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Infection knee arthroplasty

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https://www.readbyqxmd.com/read/29349982/-effects-of-tranexamic-acid-combined-with-temporary-drain-clamping-on-postoperative-blood-loss-in-total-knee-arthroplasty
#1
Yi-Long Dong, Yue-Nan Qian, Xi-Qiang Zhong, Guang-Jie Shen, Chun-Yuan Cai
OBJECTIVE: To evaluate the efficacy and safety of one dose tranexamic acid combined with temporary drain lamping in primary unilateral total knee arthroplasty. METHODS: Total 160 patients undergoing unilateral primary total knee arthroplasty between January 2012 and December 2013 were randomly divided into four groups(40 cases in each group):group A (the drain was clamped for 2 hours after the operation and the patients received 20 ml physiological saline), group B(the drain was clamped for 2 hours after the operation and the patients received 10 ml tranexamic acid and 10 ml physiological saline), group C (the drain was clamped for 4 hours after the operation and the patients received 20 ml physiological saline) and group D(the drain was clamped for 4 hours after the operation and the patients received 10 ml tranexamic acid and 10 ml physiological saline)...
April 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29343282/investigation-of-perioperative-safety-and-clinical-results-of-one-stage-bilateral-total-knee-arthroplasty-in-selected-low-risk-patients
#2
Hirotaka Mutsuzaki, Arata Watanabe, Tetsuya Komatsuzaki, Tomonori Kinugasa, Kotaro Ikeda
BACKGROUND: An increased perioperative complication rate has been a concern with one-stage bilateral total knee arthroplasty (TKA). The purpose of this study was to retrospectively investigate the perioperative safety and clinical results of one-stage bilateral TKA in selected low-risk patients. METHODS: Sixty-seven patients who received one-stage bilateral TKAs for osteoarthritis who were American Society of Anesthesiology (ASA) class 1 or 2 were included in this study...
January 17, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29342496/-adverse-events-in-the-treatment-of-periprosthetic-fractures-around-the-knee-a-clinical-and-radiological-outcome-analysis
#3
Anna Janine Schreiner, Christoph Gonser, Christoph Ihle, Max Konstantin Zauleck, Tim Klopfer, Fabian Stuby, Ulrich Stöckle, Björn Gunnar Ochs
BACKGROUND: The incidence of periprosthetic fractures associated with total knee arthroplasty (PpFxK) has been reported to be 0.3 - 5.5%. 40% of all cases are related to revision TKA. The most common localisation is the distal femur. Classification is performed according to Rorabeck (RB). RB I - II fractures are usually treated with locked plating and retrograde intramedullary nailing, whereas RB III fractures are an indication for revision arthroplasty using a hinged endoprosthesis...
January 17, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29342065/diagnosis-of-periprosthetic-joint-infection-the-potential-of-next-generation-sequencing
#4
Majd Tarabichi, Noam Shohat, Karan Goswami, Abtin Alvand, Randi Silibovsky, Katherine Belden, Javad Parvizi
BACKGROUND: Next-generation sequencing is a well-established technique for sequencing of DNA and has recently gained attention in many fields of medicine. Our aim was to evaluate the accuracy of next-generation sequencing in identifying the causative organism(s) in patients with periprosthetic joint infection. METHODS: In this prospective study, samples were collected from 65 revision arthroplasties (39 knees and 26 hips) and 17 primary arthroplasties (9 hips and 8 knees)...
January 17, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29338761/is-total-femoral-replacement-for-non-oncologic-and-oncologic-indications-a-safe-procedure-in-limb-preservation-surgery-a-single-center-experience-of-22-cases
#5
Andreas Toepfer, Norbert Harrasser, Isabel Petzschner, Florian Pohlig, Ulrich Lenze, Ludger Gerdesmeyer, Ruediger von Eisenhart-Rothe, Heinrich Mühlhofer, Christian Suren
BACKGROUND: Several surgical options for the reconstruction of massive bone defects have been described and include biologic methods with autografts and allografts, and the use of tumor endoprostheses (total femoral replacement, TFR). Several types of modular TFR are available, but nevertheless unpredictable outcomes and high complication rates have been described from most authors. The present study aims to compare results after TFR performed with modular total femur prosthesis MML (Fa...
January 16, 2018: European Journal of Medical Research
https://www.readbyqxmd.com/read/29332662/a-survivorship-study-of-838-total-elbow-replacements-a-report-from-the-norwegian-arthroplasty-register-1994-2016
#6
Yngvar Krukhaug, Geir Hallan, Eva Dybvik, Stein A Lie, Ove N Furnes
BACKGROUND: The aim of this study was to present the long-term survivorship (20 years) of total elbow arthroplasty (TEA) for a relatively large population and to compare different prosthesis brands and patient subgroups. METHODS: Between 1994 and 2017, a total of 838 primary TEAs were reported to the Norwegian Arthroplasty Register. Implant survival was calculated using the Kaplan-Meier method. Risk differences were examined using Cox regression analyses and exact Cox regression for rare events...
February 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29329883/oxidation-damage-mechanisms-and-reasons-for-revision-of-sequentially-annealed-highly-crosslinked-polyethylene-in-total-knee-arthroplasty
#7
Daniel W MacDonald, Genymphas B Higgs, Antonia F Chen, Arthur L Malkani, Michael A Mont, Steven M Kurtz
BACKGROUND: Sequentially annealed, highly crosslinked polyethylene (HXLPE) has been used clinically in total knee arthroplasty (TKA) for over a decade. However, little is known about the revision reasons; its surface damage mechanisms; or its in vivo oxidative stability relative to conventional polyethylene. We asked whether retrieved HLXPE tibial inserts exhibited: (1) similar revision reasons; (2) improved resistance to surface damage; and (3) improved oxidative stability, when compared with conventional gamma inert sterilized polyethylene inserts...
September 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29325840/early-comparative-outcomes-of-unicompartmental-and-total-knee-arthroplasty-in-severely-obese-patients
#8
Zachary C Lum, David A Crawford, Adolph V Lombardi, Jason M Hurst, Michael J Morris, Joanne B Adams, Keith R Berend
BACKGROUND: Medial unicompartmental knee arthroplasty (UKA) may have advantages over total knee arthroplasty (TKA) in the setting of obesity. There has been no direct comparison between the two cohorts. This study compares outcomes and complications of severely obese patients undergoing medial UKA versus TKA. METHODS: Six hundred and fifty medial UKA and 1300 TKA were performed in patients with BMI >35kg/m2 (mean 41kg/m2) between 2007 and 2012. Pre- and postoperative ROM, Knee Society scores, perioperative factors, complications and reoperations were compared...
January 8, 2018: Knee
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
#9
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/29312854/antibiotic-bone-cement-s-effect-on-infection-rates-in-primary-and-revision-total-knee-arthroplasties
#10
Donald Kleppel, Jacob Stirton, Jiayong Liu, Nabil A Ebraheim
AIM: To compare infection rates in primary and revision total knee arthroplasty (TKA) procedures using antibiotic impregnated bone cement (AIBC) to those rates in procedures not using AIBC. METHODS: A systematic review and meta-analysis was conducted in search for randomized controlled trials/studies (RCTs) pertaining to the field of antibiotic AIBC vs non-AIBC groups in both primary and revision TKA procedures. The primary literature search performed was to identify all RCTs that assessed AIBC in primary and revision TKA procedures...
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
#11
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/29299473/economic-evaluation-of-different-suture-closure-methods-barbed-versus-traditional-interrupted-sutures
#12
REVIEW
Randa K Elmallah, Anton Khlopas, Mhamad Faour, Morad Chughtai, Arthur L Malkani, Peter M Bonutti, Martin Roche, Steven F Harwin, Michael A Mont
Healthcare systems are receiving increasing pressures from payers, such as the Centers for Medicare and Medicaid (CMS), to reduce the costs associated with procedures, and with the implementation of the Affordable Care Act, high costs are addressed through pay-for-performance programs. Thus, multiple areas of total knee arthroplasty (TKA) surgery are under scrutiny, including surgical times, material costs, and the costs of associated complications and readmissions. Suture type has been determined to be a factor that may influence closure times, as well as direct material costs...
December 2017: Annals of Translational Medicine
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
#13
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
#14
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/29288184/leak-study-design-of-a-nationwide-randomised-controlled-trial-to-find-the-best-way-to-treat-wound-leakage-after-primary-hip-and-knee-arthroplasty
#15
Claudia A M Löwik, Frank-Christiaan Wagenaar, Walter van der Weegen, Rudolf W Poolman, Rob G H H Nelissen, Sjoerd K Bulstra, Yvette Pronk, Karin M Vermeulen, Marjan Wouthuyzen-Bakker, Inge van den Akker-Scheek, Martin Stevens, Paul C Jutte
INTRODUCTION: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are highly successful treatment modalities for advanced osteoarthritis. However, prolonged wound leakage after arthroplasty is linked to prosthetic joint infection (PJI), which is a potentially devastating complication. On the one hand, wound leakage is reported as a risk factor for PJI with a leaking wound acting as a porte d'entrée for micro-organisms. On the other hand, prolonged wound leakage can be a symptom of PJI...
December 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/29287060/clinical-outcome-of-total-knee-arthroplasty-performed-using-patient-specific-cutting-guides
#16
Murat Çalbıyık
BACKGROUND Patient-specific instruments have recently gained attention for ensuring the accuracy of osteotomy and correct alignment in total knee arthroplasty (TKA). We aimed to report our experience with TKA performed by using CT-based 3D model of cutting guides in our clinic. MATERIAL AND METHODS A total of 36 patients (mean age, 67.58±8.46 years; 24 females, 12 males) who underwent TKA with 3D patient-specific cutting guides in our clinic were included in the study. Differences between preoperatively planned bone resections and actual bone resections were calculated...
December 29, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29286958/chronic-nocardia-cyriacigeorgica-periprosthetic-knee-infection-successfully-treated-with-a-two-stage-revision-a-case-report
#17
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/29286032/-bidirectional-knotless-barbed-sutures-during-primary-total-knee-arthroplasty-effective-solution-or-new-problem
#18
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/29281992/rapidly-growing-mycobacterial-infection-a-recognized-cause-of-early-onset-prosthetic-joint-infection
#19
Anupop Jitmuang, Varah Yuenyongviwat, Keerati Charoencholvanich, Methee Chayakulkeeree
BACKGROUND: Prosthetic joint infection (PJI) is a major complication of total hip and total knee arthroplasty (THA, TKA). Although mycobacteria are rarely the causative pathogens, it is important to recognize and treat them differently from non-mycobacterial infections. This study aimed to compare the clinical characteristics, associated factors and long-term outcomes of mycobacterial and non-mycobacterial PJI. METHODS: We conducted a retrospective case-control study of patients aged ≥18 years who were diagnosed with PJI of the hip or knee at Siriraj Hospital from January 2000 to December 2012...
December 28, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29274863/total-knee-arthroplasty-with-the-medial-pivot-knee-system-clinical-and-radiological-outcomes-at-9-5-years-mean-follow-up
#20
M Dehl, Y Bulaïd, M Chelli, B Ramy, A Gabrion, E Havet, P Mertl
INTRODUCTION: The "ball-in-socket" design of the Medial-Pivot Knee System (MicroPort Orthopedics, Arlington, Tennessee, USA) aims to reproduce normal knee kinematics by medializing its rotational axis. The goal of this study was to measure knee range of motion (ROM) with this implant after a mean follow-up of 10 years and to report the survivorship and long-term clinical and radiological outcomes. We hypothesized the prosthetic knee would have at least 120 flexion at 10 years. MATERIAL AND METHODS: This was retrospective, single-centre study of 74 Medial-Pivot knees implanted in 71 patients (average age of 69 years) between May 2005 and November 2007...
December 21, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
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