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Periprosthetic joint infections

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https://www.readbyqxmd.com/read/29325835/synthetic-mesh-vs-allograft-extensor-mechanism-reconstruction-in-total-knee-arthroplasty-a-systematic-review-of-the-literature-and-meta-analysis
#1
REVIEW
David Shau, Ryan Patton, Suhag Patel, Laura Ward, George Guild
BACKGROUND: Extensor mechanism disruption after total knee arthroplasty (TKA) is a devastating complication. Reconstruction with allograft and synthetic mesh has been described. However, these reports have typically been small case series, and controversy exists with regard to which reconstruction technique is optimal. METHODS: The authors performed a systematic review using PUBMED, MEDLINE, EMBASE, BIOSIS, Clinicaltrials.gov, and Cochrane Database of Systematic Reviews identifying 14 articles meeting inclusion criteria and producing 204 knees for comparison...
January 8, 2018: Knee
https://www.readbyqxmd.com/read/29325724/rheumatoid-arthritis-disease-modifying-agents-and-periprosthetic-joint-infection-what-does-a-joint-surgeon-need-to-know
#2
REVIEW
Mehrnoush H Yeganeh, Michael M Kheir, Alisina Shahi, Javad Parvizi
The incidence of periprosthetic joint infection (PJI) among patients with rheumatoid arthritis (RA) is 1.6× greater than in patients undergoing the same procedure for osteoarthritis. This higher risk "may" be due to the immunosuppressive therapies for RA patients including corticosteroids, such as prednisone, and disease-modifying antirheumatic drugs (DMARDs), such as methotrexate. There is a debate about the role of DMARDs in increasing the incidence of subsequent PJI. Studies show conflicting results, with some demonstrating no significant increase in the rates of PJI and some finding otherwise...
November 23, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29316602/no-evidence-of-increased-infection-risk-with-forced-air-warming-devices-a-systematic-review
#3
Heather S Haeberle, Sergio M Navarro, Linsen T Samuel, Anton Khlopas, Assem A Sultan, Nipun Sodhi, Morad Chughtai, Michael A Mont, Prem N Ramkumar
INTRODUCTION: Forced-air warming devices have been reported to present a potential risk for surgical site infections (SSIs) and periprosthetic joint infections. Due to a lack of consensus, we reviewed the infection risk of forced-air warming devices. MATERIALS AND METHODS: A systematic literature review was performed, evaluating overall infection risk and bacterial load. A total of eight studies reporting outcomes from 1,965 subjects were included. RESULTS AND CONCLUSIONS: There is no current evidence in the orthopaedic literature that forced-air warming devices translate to increased SSIs...
December 22, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29312848/season-of-the-year-influences-infection-rates-following-total-hip-arthroplasty
#4
Samuel Rosas, Alvin C Ong, Leonard T Buller, Karim G Sabeh, Tsun Yee Law, Martin W Roche, Victor H Hernandez
AIM: To research the influence of season of the year on periprosthetic joint infections. METHODS: We conducted a retrospective review of the entire Medicare files from 2005 to 2014. Seasons were classified as spring, summer, fall or winter. Regional variations were accounted for by dividing patients into four geographic regions as per the United States Census Bureau (Northeast, Midwest, West and South). Acute postoperative infection and deep periprosthetic infections within 90 d after surgery were tracked...
December 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/29310922/are-all-periprosthetic-joint-infections-the-same-evaluating-major-vs-minor-criteria
#5
Mitchell R Klement, Ahmed Siddiqi, Justin M Rock, Thorsten M Seyler, Javad Parvizi, Antonia F Chen
BACKGROUND: The diagnosis of periprosthetic joint infection (PJI) can be made when 1 major criterion or 3 of 5 minor criteria are present. However, the outcomes of patients with a major vs minor criteria for diagnosis have not been studied. The objective of this study was to evaluate if a difference in outcome of surgical intervention existed between patients with PJI who were diagnosed with a major criterion or a combination of minor criteria. METHODS: A retrospective chart review identified 277 primary total hip or knee arthroplasty patients who had developed PJI based on the International Consensus Meeting definition...
December 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29305453/synovasure-quick-test-is-not-as-accurate-as-the-laboratory-based-%C3%AE-defensin-immunoassay-a-systematic-review-and-meta-analysis
#6
K Suen, M Keeka, R Ailabouni, P Tran
AIMS: α-defensin is a biomarker which has been described as having a high degree of accuracy in the diagnosis of periprosthetic joint infection (PJI). Current meta-analyses are based on the α-defensin laboratory-based immunoassay rather than the quick on-table lateral flow test kit. This study is the first meta-analysis to compare the accuracy of the α-defensin laboratory-based immunoassay and the lateral flow test kit for the diagnosis of PJI. MATERIALS AND METHODS: A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...
January 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29305426/rapid-detection-of-periprosthetic-joint-infection-using-a-combination-of-16s-rdna-polymerase-chain-reaction-and-lateral-flow-immunoassay-a-pilot-study
#7
V Janz, J Schoon, C Morgenstern, B Preininger, S Reinke, G Duda, A Breitbach, C F Perka, S Geissler
OBJECTIVES: The objective of this study was to develop a test for the rapid (within 25 minutes) intraoperative detection of bacteria from synovial fluid to diagnose periprosthetic joint infection (PJI). METHODS: The 16s rDNA test combines a polymerase chain reaction (PCR) for amplification of 16s rDNA with a lateral flow immunoassay in one fully automated system. The synovial fluid of 77 patients undergoing joint aspiration or primary or revision total hip or knee surgery was prospectively collected...
January 2018: Bone & Joint Research
https://www.readbyqxmd.com/read/29305046/proinflammatory-biomarkers-level-and-functional-genetic-polymorphisms-in-periprosthetic-joint-infection
#8
Bülent Erdemli, Emre Anıl Özbek, Kerem Başarir, Zeynep Ceren Karahan, Duygu Öcal, Derya Biriken
OBJECTIVE: The aims of this study were 1) to identify the level of inflammatory biomarkers interleukin (IL)-1α, IL-1β, IL-6, IL-8, IL-17, C-reactive protein (CRP), granulocyte colony-stimulating factor (GCSF), ferritin, and tumor necrosis factor (TNF)-α in serum and synovial fluid samples of patients who underwent revision arthroplasty surgery; 2) to establish the relationship between serum and synovial fluid levels; 3) to determine if any of the 11 genetic polymorphisms of TNFα, IL-1, IL-6, IL-8, IL-17, and GCSF on the encoding genes was associated with periprosthetic joint infection (PJI)...
January 2, 2018: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/29302137/rethinking-pyogenic-flexor-tenosynovitis-biofilm-formation-treated-in-a-cadaveric-model
#9
Constantinos Ketonis, Noreen J Hickock, Asif M Ilyas
Introduction  Pyogenic flexor tenosynovitis (PFT) of the hand remains a challenging problem that often requires surgical irrigation and parenteral or oral antibiotics. The authors hypothesize that the pathophysiology and microenvironment of PFT can be likened to that of periprosthetic joint infections (PJIs), in which bacteria thrive in a closed synovial space with limited blood supply. As such, they postulate that PFT is also facilitated by bacterial attachment and biofilm formation rendering standard treatments less effective...
December 2017: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/29298271/high-fidelity-point-of-care-diagnostic-test-for-periprosthetic-joint-infection-commentary-on-an-article-by-thorsten-gehrke-md-et-al-the-accuracy-of-the-alpha-defensin-lateral-flow-device-for-diagnosis-of-periprosthetic-joint-infection-comparison-with-a-gold
#10
https://www.readbyqxmd.com/read/29298259/the-accuracy-of-the-alpha-defensin-lateral-flow-device-for-diagnosis-of-periprosthetic-joint-infection-comparison-with-a-gold-standard
#11
Thorsten Gehrke, Christian Lausmann, Mustafa Citak, Tommaso Bonanzinga, Lars Frommelt, Akos Zahar
BACKGROUND: Alpha defensin is a new biomarker that has been shown to have a very high accuracy to rule out periprosthetic joint infection. Recently, a new rapid lateral flow version of the alpha defensin test was developed and introduced to detect high levels of alpha defensin in synovial fluid quickly and with ease. We conducted a single-center prospective clinical study to compare the results of the Synovasure Alpha Defensin Test with those of the Musculoskeletal Infection Society (MSIS) criteria, which are considered to be the gold standard for diagnosing periprosthetic joint infection...
January 3, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29291158/antibiotic-prophylaxis-and-dair-treatment-in-primary-total-hip-and-knee-arthroplasty-a-national-survey-in-the-netherlands
#12
Ewout S Veltman, Dirk Jan F Moojen, Rob Ghh Nelissen, Rudolf W Poolman
BACKGROUND: To prevent postoperative infection the use of systemic antibiotic prophylaxis is common ground. Type of antibiotic used and duration of prophylaxis are subject to debate. In case of suspected early periprosthetic infection a debridement, antibiotics and implant retention (DAIR) procedure is treatment of first choice. This study evaluated the antibiotic prophylaxis and DAIR treatment protocols nationwide as well as reporting of these DAIR procedures to the national joint registry...
2018: Journal of Bone and Joint Infection
https://www.readbyqxmd.com/read/29286958/chronic-nocardia-cyriacigeorgica-periprosthetic-knee-infection-successfully-treated-with-a-two-stage-revision-a-case-report
#13
Michael M Hadeed, J Ryan MacDonell, Ian J Dempsey, Christopher C Moore, James A Browne
CASE: We report the successful treatment of a Nocardia cyriacigeorgica periprosthetic joint infection (PJI) that occurred at the site of a total knee arthroplasty. To our knowledge, this organism has not previously been reported in the literature as a cause of PJI. Given the need for a prolonged duration of treatment for this organism (a minimum of 6 to 12 months), modifications to the standard 2-stage revision were made in consultation with infectious-disease specialists. CONCLUSION: PJI is a devastating complication that leads to substantial patient morbidity and utilization of health-care resources...
October 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29286460/novel-diagnostics-in-revision-arthroplasty-implant-sonication-and-multiplex-polymerase-chain-reaction
#14
Gunnar T R Hischebeth, Sascha Gravius, Johanna K Buhr, Ernst Molitor, Matthias D Wimmer, Achim Hoerauf, Isabelle Bekeredjian-Ding, Thomas M Randau
In orthopedic patients, foreign body-associated infections, especially periprosthetic joint infections (PJIs), are a devastating complication of arthroplasty. Infection requires complex treatment, may result in long hospitalization and causes considerable costs. Multiple surgical revisions can be necessary in these patients, with a loss in function as well as in quality of life. The routine preoperative diagnostics include blood examination for C-reactive protein (CRP) and other biomarkers, as well as joint aspirate analysis for cell count, differentiation, and culture...
December 3, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29286032/-bidirectional-knotless-barbed-sutures-during-primary-total-knee-arthroplasty-effective-solution-or-new-problem
#15
D V Chugaev, N N Kornilov, S A Lasunskii
THE HYPOTHESIS OF THE STUDY: The use of bidirectional knotless barbed sutures for closure of capsule and subcutaneous fat tissue in primary total knee arthroplasty (TKA) is safe and time-saving. MATERIAL AND METHODS: 302 patients with end-stage osteoarthritis scheduled for primary non-complex TKA were randomly divided into two prospective groups: in group I (N=102) the capsule of the knee joint and subcutaneous fat tissues were closed by continuous braided suture while in group II (N=200) by bidirectional knotless barbed sutures...
2017: Khirurgiia
https://www.readbyqxmd.com/read/29277515/complications-with-cement-spacers-in-2-stage-treatment-of-periprosthetic-joint-infection-on-total-hip-replacement
#16
R Erivan, T Lecointe, G Villatte, A Mulliez, S Descamps, S Boisgard
INTRODUCTION: The aim of the present study was to assess our management of infected total hip replacement in indications for 2-stage surgical treatment according to current guidelines when a cement spacer has been used. The study hypothesis was that the complications rate related to cement spacers is low. MATERIAL AND METHOD: A single-center retrospective study included 26 patients receiving a spacer between the two stages of total hip replacement, over a 5 year period...
December 22, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29275901/complications-of-semiconstrained-distal-radioulnar-joint-arthroplasty
#17
Kate D Bellevue, Mary K Thayer, Michael Pouliot, Jerry I Huang, Douglas P Hanel
PURPOSE: The Aptis total distal radioulnar joint (DRUJ) prosthesis is a semiconstrained implant designed for treatment of DRUJ arthritis and instability. The purpose of this study was to analyze short-term complications of this device. METHODS: We performed a retrospective chart review of patients undergoing semiconstrained DRUJ arthroplasty from 2007 to 2015 at a single institution. Records were analyzed for complications and the need for subsequent surgical procedures...
December 22, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29275114/in-hospital-acute-kidney-injury-after-tka-revision-with-placement-of-an-antibiotic-cement-spacer
#18
Zachary P Berliner, Andrew Z Mo, David A Porter, Jamie M Grossman, Matthew S Hepinstall, H John Cooper, Giles R Scuderi
BACKGROUND: There is mounting evidence that treatment of periprosthetic joint infection of the knee with an antibiotic cement spacer (ACS) may increase risk for acute kidney injury (AKI). We sought to determine the incidence, as well as potential risk factors, of in-hospital AKI in this cohort. METHODS: We retrospectively identified 75 patients that received either a static or articulating ACS at a single institution. In-hospital AKI was defined by a more than 50% rise in serum creatinine from preoperative baseline to at least 1...
December 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29273290/risk-factors-and-costs-associated-with-clostridium-difficile-colitis-in-patients-with-prosthetic-joint-infection-undergoing-revision-total-hip-arthroplasty
#19
Ronald E Delanois, Nicole E George, Jennifer I Etcheson, Chukwuweike U Gwam, Jaydev B Mistry, Michael A Mont
BACKGROUND: With the increased demand for primary total hip arthroplasty (THA) and corresponding rise in revision procedures, it is imperative to understand the factors contributing to the development of Clostridium difficile colitis. We aimed to provide a detailed analysis of: (1) the incidence of; (2) the demographics, lengths of stay, and total costs for; and (3) the risk factors and mortality associated with the development of C. difficile colitis after revision THA. METHODS: The National Inpatient Sample database was queried for all individuals diagnosed with a periprosthetic joint infection and who underwent all-component revision THA between 2009 and 2013 (n = 40,876)...
December 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29259853/infection-after-total-knee-arthroplasty-and-its-gold-standard-surgical-treatment-spacers-used-in-two-stage-revision-arthroplasty
#20
REVIEW
Junren Lu, Jing Han, Chi Zhang, Yi Yang, Zhenjun Yao
Periprosthetic joint infection (PJI) is one of the most devastating postoperative complications of total knee arthroplasty (TKA). Treatment varies depending on the type of infection, but two-stage revision arthroplasty using an antibiotic spacer is considered to be the gold standard of treatment. Several types of spacers are available at the moment, each with different benefits and indications, and these spacers may be improved in the future. The primary goals of selecting a given spacer are to locally deliver antibiotics and to preserve soft tissue...
November 2017: Intractable & Rare Diseases Research
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