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Periprosthetic joint infections

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https://www.readbyqxmd.com/read/28436379/economic-analysis-of-4221-revisions-due-to-periprosthetic-joint-infection-in-poland
#1
Ireneusz Babiak, Piotr Pędzisz, Jakub Janowicz, Mateusz Kulig, Paweł Małdyk
BACKGROUND: Periprosthetic joint infection (PJI) is one of the most severe complications of total hip (THA) and total knee (TKA) arthroplasty. The aim of the study is to determine the number and type of hip and knee prosthesis revisions in Poland performed due to infection and reimbursement of the cost of septic revisions and to compare the costs of septic and aseptic revisions in Poland and other countries. MATERIAL AND METHODS: The data published for the period 2009-2013 by the National Health Fund (NHF) were analysed and the average cost of septic and aseptic revisions was calculated...
January 26, 2017: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28434697/poor-outcomes-of-irrigation-and-debridement-in-acute-periprosthetic-joint-infection-with-antibiotic-impregnated-calcium-sulfate-beads
#2
Michael A Flierl, Brian M Culp, Kamil T Okroj, Bryan D Springer, Brett R Levine, Craig J Della Valle
BACKGROUND: One proposed strategy to increase the success of irrigation and debridement with implant retention for the treatment of acute periprosthetic joint infection (PJI) is the use of dissolvable antibiotic-impregnated calcium sulfate beads to provide a local depot of antibiotics. The purpose of this study was to evaluate the outcome of such an approach. METHODS: Thirty-two patients with acute hematogenous (18 patients; 1 bilateral) or acute postoperative (14 patients) PJIs who underwent irrigation and debridement with implant retention and addition of antibiotic-impregnated calcium sulfate beads were retrospectively reviewed...
March 29, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28434696/complete-eradication-of-biofilm-from-orthopedic-materials
#3
Jeffrey T Leary, Matthew M Werger, William H Broach, Lindsey N Shaw, Brandon G Santoni, Thomas L Bernasek, Steven T Lyons
BACKGROUND: Interest exists in finding alternatives to current management strategies in periprosthetic joint infections, which typically include a 2-stage revision with placement of an antibiotic spacer and delayed placement of a new implant. We studied the efficacy of autoclaving, ultrasonication, and mechanical scrubbing for sterilization and biofilm eradication on infected cobalt-chrome discs. METHODS: Strains of Staphylococcus aureus MRSA252 or Staphylococcus epidermidis RP62A were grown on the discs...
March 29, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28421514/corr-insights-%C3%A2-vancomycin-prophylaxis-for-total-joint-arthroplasty-incorrectly-dosed-and-has-a-higher-rate-of-periprosthetic-infection-than-cefazolin
#4
Alex Soriano
No abstract text is available yet for this article.
April 18, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28421237/radiographic-interpretation-of-carpometacarpal-arthroplasty-correlation-between-radiographic-loosening-and-clinical-outcome
#5
Laurence Stillwater, Brett Memauri, Imran Ratanshi, Avinash Islur, Thelina Amaratunga
OBJECTIVE: To assess the radiographic appearance and interpretation of loosening in patients following first carpometacarpal joint pyrohemisphere arthroplasty. MATERIALS AND METHODS: A retrospective review over a 6-year period was performed identifying patients with first carpometacarpal pyrohemisphere implants. All postoperative radiographs were reviewed and compared with clinical information. Loosening was defined as greater than 1 mm of periprosthetic lucency or increasing lucency on serial studies...
April 19, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28419033/oral-only-linezolid-rifampin-is-highly-effective-compared-with-other-antibiotics-for-periprosthetic-joint-infection-study-of-a-mouse-model
#6
John M Thompson, Vikram Saini, Alyssa G Ashbaugh, Robert J Miller, Alvaro A Ordonez, Roger V Ortines, Yu Wang, Robert S Sterling, Sanjay K Jain, Lloyd S Miller
BACKGROUND: The medical treatment of periprosthetic joint infection (PJI) involves prolonged systemic antibiotic courses, often with suboptimal clinical outcomes including increased morbidity and health-care costs. Oral and intravenous monotherapies and combination antibiotic regimens were evaluated in a mouse model of methicillin-resistant Staphylococcus aureus (MRSA) PJI. METHODS: Oral linezolid with or without oral rifampin, intravenous vancomycin with oral rifampin, intravenous daptomycin or ceftaroline with or without oral rifampin, oral doxycycline, or sham treatment were administered at human-exposure doses for 6 weeks in a mouse model of PJI...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28418574/inadequacy-of-joint-aspiration-for-detection-of-persistent-periprosthetic-infection-during-two-stage-septic-revision-knee-surgery
#7
Bernd Preininger, Viktor Janz, Philipp von Roth, Andrej Trampuz, Carsten F Perka, Tilman Pfitzner
Despite the lack of validation, synovial aspiration remains a common practice during 2-stage septic revision total knee arthroplasty (TKA). The goal of this study was to investigate the diagnostic validity of synovial polymethylmethacrylate (PMMA) spacer aspiration of temporary knee arthrodesis to detect persistent periprosthetic joint infection before TKA reimplantation. This retrospective cohort study included 73 consecutive patients who underwent 2-stage septic revision TKA according to a standard protocol...
April 18, 2017: Orthopedics
https://www.readbyqxmd.com/read/28407423/orthopaedic-biofilm-infections
#8
REVIEW
Werner Zimmerli, Parham Sendi
Many infections of the musculoskeletal system are biofilm infections that develop on non-living surfaces. Microorganisms adhere either on dead bone (sequesters) or implants. As a rule for a curative concept, chronic osteomyelitis or implant-associated bone infection must be treated with a combination of surgery and antimicrobial therapy. If an implant is kept in place, or a new device is implanted before complete healing of infection, a biofilm-active antibiotic should be used. Rifamycins are active against biofilms of staphylococci, and fluoroquinolones against those of Gram-negative bacilli...
April 2017: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
https://www.readbyqxmd.com/read/28401341/vancomycin-prophylaxis-for-total-joint-arthroplasty-incorrectly-dosed-and-has-a-higher-rate-of-periprosthetic-infection-than-cefazolin
#9
Michael M Kheir, Timothy L Tan, Ibrahim Azboy, Dean D Tan, Javad Parvizi
BACKGROUND: In total joint arthroplasty (TJA), vancomycin is used as perioperative antibiotic prophylaxis in patients with penicillin allergy or in patients colonized with methicillin-resistant Staphylococcus aureus (MRSA). Although vancomycin dosing should be weight-based (15 mg/kg), not all surgeons are aware of this; a fixed 1-g dose is instead frequently administered. QUESTIONS/PURPOSES: (1) Is there a difference in the risk of periprosthetic joint infection (PJI) in patients receiving vancomycin or cefazolin prophylaxis after primary TJA? (2) What proportion of patients is adequately dosed with vancomycin? (3) Compared with actual fixed dosing, does weight-based dosing result in a greater proportion of patients staying above the recommended 15-mg/L level at the beginning and end of surgery? (4) Are patients overdosed with vancomycin at greater risk of developing nephrotoxicity and acute kidney injury? METHODS: A single-institution, retrospective study was performed on 1828 patients undergoing primary TJAs who received vancomycin prophylaxis between 2008 and 2014...
April 11, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28390889/periprosthetic-joint-infection-the-current-hot-topic
#10
EDITORIAL
Javad Parvizi
No abstract text is available yet for this article.
March 3, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28390886/epidemiology-and-antibiotic-resistance-of-late-prosthetic-knee-and-hip-infections
#11
Lorenzo Drago, Elena De Vecchi, Monica Bortolin, Luigi Zagra, Carlo L Romanò, Laura Cappelletti
BACKGROUND: Prosthetic joint infections (PJI) are still a major complication of hip and knee arthroplasties. Identification of the causative pathogens and knowledge of their antibiotic susceptibilities are essential for the management of these infections. The main purpose of the study was to identify and compare the causative bacteria of prosthetic knee and hip joint infections in a reference Italian orthopedic center and to characterize antibiotic resistance profiles of bacteria involved...
March 15, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28389865/what-is-the-long-term-economic-societal-effect-of-periprosthetic-infections-after-tha-a-markov-analysis
#12
Thomas J Parisi, Joseph F Konopka, Hany S Bedair
BACKGROUND: Current estimates for the direct costs of a single episode of care for periprosthetic joint infection (PJI) after THA are approximately USD 100,000. These estimates do not account for the costs of failed treatments and do not include indirect costs such as lost wages. QUESTIONS/PURPOSES: The goal of this study was to estimate the long-term economic effect to society (direct and indirect costs) of a PJI after THA treated with contemporary standards of care in a hypothetical patient of working age (three scenarios, age 55, 60, and 65 years)...
April 7, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28385345/outcome-following-debridement-antibiotics-and-implant-retention-in-hip-periprosthetic-joint-infection-an-18-year-experience
#13
George Grammatopoulos, Benjamin Kendrick, Martin McNally, Nicholas A Athanasou, Bridget Atkins, Peter McLardy-Smith, Adrian Taylor, Roger Gundle
BACKGROUND: Debridement-antibiotics-and-implant-retention (DAIR) may be considered a suitable surgical option in periprosthetic joint infections (PJIs) with soundly fixed prostheses, despite chronicity. This study aims to define the long-term outcome following DAIR in hip PJI. METHODS: We reviewed all hip DAIRs performed between 1997 and 2013 (n = 122) to define long-term outcome and identify factors influencing it. Data recorded included patient demographics, medical history, type of DAIR performed (+/- exchange of modular components), and organisms identified...
March 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28384558/temporary-total-hip-arthroplasty-like-spacer-for-treating-an-infected-periprosthetic-femoral-fracture-using-a-long-stem-a-case-report
#14
Youngwoo Kim, Yoshiaki Katsura, Nina Kasahara, Takashi Kasahara, Masashi Kanamura, Keiichi Kawanabe
INTRODUCTION: Infected periprosthetic femoral fractures are among the most complex and significant complications of total hip arthroplasty (THA). We report the novel use of a temporary THA-like spacer for treating an infected periprosthetic femoral fracture after revision surgery using a long stem. CASE PRESENTATION: We present a 72-year-old woman sustained a left infected periprosthetic femoral fracture after revi - streptococci in the culture sample. On suspicion of a periprosthetic joint infection, we planned a two-stage procedure...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28372917/fewer-complications-following-revision-hip-and-knee-arthroplasty-in-patients-with-normal-vitamin-d-levels
#15
Sophia A Traven, Alexander M Chiaramonti, William R Barfield, Patricia A Kirkland, Harry A Demos, Harold D Schutte, Jacob M Drew
BACKGROUND: Surgeons and hospitals increasingly face penalty for complications and readmission following total joint arthroplasty; therefore, optimization of modifiable risk factors is paramount. Literature associates low vitamin D with risk of periprosthetic joint infection, and we hypothesized low vitamin D to be predictive of increased rate of complications and readmissions. METHODS: A retrospective review of 126 revision total joint arthroplasty patients between 2010 and 2014 was performed...
March 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28369296/the-not-so-good-prognosis-of-streptococcal-periprosthetic-joint-infection-managed-by-implant-retention-the-results-of-a-large-multicenter-study
#16
Jaime Lora-Tamayo, Éric Senneville, Alba Ribera, Louis Bernard, Michel Dupon, Valérie Zeller, Ho Kwong Li, Cédric Arvieux, Martin Clauss, Ilker Uçkay, Dace Vigante, Tristan Ferry, José Antonio Iribarren, Trisha N Peel, Parham Sendi, Nina Gorišek Miksic, Dolors Rodríguez-Pardo, María Dolores Del Toro, Marta Fernández-Sampedro, Ulrike Dapunt, Kaisa Huotari, Joshua S Davis, Julián Palomino, Danielle Neut, Benjamin M Clark, Thomas Gottlieb, Rihard Trebše, Alex Soriano, Alberto Bahamonde, Laura Guío, Alicia Rico, Mauro Jc Salles, M José G Pais, Natividad Benito, Melchor Riera, Lucía Gómez, Craig A Aboltins, Jaime Esteban, Juan Pablo Horcajada, Karina O'Connell, Matteo Ferrari, Gábor Skaliczki, Rafael San Juan, Javier Cobo, Mar Sánchez-Somolinos, Antonio Ramos, Efthymia Giannitsioti, Alfredo Jover-Sáenz, Josu Mirena Baraia-Etxaburu, José María Barbero, Peter F M Choong, Nathalie Asseray, Séverine Ansart, Gwenäel Le Moal, Werner Zimmerli, Javier Ariza
Background: Streptococci are not an infrequent cause of periprosthetic joint infection (PJI). Management by debridement, antibiotics, and implant retention (DAIR) is thought to produce a good prognosis, but little is known about the real likelihood of success. Methods: Retrospective, observational, multicenter, international study performed during 2003-2012. Eligible patients had a streptococcal PJI that was managed with DAIR. The primary endpoint was failure, defined as death related to infection, relapse/persistence of infection, or the need for salvage therapy...
March 23, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28366315/prevention-of-periprosthetic-joint-infection-examining-the-recent-guidelines
#17
Noam Shohat, Javad Parvizi
BACKGROUND: The global rise in infectious disease has led the Center for Disease Control and Prevention and the World Health Organization to release new guidelines for the prevention of surgical site infection. METHODS: In this article, we summarize current recommendations based on level of evidence, review unresolved and unaddressed issues, and supplement them with new literature. RESULTS: Although the guidelines discuss major issues in reducing surgical site infection, many questions remain unanswered...
March 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28363888/prevention-of-periprosthetic-joint-infection-new-guidelines
#18
REVIEW
J Parvizi, N Shohat, T Gehrke
The World Health Organization (WHO) and the Centre for Disease Control and Prevention (CDC) recently published guidelines for the prevention of surgical site infection. The WHO guidelines, if implemented worldwide, could have an immense impact on our practices and those of the CDC have implications for healthcare policy in the United States. Our aim was to review the strategies for prevention of periprosthetic joint infection in light of these and other recent guidelines. Cite this article: Bone Joint J 2017;99-B(4 Supple B):3-10...
April 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28353049/single-stage-acetabular-revision-during-two-stage-tha-revision-for-infection-is-effective-in-selected-patients
#19
Bernd Fink, Michael Schlumberger, Damian Oremek
BACKGROUND: The treatment of periprosthetic infections of hip arthroplasties typically involves use of either a single- or two-stage (with implantation of a temporary spacer) revision surgery. In patients with severe acetabular bone deficiencies, either already present or after component removal, spacers cannot be safely implanted. In such hips where it is impossible to use spacers and yet a two-stage revision of the prosthetic stem is recommended, we have combined a two-stage revision of the stem with a single revision of the cup...
March 28, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28343870/cd15-focus-score-infection-diagnosis-and-stratification-into-low-virulence-and-high-virulence-microbial-pathogens-in-periprosthetic-joint-infection
#20
V T Krenn, M Liebisch, B Kölbel, N Renz, T Gehrke, M Huber, M G Krukemeyer, A Trampuz, H Resch, V Krenn
INTRODUCTION: The aim of the work was to validate the CD15 focus score for the infection pathology of periprosthetic joint infection in a large group and to clarify whether a stratification into low-virulence and high-virulence microbial pathogens is possible by means of the CD15 focus score (quantification of CD15 positive granulocytes). METHODS: The histopathology of 275 synovial tissue samples taken intraoperatively during revision operations (n=127 hip, n=141 knee, n=2 shoulder, n=5 ankle) was evaluated according to the SLIM consensus classification (SLIM=synovial-like interface membrane)...
January 12, 2017: Pathology, Research and Practice
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