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Periprosthetic infection

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https://www.readbyqxmd.com/read/29137901/impact-of-femoral-stem-design-on-failure-after-anterior-approach-total-hip-arthroplasty
#1
Krishna R Cidambi, Steven L Barnett, Paige R Mallette, Jay J Patel, Nader A Nassif, Robert S Gorab
BACKGROUND: An increased rate of complications related to femoral component failure has been described with less invasive total hip arthroplasty (THA). This study evaluated the incidence of femoral complications associated with the direct anterior approach for THA. METHODS: Retrospective review was performed of the initial 1120 consecutive patients who underwent direct anterior THA by 2 surgeons. RESULTS: A total of 899 patients (80.3%) had a 2-year follow-up (range, 2-8 years)...
November 11, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29132552/intravenous-drug-abuse-is-a-risk-factor-in-the-failure-of-two-stage-treatment-for-infected-total-hip-arthroplasty
#2
Yu-Jie Su, Sung-Yen Lin, Hsuan-Ti Huang, Je-Ken Chang, Chung-Hwan Chen
Reinfection after two-stage revision hip arthroplasty (RHA) is still a complex issue. Only few studies revealed the factors affecting the success rate in the treatment of periprosthetic hip infection (PHI), especially risk factors. A retrospective study was conducted using records of 30 patients underwent two-stage RHA for infected total hip arthroplasty (THA). Treatment was defined as successful if a patient did not need any reoperation or invasive procedure such as image-guided drainage during the two years after reimplantation...
December 2017: Kaohsiung Journal of Medical Sciences
https://www.readbyqxmd.com/read/29130112/infection-risk-assessment-in-patients-undergoing-primary-total-knee-arthroplasty
#3
Lazaros A Poultsides, Georgios K Triantafyllopoulos, Vasileios I Sakellariou, Stavros G Memtsoudis, Thomas P Sculco
PURPOSE: To determine the incidence and to identify potential risk factors for in-hospital and late infections, as well as for deep periprosthetic joint infection (PJI) following TKA. METHODS: We identified 17,959 patients treated with primary TKA between 2000 and 2009. We recorded patient demographics, comorbidities and in-hospital complications. The rates of in-hospital, late, and deep PJIs were determined. Different logistic regression models were built to identify risk factors for each of the above types of infection...
November 12, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29130050/evaluating-the-use-of-serum-inflammatory-markers-for-preoperative-diagnosis-of-infection-in-patients-with-nonunions
#4
Song Wang, Peng Yin, Chenliang Quan, Kamran Khan, Guoqi Wang, Lijuan Wang, Lin Cui, Licheng Zhang, Lihai Zhang, Peifu Tang
Purpose: The aim of this study is to evaluate the effectiveness of laboratory serum tests in the diagnosis of infected nonunion. Methods: Forty-two patients suspected of having infected nonunion were investigated in the study. The serum levels of white blood-cell count (WBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and interleukin-6 (IL-6) were measured. A positive diagnosis of infection was made on the basis of the positive culture results...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29129618/rotating-hinge-implants-for-complex-primary-and-revision-total-knee-arthroplasty
#5
Sean M Kearns, Brian M Culp, Daniel D Bohl, Scott M Sporer, Craig J Della Valle, Brett R Levine
BACKGROUND: Contemporary rotating hinge knee (RHK) prosthesis has shown improved survival rates over earlier generations. However, reports of high complication and mechanical failure rates highlight the need for more clinical outcome data in the complex primary and revision setting. The purpose of this study is to report our results of using a contemporary rotating hinge for complex primary and revision total knee arthroplasty. METHODS: Using a prospectively maintained surgical database, 79 knees in 76 patients who underwent an RHK of a single design for either a complex primary (14 knees) or revision total knee arthroplasty (65 knees) were identified...
October 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29129616/risk-of-periprosthetic-joint-infection-in-patients-with-multiple-arthroplasties
#6
W Parker Abblitt, Emily W Chan, Andrew A Shinar
BACKGROUND: Risk of subsequent periprosthetic joint infection (PJI) in a second prosthetic joint following initial PJI has been shown to be 19%-20%. We sought to identify (1) the risk of developing a second PJI for our patients with multiple prosthetic joints and (2) the effect of bacteremia on development of a subsequent PJI. METHODS: We retrospectively reviewed all patients treated surgically for PJI by a single surgeon from 2003 to 2014. Time between initial and subsequent infection, bacteremia, and risk factors for PJI were identified...
November 9, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29126601/an-international-cross-sectional-survey-of-the-management-of-vancouver-type-b1-periprosthetic-femoral-fractures-around-total-hip-arthroplasties
#7
Brent D Bates, David W Walmsley, Milena R Vicente, Paul R Kuzyk, Aaron Nauth, James P Waddell, Michael D McKee, Emil H Schemitsch
INTRODUCTION: The incidence of periprosthetic femoral fractures around total hip arthroplasties is increasing. Fractures around a stable implant stem (Vancouver type B1) are among the most common of these fractures. Various fixation strategies for Vancouver type B1 periprosthetic fractures have been reported in the literature; however, little high-level evidence exists. This study was designed to determine the current management strategies and opinions among orthopaedic surgeons treating Vancouver type B1 periprosthetic femoral fractures, and to evaluate the need for a large prospective randomized controlled trial for the management of these injuries...
October 26, 2017: Injury
https://www.readbyqxmd.com/read/29119076/are-there-benefits-in-early-diagnosis-of-prosthetic-joint-infection-with-multiplex-polymerase-chain-reaction
#8
Christian Lausmann, Akos Zahar, Mustafa Citak, Julian Brañes, Stefan Schmidl, Lars Frommelt, Thorsten Gehrke, Matthias Gebauer
Purpose Identification of bacteria and susceptibility are fundamental in periprosthetic joint infection (PJI). Especially in the case of systemic inflammatory response syndrome (SIRS) rapid detection of pathogens is essential for proper therapy. Bacterial cultures are time consuming. The polymerase chain reaction (PCR) is a non-culture molecular method and is able to rapidly identify pathogens and their resistance genes. Multiplex PCR (mPCR) can amplify several different DNA sequences simultaneously. The aim of this study was to show the value of mPCR for early diagnosis of PJI...
2017: Journal of bone and joint infection
https://www.readbyqxmd.com/read/29116327/the-effect-of-a-door-alarm-on-operating-room-traffic-during-total-joint-arthroplasty
#9
Scott M Eskildsen, Peter T Moskal, Jeffrey Laux, Daniel J Del Gaizo
Operating room traffic has been implicated in several studies to contribute to the risk of surgical site infections and periprosthetic joint infections. The purpose of this study was to evaluate the effect of a door alarm on operating room traffic during total joint arthroplasty. This prospective cohort study evaluated 100 consecutive primary total hip and knee arthroplasty surgeries performed by a single surgeon. An inconspicuous electronic door counter was placed on the substerile operating room door. Door openings and time left ajar were recorded...
November 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/29114643/analytical-evaluation-of-a-vancomycin-immunoassay-in-synovial-fluid
#10
REVIEW
Francesca Luceri, Fiamma Balboni, Giovanni Balato, Paola Pezzati, Nicoletta Cini, Gianni Virgili, Andrea Baldini
In clinical laboratories performing routine activities, the need to answer the burning clinical question in emerging field may be limited by lack of technology support or assays accessibility. Commercially available methods, although originally validated for specific biological matrices, may be employed for other matrices, following appropriate guidelines such as Clinical and Laboratory Standards Institute (CLSI) EP 19. We investigated the use of a vancomycin assay with synovial fluid samples, in view of a possible employment in vancomycin release study...
June 2017: Joints
https://www.readbyqxmd.com/read/29107499/clinical-outcome-of-massive-endoprostheses-used-for-managing-periprosthetic-joint-infections-of-the-hip-and-knee
#11
Abtin Alvand, George Grammatopoulos, Floris de Vos, Matthew Scarborough, Ben Kendrick, Andrew Price, Roger Gundle, Duncan Whitwell, William Jackson, Adrian Taylor, Christopher L M H Gibbons
BACKGROUND: Endoprosthetic replacement (EPR) is an option for management of massive bone loss resulting from infection around failed lower limb implants. The aim of this study is to determine the mid-term outcome of EPRs performed in the treatment of periprosthetic joint infection (PJI) and infected failed osteosyntheses around the hip and knee joint and identify factors that influence it. METHODS: We retrospectively reviewed all hip and knee EPRs performed between 2007 and 2014 for the management of chronic infection following complex arthroplasty or fracture fixation...
October 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29107493/association-between-body-mass-index-and-thirty-day-complications-after-total-knee-arthroplasty
#12
Jaiben George, Nicolas S Piuzzi, Mitchell Ng, Nipun Sodhi, Anton A Khlopas, Michael A Mont
BACKGROUND: Although previous studies have evaluated the effect of obesity on the outcomes of total knee arthroplasty (TKA), most considered obesity as a binary variable. It is important to compare different weight categories and consider body mass index (BMI) as a continuous variable to understand the effects of obesity across the entire range of BMI. Therefore, the objective of this study is to analyze the effect of BMI on 30-day readmissions and complications after TKA, considering BMI as both a categorical and a continuous variable...
October 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29105554/good-clinical-and-radiographic-outcome-of-cementless-metal-metaphyseal-sleeves-in-total-knee-arthroplasty
#13
Martin Thorsell, Margareta Hedström, Marius C Wick, Rüdiger J Weiss
Background and purpose - The number of revision total knee arthroplasties (TKA) is continuously increasing, leading to a growing need for reliable management of metaphyseal bone loss. We evaluated patients operated with a TKA using metal metaphyseal sleeves for bone defects with a minimum 5-year follow-up. Patients and methods - 37 patients had been operated on. 3 patients died and 3 patients were lost during follow-up. Of the 31 remainders (20 women), 9 had been operated on with a primary TKA and 22 with a revision TKA at the index surgery...
November 6, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/29104837/is-single-stage-revision-safe-following-infected-total-knee-arthroplasty-a-critical-review
#14
REVIEW
Raju Vaishya, Amit Kumar Agarwal, Sudheer K Rawat, Harsh Singh, Vipul Vijay
With the improvement in outcomes and modern prosthesis design, total knee arthroplasty (TKA) has now become a commonly performed surgery. It is postulated that a total of 2-5% of the primary and revision TKA becomes infected every year, requiring a revision procedure which to date is the conventional two-stage revision. The diagnosis and treatment of these periprosthetic infections is a major and challenging task, as it requires precise identification of the pathogen, meticulous debridement, and postoperative rehabilitation...
August 30, 2017: Curēus
https://www.readbyqxmd.com/read/29103812/long-term-results-of-total-elbow-arthroplasty-in-patients-with-hemophilia
#15
Lukas Ernstbrunner, Andreas Hingsammer, Mohamed A Imam, Reto Sutter, Brigit Brand, Dominik C Meyer, Karl Wieser
HYPOTHESIS: It was hypothesized that the long-term survivorship and clinical outcome are reasonable, justifying total elbow arthroplasty (TEA) in patients with end-stage hemophilic arthropathy. METHODS: From 2002 to 2012, 13 primary TEAs (Coonrad-Morrey design) were implanted in 9 consecutive patients with an average age of 55 (range, 39-76) years. Type A hemophilia was diagnosed in 7 patients and type B hemophilia in 2 patients. Clinical and radiographic results of all (11 TEAs) but 1 patient were retrospectively analyzed...
November 3, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29103776/systemic-absorption-of-antibiotics-from-antibiotic-loaded-cement-spacers-for-the-treatment-of-periprosthetic-joint-infection
#16
Adam I Edelstein, Kamil T Okroj, Thea Rogers, Craig J Della Valle, Scott M Sporer
BACKGROUND: Two-stage treatment of periprosthetic joint infections involves placement of high-dose antibiotic-loaded cement spacers (ACSs). Reports of ACS-induced nephrotoxicity have raised concern regarding systemic absorption of antibiotics after ACS placement. We sought to characterize the serum concentrations of antibiotics that occur after ACS placement. METHODS: We performed a prospective study of patients with an infected primary total hip (THA) or knee arthroplasty (TKA) treated with standardized ACSs with vancomycin, gentamicin, and tobramycin...
October 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29103074/diagnostic-accuracy-of-synovial-fluid-blood-markers-and-microbiological-testing-in-chronic-knee-prosthetic-infections
#17
Giovanni Balato, Vincenzo Franceschini, Tiziana Ascione, Alfredo Lamberti, Fiamma Balboni, Andrea Baldini
INTRODUCTION: This retrospective study was undertaken to define cut-off values for synovial fluid (SF) leukocyte count and neutrophil percentage for differentiating aseptic failure and periprosthetic joint infection (PJI) and to evaluate the diagnostic accuracy of blood inflammatory markers, and microbiological testing according to the criteria proposed by the International Consensus Meeting (ICM) of Philadelphia. METHODS: All patients who underwent revision total knee arthroplasty from January 2010 to July 2015 were included: we identified and classified 31 PJIs and 136 aseptic joints...
November 4, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29101982/acr-appropriateness-criteria-%C3%A2-imaging-after%C3%A2-total%C3%A2-knee-arthroplasty
#18
Mary G Hochman, Yulia V Melenevsky, Darlene F Metter, Catherine C Roberts, Jenny T Bencardino, R Carter Cassidy, Michael G Fox, Mark J Kransdorf, Douglas N Mintz, Nehal A Shah, Kirstin M Small, Stacy E Smith, Kathy M Tynus, Barbara N Weissman
Total knee arthroplasty (TKA) is the most commonly performed joint replacement procedure in the United States and annual demand for primary TKA is expected to grow by 673% by 2030. The first part provides an overview of imaging modalities (radiographs, CT, MRI, ultrasound, and various nuclear medicine studies) and discusses their usefulness in the imaging evaluation of TKA. The second part focuses on evidence-based imaging and imaging-guided intervention algorithms for the workup of TKA and its complications, including routine follow-up, component wear, periprosthetic infection, aseptic loosening, granulomas/osteolysis, conventional and rotational instability, periprosthetic fracture, patellar complications, and a variety of periprosthetic soft tissue abnormalities...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29100663/osteosynthesis-of-periprosthetic-type-a-and-b-femoral-fractures-using-an-unlocked-plate-with-integrated-cerclage-cable-and-trochanteric-hook-a-multicenter-retrospective-study-of-45-patients-with-mean-follow-up-of-20-months
#19
B Gavanier, F Houfani, Q Dumoulin, E Bernard, M Mangin, D Mainard
INTRODUCTION: Femoral periprosthetic fracture (FPF) is a frequent complication in dependent elderly persons, with a limited life expectancy. Their management is difficult and the choice between osteosynthesis and prosthesis is still matter of discussion. To date, there is no study on unlocked plate with integrated cerclage cable and trochanteric hook for this indication. The objectives of this study were to analyze fracture healing, complication rate and functional outcome. Our hypothesis is that this technique allows a high rate of consolidation and a return to the previous state in terms of autonomy and place of residence...
October 10, 2017: Injury
https://www.readbyqxmd.com/read/29099890/the-role-of-synovial-cytokines-in-the-diagnosis-of-periprosthetic-joint-infections-current-concepts
#20
Jared M Newman, Jaiben George, Alison K Klika, Wael K Barsoum, Carlos A Higuera
Periprosthetic joint infection (PJI) is a serious and potentially devastating complication of total joint arthroplasty. Accurate diagnosis of PJI is of utmost importance, but differentiating septic from aseptic failed total joint arthroplasty is extremely challenging, and improper management can lead to significant morbidity. The gold standard for PJI diagnosis is based on standardized laboratory and clinical criteria but relies on preoperative and intraoperative findings, which can be unreliable. Given these limitations, research has focused on new methods for diagnosing PJI...
September 2017: American Journal of Orthopedics
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