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Periprosthetic joint infections

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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
#1
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
#2
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28797875/success-rates-characteristics-and-costs-of-articulating-antibiotic-spacers-for-total-knee-periprosthetic-joint-infection
#6
Scott R Nodzo, Keely K Boyle, Sara Spiro, Allina A Nocon, Andy O Miller, Geoffrey H Westrich
BACKGROUND: The optimal type, characteristics, and success rates of articulating antibiotic spacers used during total knee arthroplasty (TKA) periprosthetic joint infection (PJI) have not been well defined in a single series. We sought to (1) determine the success rate for three unique spacer constructs and (2) evaluate any microbiological, surgical, or patient characteristics that would influence the success rate. METHODS: We retrospectively reviewed patients who underwent a two-stage exchange for a TKA PJI with a prefabricated spacer (PREFAB), home-made mold (MOLD), or autoclaved femoral component (AUTOCL)...
August 8, 2017: Knee
https://www.readbyqxmd.com/read/28791884/added-value-of-18f-fdg-pet-ct-in-diagnosing-infected-hip-prosthesis
#7
Robert M Kwee, Wouter Am Broos, Boudewijn Brans, Geert Him Walenkamp, Jan Geurts, René E Weijers
Background The diagnosis of infected hip prosthesis is frequently not straightforward yet very important as it changes treatment. Purpose To retrospectively investigate the added value of 18F-FDG PET/CT to conventional tests including radiography, erythrocyte sedimentation rate (ESR)/C-reactive protein (CRP) testing, and joint aspiration, in diagnosing infected hip prosthesis. Material and Methods Seventy-eight hip prostheses of 78 patients (55% men; mean age = 66.5 years; age range = 30-85 years) with non-specific clinical presentation, i...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28790468/management-of-the-infected-total-hip-arthroplasty
#8
D'jon Lopez, Isabel Leach, Elinor Moore, Alan R Norrish
In the United Kingdom approximately 80,000 total hip arthroplasties are undertaken on an average each year. The popularity and demand for this operation are continually increasing. Our understanding of arthroplasty surgery and its complications has evolved greatly, and as a result infection rates are undeniably at an all-time low. The increasing volume of operations being performed does, however, mean that we still continue to see an increased number of cases of infection. There is no doubt that periprosthetic joint infection (PJI) poses a complex clinical and diagnostic predicament to clinicians...
July 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28760710/the-impact-of-preoperative-bacteriuria-on-the-risk-of-periprosthetic-joint-infection-after-primary-knee-or-hip-replacement-a-retrospective-study-with-a-one-year-follow-up
#9
Meeri Honkanen, Esa Jämsen, Matti Karppelin, Reetta Huttunen, Heini Huhtala, Antti Eskelinen, Jaana Syrjänen
OBJECTIVES: Patients who undergo elective joint replacement are traditionally screened and treated for preoperative bacteriuria in order to prevent periprosthetic joint infection (PJI). More recently, this practice has been questioned. The purpose of this study was to determine whether preoperative bacteriuria is associated with an increased risk of PJI. METHODS: Patients who had undergone a primary hip or knee replacement in a tertiary care hospital between September 2002 and December 2013 were identified from the hospital database (23 171 joint replacements, 10 200 hips, and 12 971 knees)...
July 28, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28759874/effects-of-vitamin-e-diffused-highly-cross-linked-uhmwpe-particles-on-inflammation-apoptosis-and-immune-response-against-s-%C3%A2-aureus
#10
Weishen Chen, David A Bichara, Jeremy Suhardi, Puyi Sheng, Orhun K Muratoglu
Particle-induced osteolysis and periprosthetic joint infection (PJI) are closely associated with periprosthetic tissue immune function. The objective of this study was to determine the effects of polyethylene particles on inflammation and response against S. aureus. Effects that vitamin E-diffused cross-linked UHMWPE (VE-PE) particles had on apoptosis, inflammation, and bactericidal activities compared to virgin cross-linked UHMWPE (control PE) particles were examined. Murine RAW 264.7 macrophages exposed to VE-PE particles in vitro were less apoptotic, secreted less tumor necrosis factor (TNF)-α, and responded more effectively against lipopolysaccharide or S...
July 24, 2017: Biomaterials
https://www.readbyqxmd.com/read/28750797/reliability-of-a-multiplex-pcr-system-for-diagnosis-of-early-and-late-prosthetic-joint-infections-before-and-after-broth-enrichment
#11
Francesca Villa, Marco Toscano, Elena De Vecchi, Monica Bortolin, Lorenzo Drago
Early microbiological diagnosis of prosthetic joint infection (PJI) is essential for successful antimicrobial treatment; however, culture has limited sensitivity, particularly in patients who had received antibiotic therapy, and the utility of molecular methods for diagnosing PJIs remains debated. We investigated the reliability of a multiplex PCR system for the microbiological diagnosis of early and late PJIs. Samples of periprosthetic tissues, synovial fluid, and prosthetic implants from 47 patients with early (n=13) or late (n=34) PJI were analyzed by conventional culture and with the multiplex-PCR Unyvero ITI(®) (U-ITI) cartridge system...
July 18, 2017: International Journal of Medical Microbiology: IJMM
https://www.readbyqxmd.com/read/28735470/staged-reimplantation-of-a-total-hip-prosthesis-after-co-infection-with-candida-tropicalis-and-staphylococcus-haemolyticus-a-case-report
#12
Sujeesh Sebastian, Rajesh Malhotra, Ashish Pande, Deepak Gautam, Immaculata Xess, Benu Dhawan
Fungal prosthetic joint infection is a rare complication in total joint arthroplasty. There are no established guidelines for management of these infections. We present a case of a 53-year-old male with a hip joint prosthesis co-infected with Candida tropicalis and Staphylococcus haemolyticus. A two-stage exchange arthroplasty was performed. The patient underwent implant removal, debridement, irrigation with saline solution and application of cement spacer impregnated with vancomycin followed by aggressive antimicrobial treatment in first stage...
July 22, 2017: Mycopathologia
https://www.readbyqxmd.com/read/28731488/contamination-risk-of-synovial-biopsy-cultures-in-total-hip-arthroplasty-a-prospective-review-of-100-cases
#13
Christophe Pattyn, Thomas De Bo, Joris Anthonissen, Philippe Willekens, Geert Claeys, Emmanuel A Audenaert
INTRODUCTION: Cultures of deep synovial biopsies remain an important tool in diagnosing periprosthetic joint infection, a devastating complication following total hip arthroplasty (THA). Recent reports of unexpected positive intraoperative cultures in aseptic revision arthroplasty, however, challenge the validity and interpretation of these cultures. The aim of this study was to evaluate the contamination risk of synovial biopsy cultures collected intraoperatively during primary THA of healthy subjects...
July 19, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28714050/superiority-of-the-sonication-method-against-conventional-periprosthetic-tissue-cultures-for-diagnosis-of-prosthetic-joint-infections
#14
Sofia Tani, Panagiotis Lepetsos, Antonios Stylianakis, John Vlamis, Konstantinos Birbas, Ioannis Kaklamanos
INTRODUCTION: Diagnosis of periprosthetic infections is challenging. The aim of this study was to compare the diagnostic accuracy of conventional periprosthetic tissue culture and culture of sonication fluid of the explanted prostheses. METHODS: We prospectively enrolled 114 patients undergoing revision hip or knee arthroplasty because of loosening of the prostheses, at our institution, between July 2012 and July 2016. Patients' medical history and demographic characteristics were recorded...
July 17, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28713524/forced-air-warming-discontinued-periprosthetic-joint-infection-rates-drop
#15
REVIEW
Scott D Augustine
Several studies have shown that the waste heat from forced-air warming (FAW) escapes near the floor and warms the contaminated air resident near the floor. The waste heat then forms into convection currents that rise up and contaminate the sterile field above the surgical table. It has been shown that a single airborne bacterium can cause a periprosthetic joint infection (PJI) following joint replacement surgery. We retrospectively compared PJI rates during a period of FAW to a period of air-free conductive fabric electric warming (CFW) at three hospitals...
June 23, 2017: Orthopedic Reviews
https://www.readbyqxmd.com/read/28712799/diagnosing-periprosthetic-joint-infection-and-the-winner-is
#16
Alisina Shahi, Timothy L Tan, Michael M Kheir, Dean D Tan, Javad Parvizi
BACKGROUND: Diagnosis of periprosthetic joint infection (PJI) remains a challenge despite a wide variety of available diagnostic tests. The question that arises is which of these tests has a better performance for diagnosing PJI. Diagnostic odds ratio (DOR) has been described as the best indicator for test performance. METHODS: To compare the performance of the standard diagnostic tests, the DOR of serum erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), synovial fluid (SF) white blood cell (WBC) count, SF polymorphonuclear (PMN%), and leukocyte esterase (LE) were calculated...
June 10, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28708567/%C3%AE-defensin-point-of-care-test-for-diagnosis-of-prosthetic-joint-infections-neglected-role-of-laboratory-and-clinical-pathologists
#17
REVIEW
Lorenzo Drago, Marco Toscano, Lorenza Tacchini, Giuseppe Banfi
Periprosthetic joint infection (PJI) is a serious complication that may occur after native joint replacement leading to a severe health and economic burden. Currently, due to several confounding factors, PJI is difficult to diagnose. Today, a multidisciplinary approach is indispensable to correctly define a periprosthetic joint infection; indeed, tissue histology, microbiology cultures and clinical findings are used together to achieve this goal. Analysis of α-defensin is commonly used for PJI diagnosis, as it allows the rapid detection of α-defensin present in the synovial fluid following a microbial infection...
July 14, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28702746/corr-insights-%C3%A2-periprosthetic-joint-infection-is-the-main-cause-of-failure-for-modern-knee-arthroplasty-an-analysis-of-11-134-knees
#18
Christina Ilona Esposito
No abstract text is available yet for this article.
July 12, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28701012/-diagnosis-of-periprosthetic-joint-infection-of-shoulder-arthroplasties
#19
Bernd Fink, Florian Sevelda
Periprosthetic joint infection of shoulder arthroplasties is one of the most frequent reasons for pain and revision surgery of shoulder arthroplasties. Propionibacterium acnes is one of the commonest microorganisms causing periprosthetic joint infection in shoulder arthroplasties. It is difficult to detect this slow growing microorganism. This paper gives an overview of the different diagnostic methods. A combination of unspecific and specific tests (detection of microorganism and sensitivity to antibiotics) is helpful in identifying a periprosthetic shoulder infection...
July 12, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28690466/propionibacterium-acnes-host-inflammatory-response-during-periprosthetic-infection-is-joint-specific
#20
Scott R Nodzo, K Keely Boyle, Samrath Bhimani, Thomas R Duquin, Andy O Miller, Geoffrey H Westrich
BACKGROUND: Propionibacterium acnes (P. acnes) has become increasingly recognized as a cause of periprosthetic joint infection (PJI). QUESTIONS/PURPOSES: It is not currently known if the clinical presentation of P. acnes varies depending on the joint being infected. METHODS: We retrospectively reviewed patients infected with P. acnes after total hip, knee, and shoulder arthroplasty from two institutions. Patients were classified as having a PJI based on the Musculoskeletal Infection Society criteria and were excluded if they had a polymicrobial culture...
July 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
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