efficacy of open debridement and polyethylene exchange (ODPE) combined with proper antibiotic therapy in strictly selected patients with infection after total knee arthroplasty (TKA) and analyze factors associated with treatment failure. Materials and Methods: From January 2010 to January 2014, 25 cases that underwent ODPE under the diagnosis of infection within four weeks after TKA or acute hematogenous infection within five days of symptom onset were reviewed in this study...
September 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28854760/a-review-of-the-literature-on-culture-negative-periprosthetic-joint-infection-epidemiology-diagnosis-and-treatment
#12
REVIEW
Hong-Kwon Yoon, Seong-Hee Cho, Dong-Yeong Lee, Byeong-Hun Kang, Sang-Hyuk Lee, Dong-Gyu Moon, Dong-Hee Kim, Dae-Cheol Nam, Sun-Chul Hwang
Purpose: The prevalence of periprosthetic joint infection (PJI) has increased with the increasing incidence of arthroplasty surgery. Considering identification of causative microorganisms is crucial for treatment of PJI, culture-negative (CN) PJI is a significant clinical issue. The purpose of the present study is to describe epidemiology, diagnosis and treatment of CN PJI based on review of the literature to help prevent delayed diagnosis and improve clinical outcomes of CN PJI. Methods: MEDLINE, EMBASE, Cochrane Library and Scopus databases were searched for articles on CN PJI...
September 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28844629/total-hip-arthroplasty-after-in-situ-fixation-of-minimally-displaced-femoral-neck-fractures-in-elderly-patients
#13
Nicholas M Hernandez, Brian P Chalmers, Kevin I Perry, Daniel J Berry, Brandon J Yuan, Matthew P Abdel
BACKGROUND: In situ screw fixation remains the most common treatment for minimally displaced femoral neck fractures (FNFs). Total hip arthroplasty (THA) can be used as a salvage procedure, but the results of conversion THA in this population have not been evaluated. The goals of this study were to evaluate (1) unique complications associated with conversion THA, (2) implant survivorship free of revision and reoperation, (3) radiographic results, and (4) clinical outcomes in patients undergoing conversion THA after in situ fixation of nondisplaced FNFs...
July 29, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28835000/-therapy-of-periprosthetic-shoulder-infection
#14
Bernd Fink, Florian Sevelda
There are several therapeutic options for the treatment of periprosthetic joint infections of shoulder arthroplasties. In acute infections, the implant can remain in place with open debridement, septic lavage with antibacterial solutions such as octinedine or polyhexanide solution and exchange of all mobile components. In late infections, the therapeutic options after removal of the infected implant are: permanent spacer, resection arthroplasty, one stage revision and two stage revision with or without a temporary spacer...
August 23, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28818359/environment-of-care-is-it-time-to-reassess-microbial-contamination-of-the-operating-room-air-as-a-risk-factor-for-surgical-site-infection-in-total-joint-arthroplasty
#15
REVIEW
Javad Parvizi, Sue Barnes, Noam Shohat, Charles E Edmiston
In the modern operating room (OR), traditional surgical mask, frequent air exchanges, and architectural barriers are viewed as effective in reducing airborne microbial populations. Intraoperative sampling of airborne particulates is rarely performed in the OR because of technical difficulties associated with sampling methodologies and a common belief that airborne contamination is infrequently associated with surgical site infections (SSIs). Recent studies suggest that viable airborne particulates are readily disseminated throughout the OR, placing patients at risk for postoperative SSI...
August 14, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28813499/staphylococcus-aureus-biofilm-elicits-the-expansion-activation-and-polarization-of-myeloid-derived-suppressor-cells-in-vivo-and-in-vitro
#16
Kuo-Ti Peng, Ching-Chuan Hsieh, Tsung-Yu Huang, Pei-Chun Chen, Hsin-Nung Shih, Mel S Lee, Pey-Jium Chang
Staphylococcus aureus (S. aureus) is one of the most common causes of biofilm infections in periprosthetic joint infections (PJIs). Accumulating evidence has shown that the immunosuppressive environment established by S. aureus biofilm infection in PJIs involves the presence of myeloid-derived suppressor cells (MDSCs) and M2-macrophages. Due to the diversity of MDSCs, little is known about whether S. aureus biofilm preferentially expands specific MDSC subsets or whether MDSCs can further differentiate into M2-macrophages during S...
2017: PloS One
https://www.readbyqxmd.com/read/28811108/methylene-blue-guided-debridement-as-an-intraoperative-adjunct-for-the-surgical-treatment-of-periprosthetic-joint-infection
#17
Jeremy D Shaw, Steve Miller, Anna Plourde, Daniel L Shaw, Rosanna Wustrack, Erik N Hansen
BACKGROUND: Current methods to identify infected tissue in periprosthetic joint infection (PJI) are inadequate. The purpose of this study was (1) to assess methylene blue-guided surgical debridement as a novel technique in PJI using quantitative microbiology and (2) to evaluate clinical success based on eradication of infection and infection-free survival. METHODS: Sixteen total knee arthroplasty patients meeting Musculoskeletal Infection Society criteria for PJI undergoing the first stage of 2-stage exchange arthroplasty were included in this prospective study...
July 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28808616/periprosthetic-hip-joint-infection-with-aspergillus-terreus-a-clinical-case-and-a-review-of-the-literature
#18
Rachel Bartash, Yi Guo, John B Pope, Michael H Levi, Wendy Szymczak, Nidhi Saraiya, Priya Nori
Fungal periprosthetic joint infections due to Aspergillus species are rare but are associated with significant cost and morbidity. We present a case of Asperigillus terreus prosthetic joint infection of the hip. The patient was successfully treated with a prolonged course of systemic antifungals along with surgical management.
December 2017: Medical Mycology Case Reports
https://www.readbyqxmd.com/read/28800858/diagnostic-value-of-synovial-white-blood-cell-count-and-serum-c-reactive-protein-for-acute-periprosthetic-joint-infection-after-knee-arthroplasty
#19
Sang-Gyun Kim, Jae-Gyoon Kim, Ki-Mo Jang, Seung-Bum Han, Hong-Chul Lim, Ji-Hoon Bae
BACKGROUND: The diagnosis of periprosthetic joint infection (PJI) remains difficult, particularly in acute postoperative stage. The purpose of this study was to investigate the optimal cutoff value of synovial white blood cell (WBC) count, percentage of polymorphonuclear cells, erythrocyte sedimentation rate, and C-reactive protein (CRP) for diagnosing early postoperative infection after knee joint arthroplasty. METHODS: We retrospectively reviewed primary total knee arthroplasties and unicompartmental knee arthroplasties, with a knee aspiration within 3 weeks of surgery, from January 2006 to November 2016...
July 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28797879/using-a-non-invasive-secure-skin-closure-following-total-knee-arthroplasty-leads-to-fewer-wound-complications-and-no-patient-home-care-visits-compared-to-surgical-staples
#20
Alberto V Carli, Sara Spiro, Brian T Barlow, Steven B Haas
BACKGROUND: Superficial wound complications occur in up to 10% of total knee arthroplasty (TKA) procedures and have been associated with periprosthetic joint infection. The ideal material for TKA closure should offer: 1) fast intraoperative application, 2) minimal wound complications and 3) removable by patients without assistance. We evaluated a novel, non-invasive, removable skin closure system for TKA to determine its effect on wound complications. METHODS: We prospectively evaluated 221 consecutive TKA patients who received skin closure using a non-invasive zipper-like system ('Zip'; Zip 16 Surgical Skin Closure System; Zipline Medical)...
August 7, 2017: Knee
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