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Infection knee arthroplasty

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https://www.readbyqxmd.com/read/28109761/survivorship-of-metaphyseal-sleeves-in-revision-total-knee-arthroplasty
#1
Brian P Chalmers, Nicholas M Desy, Mark W Pagnano, Robert T Trousdale, Michael J Taunton
BACKGROUND: Metaphyseal fixation has promising early results in providing component stability and fixation in revision total knee arthroplasty (TKA). However, there are limited studies on midterm results of metaphyseal sleeves. We analyzed complications, rerevisions, and survivorship free of revision for aseptic loosening of metaphyseal sleeves in revision TKA. METHODS: Two hundred eighty patients with 393 metaphyseal sleeves (144 femoral, 249 tibial) implanted during revision TKA from 2006-2014 were reviewed...
December 14, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28091802/increased-risk-of-revision-reoperation-and-implant-constraint-in-tka-after-multiligament-knee-surgery
#2
Steven I Pancio, Paul L Sousa, Aaron J Krych, Matthew P Abdel, Bruce A Levy, Diane L Dahm, Michael J Stuart
BACKGROUND: The risk of major complications and revision arthroplasty after TKA in patients who previously underwent multiligament knee surgery have been poorly characterized. QUESTIONS/PURPOSES: Is multiligament knee surgery before TKA associated with (1) worse implant survival, (2) increased use of TKA design constraint, (3) a greater risk for major complications, and (4) poorer scores for pain and function compared with similar patients receiving TKA for primary osteoarthritis? METHODS: Fifty-nine TKAs were performed at our institution between 1985 and 2014 in 59 patients (36 men, 23 women; mean age, 53 years) with a history of previous multiligament knee surgery (≥ two ligaments)...
January 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28091766/pre-operative-intra-articular-deep-tissue-sampling-with-novel-retrograde-forceps-improves-the-diagnostics-in-periprosthetic-joint-infection
#3
Matthias D Wimmer, Milena M Ploeger, Max J Friedrich, Thomas Hügle, Sascha Gravius, Thomas M Randau
BACKGROUND: Histopathological tissue analysis is a key parameter within the diagnostic algorithm for suspected periprosthetic joint infections (PJIs), conventionally acquired in open surgery. In 2014, Hügle and co-workers introduced novel retrograde forceps for retrograde synovial biopsy with simultaneous fluid aspiration of the knee joint. We hypothesised that tissue samples acquired by retrograde synovial biopsy are equal to intra-operatively acquired deep representative tissue samples regarding bacterial detection and differentiation of periprosthetic infectious membranes...
January 14, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28089469/does-barbed-suture-lower-cost-and-improve-outcome-in-total-knee-arthroplasty-a-randomized-controlled-trial
#4
Vincent W K Chan, Ping-Keung Chan, Kwong-Yuen Chiu, Chun-Hoi Yan, Fu-Yuen Ng
BACKGROUND: Wound closure is key to prevent infection, facilitate immediate rehabilitation, and improve efficiency of total knee arthroplasty (TKA). Continuous knotless suturing with barbed suture can potentially save time and distribute tension more evenly. However, its role in TKA in terms of cost-effectiveness and wound complications is not clear. This study aims at comparing barbed and traditional sutures' wound closure time and cost in primary TKA. METHODS: One hundred nine knees were randomized into either barbed or traditional group...
December 21, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28074774/the-dair-debridement-antibiotics-and-implant-retention-procedure-for-infected-total-knee-replacement-a-literature-review
#5
Sultan Naseer Qasim, Andrew Swann, Robert Ashford
Prosthetic joint infection (PJI) is a devastating complication in total knee arthroplasty (TKA) and third most common cause of revision of TKA with significant morbidity and surgical challenges. Treatment options include non-operative measures with long term antibiotic suppression, debridement and implant retention (DAIR), one- or two-stage revision arthroplasty, arthrodesis and amputation. Implant retention without infection is ideal and DAIR has been reported to have variable success rates depending on patient factors, duration of infection, infecting micro-organisms, choice of procedure, single or multiple debridement procedures, arthroscopic or open, antibiotic choice and duration of antibiotic use...
2017: SICOT-J
https://www.readbyqxmd.com/read/28070650/revision-total-knee-arthroplasty-due-to-bone-cement-and-metal-hypersensitivity
#6
Ioannis P Stathopoulos, Nicolaos Andrianopoulos, Dimitrios Paschaloglou, Ioannis Tsarouchas
INTRODUCTION: Hypersensitivity to implants is a rare complication of total knee arthroplasty (TKA). Metal and, less frequently, bone cement can produce allergic symptomatology that if unresponsive to conservative treatment could lead to revision. MATERIALS AND METHODS: We present the case of a patient with generalized pruritus and metal taste starting during the first postoperative month after TKA. Dermal allergy exams revealed that the patient had hypersensitivity to nickel sulphate and cobalt chloride and bone cement...
January 9, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28070149/outcome-analysis-of-hip-or-knee-arthroplasty-in-patients-with-cirrhotic-liver-disease
#7
Young-Jun Seol, Taek-Rim Yoon, Dong-Hyun Lee, Sun-Ho Lee, Kyung-Soon Park
OBJECTIVE: Present helpful measures to prevent expected complications that occur in patients with liver cirrhosis undergoing arthroplasty. METHODS: 218 patients who underwent hip or knee arthroplasty were included in this study. Prognoses of patients with underlying disease of liver cirrhosis and those without are compared with measures. RESULTS: Patients with liver cirrhosis show an increase in amount of bleeding, hospital stay and infection rate compared to those who do not...
March 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28068306/revision-knee-arthroplasty-in-patients-with-inherited-bleeding-disorders-a-single-center-experience
#8
Andrzej Kotela, Magdalena Wilk-Frańczuk, Piotr Żbikowski, Paweł Łęgosz, Paweł Ambroziak, Ireneusz Kotela
BACKGROUND The results of total knee arthroplasty (TKA) in patients with inherited bleeding disorders (IBDs) are poorer when compared with those in the general population, with a notably higher risk of complications and higher revision rates. Thus, revision procedures are becoming a growing concern in this group of patients. The aim of this study was to evaluate the results of revision TKA in patients with IBD. MATERIAL AND METHODS A retrospective cohort study with longitudinal assessment of hemophilia patients scheduled for revision TKA between January 2010 and September 2015 was performed...
January 9, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28065627/revision-total-hip-and-knee-arthroplasties-after-solid-organ-transplant
#9
Cameron K Ledford, Joseph M Statz, Brian P Chalmers, Kevin I Perry, Arlen D Hanssen, Matthew P Abdel
BACKGROUND: As solid organ transplant (SOT) patients' survival improves, the number undergoing total hip (THA) and total knee arthroplasty (TKA) is increasing. Accordingly, the number of revision procedures in this higher-risk group is also increasing. The goals of this study were to identify the most common failure mechanisms, associated complications, clinical outcomes, and patient survivorship of SOT patients after revision THA or TKA. METHODS: A retrospective review identified 39 revision procedures (30 revision THAs and 9 revision TKAs) completed in 37 SOT patients between 2000 and 2013...
December 11, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28060229/repeat-two-stage-exchange-arthroplasty-for-periprosthetic-knee-infection-is-dependent-on-host-grade
#10
Keith A Fehring, Matthew P Abdel, Matthieu Ollivier, Tad M Mabry, Arlen D Hanssen
BACKGROUND: Two-stage exchange arthroplasty after a previous, failed 2-stage exchange procedure is fraught with difficulties, and there are no clear guidelines for treatment or prognosis given the heterogeneous group of patients in whom this procedure has been performed. The Musculoskeletal Infection Society (MSIS) staging system was developed in an attempt to stratify patients according to infection type, host status, and local soft-tissue status. The purpose of this study was to report the results of 2-stage exchange arthroplasty following a previous, failed 2-stage exchange protocol for periprosthetic knee infection as well as to identify risk factors for failure...
January 4, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28053257/knee-joint-distraction-compared-with-total-knee-arthroplasty-a-randomised-controlled-trial
#11
J A D van der Woude, K Wiegant, R J van Heerwaarden, S Spruijt, P J Emans, S C Mastbergen, F P J G Lafeber
AIMS: Knee joint distraction (KJD) is a relatively new, knee-joint preserving procedure with the goal of delaying total knee arthroplasty (TKA) in young and middle-aged patients. We present a randomised controlled trial comparing the two. PATIENTS AND METHODS: The 60 patients ≤ 65 years with end-stage knee osteoarthritis were randomised to either KJD (n = 20) or TKA (n = 40). Outcomes were assessed at baseline, three, six, nine, and 12 months. In the KJD group, the joint space width (JSW) was radiologically assessed, representing a surrogate marker of cartilage thickness...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28046049/health-care-needs-and-support-for-patients-undergoing-treatment-for-prosthetic-joint-infection-following-hip-or-knee-arthroplasty-a-systematic-review
#12
Setor K Kunutsor, Andrew D Beswick, Tim J Peters, Rachael Gooberman-Hill, Michael R Whitehouse, Ashley W Blom, Andrew J Moore
BACKGROUND: Hip and knee arthroplasty are common interventions for the treatment of joint conditions, most notably osteoarthritis. Although many patients benefit from surgery, approximately 1% of patients develop infection afterwards known as deep prosthetic joint infection (PJI), which often requires further major surgery. OBJECTIVE: To assess support needs of patients undergoing treatment for PJI following hip or knee arthroplasty and to identify and evaluate what interventions are routinely offered to support such patients...
2017: PloS One
https://www.readbyqxmd.com/read/28040399/operative-time-affects-short-term-complications-in-total-joint-arthroplasty
#13
Kyle R Duchman, Andrew J Pugely, Christopher T Martin, Yubo Gao, Nicholas A Bedard, John J Callaghan
BACKGROUND: Increased operative time has been associated with increased complications after total joint arthroplasty (TJA). The purpose of the present study was to investigate the effect of operative time on short-term complications after TJA while also identifying patient and operative factors associated with prolonged operative times. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was queried from 2011-2013 to identify all patients who underwent primary total hip or knee arthroplasty...
December 14, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28032700/management-of-acute-hematogenous-infection-following-total-knee-arthroplasty-a-case-series-of-11-patients
#14
Rui He, Liu Yang, Lin Guo, Hao Chen, Ying Zhang, Dian-Ming Jiang
OBJECTIVE: Acute hematogenous infection is a devastating complication that can occur after total knee arthroplasty (TKA). The best strategies for management of this infection remain controversial. Two-stage revision has been well described as the gold standard for the management of chronic late infections. However, there is a paucity of information presently available on the management and outcomes of patients treated for acute hematogenous infections. The purpose of the present study was to report the outcome of acute hematogenous infections following TKA with the treatment of irrigation, debridement, and retention of the prosthetic components...
November 2016: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28029533/unexplained-pain-post-total-knee-arthroplasty-with-an-oxford-knee-score-%C3%A2-20-at-6-months-predicts-good-2-year-outcome
#15
Renyi Benjamin Seah, Winston Shang Rong Lim, Ngai Nung Lo, Andy Khye Soo Yew, Hwei Chi Chong, Seng Jin Yeo
BACKGROUND: Total knee arthroplasty (TKA) is an effective procedure for end-stage osteoarthritis of the knee. Some patients experience persistent unexplained pain post-TKA despite normal investigations. The purpose of this study is to identify which of these patients are likely to improve without any surgical intervention. We hypothesize that patients with unexplained persistent pain and a poor 6-month Oxford knee score (OKS) post-TKA can improve at 2 years. METHODS: Prospectively collected data for all primary unilateral TKA performed from June 2004 to January 2012 were analyzed to identify which patients with unexplained pain at 6 months will improve at 2 years...
October 4, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28028570/comparable-outcomes-after-total-knee-arthroplasty-in-patients-under-55%C3%A2-years-than-in-older-patients-a-matched-prospective-study-with-minimum-follow-up-of-10%C3%A2-years
#16
Alejandro Lizaur-Utrilla, Daniel Martinez-Mendez, Francisco A Miralles-Muñoz, Luis Marco-Gómez, Fernando A Lopez-Prats
PURPOSE: To compare outcomes after TKA for osteoarthritis between patients younger than 55 years and older patients. METHODS: A cohort of 61 patients aged 55 years or younger was prospectively matched for gender, body mass index and knee function with patients with median age of 66 (range 60-70) years. Clinical evaluation was performed by the Knee Society scores (KSS), reduced Western Ontario and McMasters Universities (WOMAC) and Short-Form 12 (SF12) questionnaires...
December 27, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28027814/outcome-of-total-hip-and-total-knee-revision-arthroplasty-with-minor-infection-criteria-a-retrospective-matched-pair-analysis
#17
Kevin Staats, Paul Kolbitsch, Irene K Sigmund, Gerhard M Hobusch, Johannes Holinka, Reinhard Windhager
BACKGROUND: Although diagnostic modalities for the detection of periprosthetic joint infection have improved, some infectious revision cases may still be diagnosed as aseptic complications. We raised the question whether patients with positive Musculoskeletal Infection Society minor infection criteria differ in their outcome parameters (revision-free survival, revision rate) when compared to patients with "true" aseptic complications. Additionally, we asked whether the indication for revision surgery (eg, loosening) might have an influence on possible outcome discrepancies...
November 19, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28027387/impact-of-smoking-cessation-counseling-prior-to-total-joint-arthroplasty
#18
Sina Akhavan, Long-Co Nguyen, Vanessa Chan, Jamal Saleh, Kevin J Bozic
Perioperative smoking has been linked to surgical complications including poor wound healing, infection, myocardial infarction, prolonged length of stay, need for mechanical ventilation, and death. This study evaluated the effectiveness of preoperative counseling on smoking cessation for patients undergoing elective total joint arthroplasty. Thirty smokers with hip or knee osteoarthritis seeking hip or knee replacement surgery were enrolled prospectively. Interventions included counseling, referrals to smoking cessation programs including the California Smokers' Helpline and the Fontana Tobacco Treatment Program, nicotine replacement therapy (NRT), or instructing patients quit through the "cold turkey" method of abstinence...
December 27, 2016: Orthopedics
https://www.readbyqxmd.com/read/28026737/-bilateral-total-knee-arthroplasty-short-term-results
#19
S Křivánek, M Hrubina, M Chmúrny, M Rovňák, M Melišík, L Nečas
PURPOSE OF THE STUDY Evaluation of short-term functional results in patients undergoing one-stage surgery involving sequential bilateral total knee arthroplasty (TKA) and comparison with the results of patients after unilateral TKA. MATERIAL AND METHODS The group with bilateral TKA consisted of 171 patients with 342 total knee replacements treated between 2009 and 2013. The control group included 50 patients with 50 TKAs operated on in the years 2010 to 2012. The indications to bilateral knee replacement included bilateral gonarthrosis, grade III or more in patients who were in good health and had a stable knee joint with axis deviation up to 20 degrees...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28026726/-intra-articular-application-of-tranexamic-acid-significantly-reduces-blood-loss-and-transfusion-requirement-in-primary-total-knee-arthroplasty
#20
J Lošťák, J Gallo, J Špička, K Langová
PURPOSE OF THE STUDY The aim of this prospective study was to investigate the effect of topical application of tranexamic acid (TXA, Exacyl) on the amount of post-operative blood loss, and blood transfusion requirement in patients undergoing primary total knee arthroplasty (TKA). Attention was paid to early complications potentially associated with TXA administration, such as haematoma, wound exudate, or knee swelling. In addition, the economic benefit of TXA treatment was also taken into account. MATERIAL AND METHODS The study included 238 patients (85 men and 153 women) who underwent primary total knee arthroplasty (TKA) at our department between January 2013 and November 2015...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
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