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Infection knee arthroplasty

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https://www.readbyqxmd.com/read/28442852/perioperative-systemic-glucocorticoids-in-total-hip-and-knee-arthroplasty-a-systematic-review-of-outcomes
#1
REVIEW
Jeffrey Hartman, Vickas Khanna, Anthony Habib, Forough Farrokhyar, Muzammil Memon, Anthony Adili
BACKGROUND: Perioperative systemic glucocorticoids are frequently included in multimodal analgesia and antiemetic regimens administered to patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). The objective of this systematic review was to evaluate the available randomized controlled trials (RCTs) to determine the effect of perioperative systemic glucocorticoids on postoperative nausea and vomiting (PONV), pain, narcotic consumption, antiemetic consumption, length of stay in hospital, and major complications in patients undergoing elective THA or TKA...
June 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28442185/modified-frailty-index-is-an-effective-risk-assessment-tool-in-primary-total-knee-arthroplasty
#2
Robert P Runner, Jaime L Bellamy, CatPhuong Cathy L Vu, Greg A Erens, Mara L Schenker, George N Guild
BACKGROUND: "Frailty" is a marker of physiological decline of multiple organ systems, and the frailty index identifies patients who are more susceptible to postoperative complications. The purpose of this study is to validate the modified frailty index (MFI) as a predictor of postoperative complications, reoperations, and readmissions in patients who underwent primary total knee arthroplasty (TKA). METHODS: The American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2014 was queried by the Current Procedural Terminology code for primary TKA (27447)...
March 29, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28437545/union-knee-alignment-and-clinical-outcomes-of-patients-treated-with-autologous-bone-grafting-for-medial-tibial-defects-in-primary-total-knee-arthroplasty
#3
Kunihiro Hosaka, Shu Saito, Teruyasu Oyama, Hirohisa Fujimaki, Eiji Cho, Kanki Ishigaki, Yasuaki Tokuhashi
Autologous bone grafting is an established method to overcome bone deficiencies in primary total knee arthroplasty (TKA). However, recently, metal augments have been used by many surgeons. Although autologous bone grafting is a common technique, few large studies have described its success in achieving bone union in primary TKA. The goal of this study was to evaluate primary TKA with autologous bone grafting for tibial defects. A total of 68 knees that had undergone arthroplasty with autologous bone grafting with more than 1 year of follow-up were evaluated...
April 24, 2017: Orthopedics
https://www.readbyqxmd.com/read/28436379/economic-analysis-of-4221-revisions-due-to-periprosthetic-joint-infection-in-poland
#4
Ireneusz Babiak, Piotr Pędzisz, Jakub Janowicz, Mateusz Kulig, Paweł Małdyk
BACKGROUND: Periprosthetic joint infection (PJI) is one of the most severe complications of total hip (THA) and total knee (TKA) arthroplasty. The aim of the study is to determine the number and type of hip and knee prosthesis revisions in Poland performed due to infection and reimbursement of the cost of septic revisions and to compare the costs of septic and aseptic revisions in Poland and other countries. MATERIAL AND METHODS: The data published for the period 2009-2013 by the National Health Fund (NHF) were analysed and the average cost of septic and aseptic revisions was calculated...
January 26, 2017: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28434697/poor-outcomes-of-irrigation-and-debridement-in-acute-periprosthetic-joint-infection-with-antibiotic-impregnated-calcium-sulfate-beads
#5
Michael A Flierl, Brian M Culp, Kamil T Okroj, Bryan D Springer, Brett R Levine, Craig J Della Valle
BACKGROUND: One proposed strategy to increase the success of irrigation and debridement with implant retention for the treatment of acute periprosthetic joint infection (PJI) is the use of dissolvable antibiotic-impregnated calcium sulfate beads to provide a local depot of antibiotics. The purpose of this study was to evaluate the outcome of such an approach. METHODS: Thirty-two patients with acute hematogenous (18 patients; 1 bilateral) or acute postoperative (14 patients) PJIs who underwent irrigation and debridement with implant retention and addition of antibiotic-impregnated calcium sulfate beads were retrospectively reviewed...
March 29, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28434695/the-influence-of-a-failed-irrigation-and-debridement-on-the-outcomes-of-a-subsequent-2-stage-revision-knee-arthroplasty
#6
Scott R Nodzo, Keely K Boyle, Allina A Nocon, Michael W Henry, David J Mayman, Geoffrey H Westrich
BACKGROUND: Previous work has suggested a failed irrigation and debridement (I&D) before a 2-stage exchange negatively impacts the outcome of the subsequent 2-stage revision. METHODS: This was a retrospective review of 132 patients who underwent a 2-stage exchange without prior I&D (2-Stage), and 45 patients had a failed I&D before their 2-stage exchange (I&D+2Stage) between April 2009 and April 2015. Charts were reviewed for patient demographics, presenting inflammatory laboratory values, type of antibiotic spacer used, surgical details, microbiology data, length of postoperative antibiotic treatment, and reoperation...
March 22, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28420544/disclosing-agents-for-the-intraoperative-identification-of-biofilms-on-orthopedic-implants
#7
Joshua A Parry, Melissa J Karau, Sanjeev Kakar, Arlen D Hanssen, Robin Patel, Matthew P Abdel
BACKGROUND: Disclosing agents are dyes used in dentistry to colorize plaque (biofilm) and may offer a means for intraoperative detection of biofilms on orthopedic implants. Methylene blue (MB) stains biofilm and is safely used in orthopedic applications. Injection of MB into acutely infected prosthetic knees before debridement may enable visualization of biofilm, which could influence treatment decisions. The aims of this study were to determine if MB could be used to visualize biofilm on total knee arthroplasty (TKA) implants and to determine if MB staining has an antimicrobial effect that might interfere with subsequent culture...
March 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28418574/inadequacy-of-joint-aspiration-for-detection-of-persistent-periprosthetic-infection-during-two-stage-septic-revision-knee-surgery
#8
Bernd Preininger, Viktor Janz, Philipp von Roth, Andrej Trampuz, Carsten F Perka, Tilman Pfitzner
Despite the lack of validation, synovial aspiration remains a common practice during 2-stage septic revision total knee arthroplasty (TKA). The goal of this study was to investigate the diagnostic validity of synovial polymethylmethacrylate (PMMA) spacer aspiration of temporary knee arthrodesis to detect persistent periprosthetic joint infection before TKA reimplantation. This retrospective cohort study included 73 consecutive patients who underwent 2-stage septic revision TKA according to a standard protocol...
April 18, 2017: Orthopedics
https://www.readbyqxmd.com/read/28416968/safety-and-efficacy-of-resistive-polymer-versus-forced-air-warming-in-total-joint-surgery
#9
Melanie F Sandoval, Paul D Mongan, Michael R Dayton, Craig A Hogan
BACKGROUND: Forced-air warming is used as a mechanism to prevent hypothermia and adverse outcomes associated with hypothermia among patients undergoing surgery. Patient safety in healthcare includes the use of devices and technology that minimize potential adverse events to patients. The present study sought to compare the capabilities of patient warming between two different devices that use different mechanisms of warming: forced-air warming and non-air warming. METHODS: One hundred twenty patients undergoing total hip or total knee arthroplasty received patient warming via a forced warming device or non-air warming fabric conductive material...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28416830/-analysis-on-the-causes-of-unscheduled-suspensions-of-knee-and-hip-arthroplasty
#10
Y Li, Z J Li, K Zhang, H Tian, Y Q Liu, H Cai, F Li, M W Zhao
OBJECTIVE: To analyze and summarize the causes of unscheduled suspension of knee and hip arthroplasty and to provide the method for optimizing the patient's preoperative management and improving the efficiency of medical resources as well as the patient's satisfaction. METHODS: The data for this report was retrospectively collected from September 2013 to August 2014 in our hospital, from cases of knee and hip arthroplasty that were suspended before the scheduled operation time...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28411549/stability-of-knee-ligament-complex-of-thiel-embalmed-cadaver-compared-to-in-vivo-knee
#11
Florian Völlner, Ulrike Pilsl, Benjamin Craiovan, Florian Zeman, Michael Schneider, Michael Wörner, Joachim Grifka, Markus Weber
BACKGROUND: The first biomechanical evaluation of new implants is usually carried out with cadavers. Fixation of Thiel-embalmed cadavers is supposed to preserve the histological structure, colour and consistency of the tissue and has a low risk of infection and toxicity. However, the biomechanical properties of Thiel-fixated tissue are still unknown. The aim of this study was to quantify the effect of the Thiel-embalming method on the elastic properties of the ligament complex of the knee compared to in vivo knees during total knee arthroplasty...
April 7, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28396931/does-low-constraint-mobile-bearing-knee-prosthesis-give-satisfactory-results-for-severe-coronal-deformities-a-five-to-twelve-year-follow-up-study
#12
Jaroslaw Czekaj, Camdon Fary, Thierry Gaillard, Sebastien Lustig
PURPOSE: Severe varus and valgus knee deformities traditionally are replaced with constrained implants, with a number of disadvantages. We present our results in this challenging group using a low constraint deep-dish mobile bearing implant design. METHODS: One hundred fifty-four patients (170 arthroplasties) who underwent primary TKA using a deep-dish, mobile bearing posterior-stabilized implant for severe varus (HKA < 170°) or valgus (HKA > 190°) deformity between 2004 and 2009 were evaluated at a mean of 6...
April 11, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28395370/intra-articular-tranexamic-acid-in-primary-total-knee-arthroplasty-meta-analysis
#13
Joseph T Moskal, Susan G Capps
Total knee arthroplasty (TKA) is associated with an increased need for blood transfusions and thus an increase in risks associated with blood transfusion such as transfusion reactions, infections, fluid overload, and altered mental status. Tranexamic acid (TXA) is an antifibrinolytic medication that can reduce perioperative blood loss in TKA. However, the best method of delivery has not been defined although topical intra-articular TXA (IA-TXA) may have a theoretical advantage as it is applied directly when and where it is needed to control bleeding...
April 10, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28390887/single-stage-revision-arthroplasty-for-infection-an-underutilized-treatment-strategy
#14
Jonathan J Negus, Peter B Gifford, Fares S Haddad
BACKGROUND: The burden of revision arthroplasty surgery for infection is rising as the rate of primary arthroplasty surgery increases. Infected arthroplasty rates are now relatively low, but the sheer increase in volume is leading to considerable patient morbidity and significant increases in costs to the health care system. Single-stage revision for infection is one of the several accepted treatment options, but the indications and results are debated. This review aims to clarify the current evidence...
March 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28390886/epidemiology-and-antibiotic-resistance-of-late-prosthetic-knee-and-hip-infections
#15
Lorenzo Drago, Elena De Vecchi, Monica Bortolin, Luigi Zagra, Carlo L Romanò, Laura Cappelletti
BACKGROUND: Prosthetic joint infections (PJI) are still a major complication of hip and knee arthroplasties. Identification of the causative pathogens and knowledge of their antibiotic susceptibilities are essential for the management of these infections. The main purpose of the study was to identify and compare the causative bacteria of prosthetic knee and hip joint infections in a reference Italian orthopedic center and to characterize antibiotic resistance profiles of bacteria involved...
March 15, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28389759/risk-factors-for-amputation-in-periprosthetic-knee-infection
#16
Alan Giovanni Polanco-Armenta, Adrián Miguel-Pérez, Adrián Huetzemani Rivera-Villa, Manuel Ignacio Barrera-García, María Guadalupe Sánchez-Prado, Alberto Vázquez-Noya, Fernando Vidal-Cervantes, José de Jesús Guerra-Jasso, José Manuel Pérez-Atanasio
Treatment for prosthetic knee replacement is becoming more common. Infection is an arthroplasty-related complication leading to prolonged hospitalization, multiple surgical procedures, permanent loss of the implant, impaired function, impaired quality of life and even amputation of the limb. Previous studies have evaluated the risk factors associated with periprosthetic knee infection, but scarce information related to risk factors associated with amputation in this group of patients is available. The purpose of this study was to identify risk factors for amputation in periprosthetic infected knee through a case-control study, analyzing patients treated from January 2012 to November 2016 in a hospital with a high incidence of this diagnosis...
April 7, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28378008/surgical-site-infection-and-transfusion-rates-are-higher-in-underweight-total-knee-arthroplasty-patients
#17
Jorge Manrique, Antonia F Chen, Miguel M Gomez, Mitchell G Maltenfort, William J Hozack
BACKGROUND: Underweight (UW) patients undergoing total hip arthroplasty have exhibited higher complication rates, including infection and transfusion. No study to our knowledge has evaluated UW total knee arthroplasty (TKA) patients. We, therefore, conducted a study to investigate if these patients are at increased risk for complications, including infection and transfusion. METHODS: A case-control study was conducted using a prospectively collected institutional database...
March 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28372917/fewer-complications-following-revision-hip-and-knee-arthroplasty-in-patients-with-normal-vitamin-d-levels
#18
Sophia A Traven, Alexander M Chiaramonti, William R Barfield, Patricia A Kirkland, Harry A Demos, Harold D Schutte, Jacob M Drew
BACKGROUND: Surgeons and hospitals increasingly face penalty for complications and readmission following total joint arthroplasty; therefore, optimization of modifiable risk factors is paramount. Literature associates low vitamin D with risk of periprosthetic joint infection, and we hypothesized low vitamin D to be predictive of increased rate of complications and readmissions. METHODS: A retrospective review of 126 revision total joint arthroplasty patients between 2010 and 2014 was performed...
March 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28366313/short-to-midterm-outcomes-of-revision-total-knee-arthroplasty-patients-with-a-total-stabilizer-knee-system
#19
Chukwuweike U Gwam, Morad Chughtai, Anton Khlopas, Nequesha Mohamed, Randa K Elmallah, Arthur L Malkani, Michael A Mont
BACKGROUND: Revision total knee arthroplasty (TKA) can often be challenging. The use of a new revision system may aid in providing better stability, improved function, fit, and implant longevity. Therefore, we assessed: (1) survivorship, (2) clinical outcomes, (3) postoperative complications, and (4) radiographic outcomes of patients who underwent revision TKA using this system. METHODS: Patients from 2 hospitals who underwent revision TKA using a newer generation revision knee system between June 2008 and December 2013 for component instability or aseptic loosening were included...
March 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28366312/impact-of-gender-on-30-day-complications-after-primary-total-joint-arthroplasty
#20
Jonathan Robinson, John I Shin, James E Dowdell, Calin S Moucha, Darwin D Chen
BACKGROUND: Impact of gender on 30-day complications has been investigated in other surgical procedures but has not yet been studied in total hip arthroplasty (THA) or total knee arthroplasty (TKA). METHODS: Patients who received THA or TKA from 2012 to 2014 were identified in the National Surgical Quality Improvement Program database. Patients were divided into 2 groups based on gender. Bivariate and multivariate analyses were performed to assess associations between gender and patient factors and complications after THA or TKA and to assess whether gender was an independent risk factor...
March 10, 2017: Journal of Arthroplasty
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