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Infection knee arthroplasty

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https://www.readbyqxmd.com/read/28645839/antibiotic-prophylaxis-adequacy-in-knee-arthroplasty-and-surgical-wound-infection-prospective-cohort-study
#1
J A Del-Moral-Luque, A Checa-García, Á López-Hualda, M C Villar-Del-Campo, J Martínez-Martín, F J Moreno-Coronas, J Montejo-Sancho, G Rodríguez-Caravaca
OBJECTIVE: Antibiotic prophylaxis is the most suitable tool for preventing surgical wound infection. This study evaluated adequacy of antibiotic prophylaxis in surgery for knee arthroplasty and its effect on surgical site infection. MATERIAL AND METHOD: Prospective cohort study. We assessed the degree of adequacy of antibiotic prophylaxis, the causes of non-adequacy, and the effect of non-adequacy on surgical site infection. Incidence of surgical site infection was studied after a maximum incubation period of a year...
June 20, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28642657/negative-pressure-wound-therapy-in-the-treatment-of-complex-injuries-after-total-knee-arthroplasty
#2
Camilo Partezani Helito, Daniel Kamura Bueno, Pedro Nogueira Giglio, Marcelo Batista Bonadio, José Ricardo Pécora, Marco Kawamura Demange
OBJECTIVE: To present an experience with negative-pressure wound therapy (NPWT) in the treatment of surgical wounds in patients treated for infections after total knee arthroplasty (TKA) with or without dehiscence and prophylaxis in wounds considered at risk of healing problems. METHODS: We prospectively evaluated patients with TKA infection with or without surgical wound dehiscence and patients with risk factors for infection or surgical wound complications treated with Pico((r)) device for NPWT in addition to standard treatment of infection or dehiscence in our institution...
March 2017: Acta Ortopedica Brasileira
https://www.readbyqxmd.com/read/28634096/reconstruction-of-disrupted-extensor-mechanism-after-total-knee-arthroplasty
#3
C T Lim, Derek F Amanatullah, James I Huddleston, Alex H S Harris, Katherine L Hwang, William J Maloney, Stuart B Goodman
BACKGROUND: Disruption of the extensor mechanism after total knee arthroplasty (TKA) is a debilitating complication that results in extension lag, limited range of motion, difficulty in walking, frequent falls, and chronic pain. This study presents the clinical and radiographic results of reconstruction after extensor mechanism disruption in TKA patients. METHODS: Consecutive patients with allograft reconstruction of extensor mechanism after TKA were identified retrospectively from an academic tertiary center for revision TKA...
May 11, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28634095/comparative-effectiveness-and-safety-of-drug-prophylaxis-for-prevention-of-venous-thromboembolism-after-total-knee-arthroplasty
#4
Guy Cafri, Elizabeth W Paxton, Yuexin Chen, Craig T Cheetham, Michael K Gould, Janet Sluggett, Stefano A Bini, Monti Khatod
BACKGROUND: Rates of venous thromboembolism in contemporary studies of primary total knee arthroplasty (TKA) have been reported to be as high as 3.5%. Although drug prophylaxis is effective, the best option among these regimens is not well established. The purpose of this study was to evaluate the comparative effectiveness and safety of aspirin, low-molecular-weight heparin, synthetic pentasaccharide factor Xa inhibitors, and vitamin K antagonist. METHODS: Data were from a US total joint replacement registry, with 30,499 patients receiving unilateral TKA from May 16, 2006, to December 31, 2013...
May 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28633782/factors-predicting-length-of-hospital-stay-and-extended-care-facility-admission-after-hindfoot-arthrodesis-procedures
#5
Jacob Deister, Brian G Cothern, Chad Williams, Andrew W Froehle, Richard T Laughlin
Delayed identification of patients requiring admission to extended care facilities (ECFs) can lead to greater healthcare costs through an increased length of hospital stay (LOHS). Previous studies of hip and knee arthroplasty identified factors associated with a likely discharge to an ECF. These issues have not been extensively studied for major hindfoot procedures. We conducted a retrospective review of 198 cases treated during a 3-year period to identify the risk factors for an extended LOHS and ECF admission after ankle arthrodesis, triple arthrodesis, pantalar arthrodesis, and subtalar arthrodesis...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28629903/recording-adverse-events-following-joint-arthroplasty-financial-implications-and-validation-of-an-adverse-event-assessment-form
#6
Matthew J Lee, Khalid M S Mohamed, John C Kelly, John G Galbraith, John Street, Brian J Lenehan
BACKGROUND: In Ireland, funding of joint arthroplasty procedures has moved to a pay-by-results national tariff system. Typically, adverse clinical events are recorded via retrospective chart-abstraction methods by administrative staff. Missed or undocumented events not only affect the quality of patient care but also may unrealistically skew budgetary decisions that impact fiscal viability of the service. Accurate recording confers clinical benefits and financial transparency. The aim of this study was to compare a prospectively implemented adverse events form with the current national retrospective chart-abstraction method in terms of pay-by-results financial implications...
April 11, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28622842/two-stage-knee-arthrodesis-with-a-modular-intramedullary-nail-due-to-septic-failure-of-revision-total-knee-arthroplasty-with-extensor-mechanism-deficiency
#7
Max J Friedrich, Jan Schmolders, Matthias D Wimmer, Andreas C Strauss, Milena M Ploeger, Dieter C Wirtz, Sascha Gravius, Thomas M Randau
BACKGROUND: Periprosthetic joint infection is a serious complication and reconstruction after failed revision total knee arthroplasty with significant bone loss and compromised soft-tissues can be challenging. Objective of this study was to assess clinical and functional results, implant survival and infection recurrence rates in patients treated with two-stage arthrodesis after failed revision TKA with extensor mechanism deficiencies due to PJI, and to identify the factors that affect outcomes after surgery...
June 13, 2017: Knee
https://www.readbyqxmd.com/read/28620968/clinical-practice-guidelines-incorporating-input-from-a-patient-panel
#8
Susan M Goodman, Amy S Miller, Marat Turgunbaev, Gordon Guyatt, Adolph Yates, Bryan Springer, Jasvinder A Singh
OBJECTIVE: To describe the integral role of a Patient Panel in the development of the 2017 American College of Rheumatology (ACR)/American Association of Hip and Knee Surgeons (AAHKS) clinical practice guideline. METHODS: We convened a Panel of 11 patients with rheumatoid arthritis and juvenile idiopathic arthritis, all of whom had undergone 1 or more arthroplasties, to review the evidence and provide guidance on recommendations for the 2017 ACR/AAHKS guideline to address the perioperative management of antirheumatic medication in patients with rheumatic diseases undergoing elective total hip or total knee arthroplasty...
June 16, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28614237/can-intravenous-steroid-administration-reduce-postoperative-pain-scores-following-total-knee-arthroplasty-a-meta-analysis
#9
Li-Zhi Xing, Li Li, Lan-Ju Zhang
BACKGROUND: The purpose of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to evaluate whether intravenous steroids would result in reduced acute pain and postoperative nausea and vomiting (PONV) among patients undergoing total knee arthroplasty (TKA). METHODS: Electronic databases, including PubMed, Embase, Web of Science, and the Cochrane Library, were searched to identify articles published from database inception to July 2016...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28602763/combined-versus-single-application-of-tranexamic-acid-in-total-knee-and-hip-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#10
REVIEW
M M Peng Zhang, M M Jifeng Li, M M Xiao Wang
OBJECTIVE: To compare the efficacy and safety of the combined application of both intravenous and topical tranexamic acid versus the single use of either application in patients with total knee and hip arthroplasty. METHODS: Potentially relevant studies were identified from electronic databases including Medline, PubMed, Embase, ScienceDirect and the Cochrane Library. Patients undergoing primary total knee and hip arthroplasty were included in our studies, with an experimental group that received combined intravenous and topical application of tranexamic acid and a control group that received a single application of tranexamic acid or normal saline...
June 10, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28598492/use-of-2-octyl-cyanoacrylate-adhesive-and-polyester-mesh-for-wound-closure-in-primary-knee-arthroplasty
#11
Andrew J Holte, Josef N Tofte, Greta J Dahlberg, Nicolas Noiseux
Wound closure in primary knee arthroplasty is important both for surgical success, by minimizing the risk of wound complications and infection, and for patient satisfaction with wound care and cosmesis. This article reports the use of a topical self-adhering, pressure-sensitive polyester mesh combined with 2-octyl cyanoacrylate adhesive for final skin closure of primary knee arthroplasty without external staples or sutures. During a 2.5-year period, 360 consecutive primary knee arthroplasty procedures (321 total knee arthroplasty procedures and 39 partial knee arthroplasty procedures) performed by 1 surgeon at 1 institution were reviewed...
June 9, 2017: Orthopedics
https://www.readbyqxmd.com/read/28594503/two-stage-revision-total-knee-arthroplasty-in-the-setting-of-periprosthetic-knee-infection
#12
Zain Sayeed, Afshin A Anoushiravani, Mouhanad M El-Othmani, Monique C Chambers, William M Mihalko, William A Jiranek, Wayne G Paprosky, Khaled J Saleh
Two-stage revision total knee arthroplasty (TKA) is the standard of care for patients who require a revision procedure for the mangement of a late or chronic periprosthetic knee infection. A careful examination of two-stage revision TKA is warranted as the number of patients who require revision TKA in the United States continues to rise. Surgeons should understand the intricacies involved in two-stage revision TKA, including the indications, procedural variations, and current deliberations on two-stage revision TKA in the literature...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28594502/single-stage-revision-total-knee-arthroplasty-in-the-setting-of-periprosthetic-knee-infection-indications-contraindications-and-postoperative-outcomes
#13
Afshin A Anoushiravani, Zain Sayeed, Mouhanad M El-Othmani, Monique C Chambers, William M Mihalko, William A Jiranek, Wayne G Paprosky, Khaled J Saleh
Single-stage revision total knee arthroplasty has become an increasingly common treatment option for patients with failed knee prostheses. Periprosthetic knee infection is the leading and most devastating cause of revision total knee arthroplasty. Although periprosthetic knee infection has been extensively studied in the orthopaedic literature, the role of single-stage revision total knee arthroplasty for the treatment of periprosthetic knee infection warrants further research. As healthcare reform shifts from a volume-based to a value-based system, it is imperative that orthopaedic surgeons understand the procedural indications, risks, and benefits of single-stage revision total knee arthroplasty...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28594501/prevention-and-diagnosis-of-periprosthetic-knee-infection
#14
Bilal Mahmood, Mouhanad M El-Othmani, William M Mihalko, William A Jiranek, Wayne G Paprosky, Khaled J Saleh
Total knee arthroplasty (TKA) has become an increasingly common treatment option for patients who have debilitating knee arthritis. TKA is a relatively safe and efficient procedure that results in promising outcomes and has a positive effect on a patient's quality of life. More TKAs are being performed annually because the procedure substantially reduces pain and improves functionality; however, as the number of TKAs continues to rise, there is concern for potential complications that may result in prosthetic joint failure...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28592075/-influence-of-tibial-component-slope-on-short-term-clinical-outcome-for-oxford-unicompartmental-knee-arthroplasty
#15
L Y Ma, W S Guo, Q D Zhang
Objective: To investigate the effects of tibial component slope change after microplasty (MP) Oxford unicompartmental knee arthroplasty (UKA) on short-term clinical outcome. Methods: A total of 116 patients(128 UKAs)underwent UKA in Department of Orthopaedic Surgery of China-Japan Friendship Hospital between January 2014 and December 2015 were retrospectively reviewed. Totally 100 patients (108 UKAs) were finally included in the study. There were 31 males and 69 females, aging from 47 to 90 years (mean 67.2 years)...
June 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28592073/-influence-of-patellofemoral-joint-degeneration-on-outcome-of-medial-unicompartmental-knee-arthroplasty
#16
B Y Xu, B C Ji, W T Guo, W B Mu, L Cao
Objective: To evaluate the influence of patellofemoral joint degeneration and pre-operative pain location on the outcome of medial Oxford unicompartmental knee arthroplasty (UKA). Methods: A total of 58 patients (58 knees) with medial Oxford UKA had been performed for medial osteoarthritis from March 2013 to July 2014 in Department of Orthopaedic Surgery at First Teaching Hospital of Xinjiang Medical University were retrospective reviewed. There were 24 males and 34 females, the age from 43 to 87 years with the mean age was 68...
June 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28585995/outcomes-of-primary-total-knee-arthroplasty-in-patients-with-hematopoietic-stem-cell-transplantation
#17
Brian P Chalmers, Cameron K Ledford, Kevin I Perry, Tad M Mabry, Arlen D Hanssen, Matthew P Abdel
Patients who have undergone hematopoietic stem cell transplantation to treat underlying bone marrow pathology represent a unique and potentially high-risk patient population for total knee arthroplasty (TKA). This study retrospectively reviewed 15 TKA procedures performed on 11 patients with a history of hematopoietic stem cell transplantation. The authors analyzed patient survivorship; clinical outcomes, including complications; and implant survivorship. Mean follow-up was 5 years (range, 2-10 years). Patient survivorship free from mortality was 91% (95% confidence interval, 76%-100%) and 55% (95% confidence interval, 25%-85%) at 2 and 5 years, respectively...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28583061/infection-after-total-knee-arthroplasty-by-m-catarrhalis-associated-with-rheumatoid-arthritis-and-dmards-therapy
#18
Perry Evangelista, Gregory Evangelista, Lauren Ogrich
Moraxella catarrhalis is not commonly associated with prosthetic joint infection (PJI). We present the first case of a patient with rheumatoid arthritis on certolizumab, an antitumor necrosis factor therapy, who developed PJI following a total knee replacement.
April 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28579447/are-the-outcomes-of-revision-knee-arthroplasty-for-flexion-instability-the-same-as-for-other-major-failure-mechanisms
#19
Ashok Rajgopal, Taufiq R Panjwani, Arun Rao, Vivek Dahiya
BACKGROUND: Aseptic loosening, infection, and flexion instability have emerged as the leading etiologies for revision after total knee arthroplasty (TKA). Although studies have reported improved outcomes after revision TKA, the relative functional and clinical outcomes of patients revised for flexion instability and other failure etiologies have not been extensively reported. The aim of the study was to compare the functional and patient-reported outcomes of revision TKA for the common failure etiologies...
May 15, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28573549/periprosthetic-joint-infection-is-the-main-cause-of-failure-for-modern-knee-arthroplasty-an-analysis-of-11-134-knees
#20
Chuan Kong Koh, Irene Zeng, Saiprassad Ravi, Mark Zhu, Kelly G Vince, Simon W Young
BACKGROUND: Although large series from national joint registries may accurately reflect indications for revision TKAs, they may lack the granularity to detect the true incidence and relative importance of such indications, especially periprosthetic joint infections (PJI). QUESTIONS/PURPOSES: Using a combination of individual chart review supplemented with New Zealand Joint Registry data, we asked: (1) What is the cumulative incidence of revision TKA? (2) What are the common indications for revising a contemporary primary TKA? (3) Do revision TKA indications differ at various followup times after primary TKA? METHODS: We identified 11,134 primary TKAs performed between 2000 and 2015 in three tertiary referral hospitals...
June 1, 2017: Clinical Orthopaedics and related Research
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