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Periprosthetic infection

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https://www.readbyqxmd.com/read/28534287/loading-with-vancomycin-does-not-decrease-gentamicin-elution-in-gentamicin-premixed-bone-cement
#1
Sebastian P Boelch, Martin C Jordan, Joerg Arnholdt, Maximilian Rudert, Martin Luedemann, Andre F Steinert
Antibiotic loaded bone cements are used as drug delivery systems for the treatment of periprosthetic joint infections. They can be loaded with antibiotics during industrial component production (premixing) and during cement preparation (manually blending). Although double premixed antibiotic loaded bone cements are available, manually blending of a gentamicin premixed antibiotic loaded bone cement with vancomycin is still popular. We compared in vitro antibiotic elution and compressive strength of 0.5 g gentamicin premixed bone cement (PALACOS® R + G), 0...
July 2017: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/28532409/variation-in-prosthetic-joint-infection-and-treatment-strategies-during-4-5%C3%A2-years-of-follow-up-after-primary-joint-arthroplasty-using-administrative-data-of-41397-patients-across-australian-european-and-united-states-hospitals
#2
Perla J Marang-van de Mheen, Ellie Bragan Turner, Susan Liew, Nora Mutalima, Ton Tran, Sten Rasmussen, Rob G H H Nelissen, Andrew Gordon
BACKGROUND: To identify best practices and quality improvement initiatives, we aimed to assess whether the incidence of Periprosthetic Joint Infection (PJI) and treatment strategies differed across patients treated in Australian, European and United States (US) hospitals. METHODS: Routinely collected administrative data for 41397 patients undergoing a primary total hip or knee arthroplasty between July 2007-December 2010 across 22 hospitals were included. Patients were followed for 2 years looking for PJI occurrence, defined as early (within 4 weeks) and late PJI, and surgical treatment during 2...
May 22, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28529862/therapeutic-use-of-antibiotic-loaded-bone-cement-in-the-treatment-of-hip-and-knee-joint-infections
#3
REVIEW
Konstantinos Anagnostakos
The use of antibiotic-loaded cement spacers is an established method in the management of periprosthetic hip and knee joint infections. Despite inconsistencies among published studies, data shows that infection control rates exceed 90% with two-stage exchange arthroplasty. The present work reviews the current literature about antibiotic-loaded cement spacers and concentrates on the indications for spacer implantation, spacer production details, antibiotic impregnation, pharmacokinetic properties, clinical success, mechanical complications, and systemic safety...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529859/treatment-of-periprosthetic-joint-infection-using-antimicrobials-dilute-povidone-iodine-lavage
#4
REVIEW
John A Ruder, Bryan D Springer
Periprosthetic joint infections (PJI) remain a challenge for the orthopaedic surgeon to treat and remain a leading cause of failure of both primary and revision total joint arthroplasty. Once a PJI develops, surgical treatment is generally indicated and includes an aggressive irrigation and debridement. One component of the irrigation and debridement involves the use of an antiseptic irrigating solution. In primary and revision TJA, dilute povidone-iodine lavage can be performed prior to wound closure. Approximately 17...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529108/a-3-to-18-year-follow-up-of-revision-total-hip-arthroplasty-with-impacted-bone-allografts-and-cemented-lubinus-sp-ii-stem-clinical-radiographic-and-survivorship-analysis-with-comparison-to-the-literature
#5
Hampus Stigbrand, Gösta Ullmark
BACKGROUND: We present the first medium- to long-term follow-up of revision total hip arthroplasty using impaction bone grafting (IBG) combined with the matte and collared Lubinus SP II stem for cases of severe osteolysis and stem loosening. METHODS: Sixty-nine femoral revisions were identified for 67 patients consecutively operated with revision femoral arthroplasty using IBG and a cemented Lubinus SP II stem. The mean age was 69 years (standard deviation, 9.9)...
April 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28526202/capnocytophaga-canimorsus-an-underestimated-cause-of-periprosthetic-joint-infection
#6
Marcel Orth, Patrick Orth, Konstantinos Anagnostakos
BACKGROUND: Periprosthetic joint infection (PJI) is a major clinical problem in orthopedic surgery. Capnocytophaga canimorsus (C. canimorsus) is an unusual and hardly detectable bacterium. A review of the literature indicates that C. canimorsus affects mainly immunocompromised patients. It has not been reported to cause periprosthetic joint infections in immunocompetent patients so far. This case report aims to raise awareness of C. canimorsus in orthopedic surgery with special regard to joint arthroplasty...
May 16, 2017: Knee
https://www.readbyqxmd.com/read/28526023/high-incidence-of-periprosthetic-joint-infection-with-propionibacterium-acnes-after-the-use-of-a-stemless-shoulder-prosthesis-with-metaphyseal-screw-fixation-a-retrospective-cohort-study-of-241-patients-propionibacter-infections-after-eclipse-tsa
#7
Lisa Johansson, Nils P Hailer, Hans Rahme
BACKGROUND: A stemless shoulder prosthesis with humeral metaphyseal screw fixation was introduced in order to save bone-stock and to facilitate reconstruction of biomechanics (Eclipse®). The aim of this study was to analyze whether the risk of infection is different with this implant compared to conventional shoulder prosthesis. METHODS: Two hundred and forty-one patients (54.8% females) were operated with a shoulder arthroplasty and followed for median 2.0 (0...
May 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28524620/clinical-performance-and-survivorship-of-navigated-floating-platform-mobile-bearing-total-knee-arthroplasty-a-minimum-10-year-follow-up
#8
Sang-Min Kim, Jai-Gon Seo, Seung-Jae Lim, Hyung-Tae Lim, Chang-Ho Cho, Young-Wan Moon
BACKGROUND: The purpose of this study is to report the outcome of navigation-assisted cruciate-retaining total knee arthroplasty (TKA) using one type of cemented, second-generation, floating-platform (FP), mobile-bearing system. METHODS: Forty-two patients who underwent cruciate retaining TKAs using e.motion-FP prostheses under navigational guidance were retrospectively reviewed. The preoperative diagnosis was osteoarthritis in all knees except one rheumatoid arthritis...
May 19, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/28522245/pin-site-complications-associated-with-computer-assisted-navigation-in-hip-and-knee-arthroplasty
#9
Eli Kamara, Zachary P Berliner, Matthew S Hepinstall, H John Cooper
BACKGROUND: There has been a great increase in the use of navigation technology in joint arthroplasty. In most types of navigation-assisted surgery, several temporary navigation pins are placed in the patient. Goals of this study are (1) to identify complications and (2) risk factors associated with placement of these pins. METHODS: This is a retrospective cohort study of all navigation-assisted hip and knee arthroplasty performed a single institution over a 3-year period...
April 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28521381/-time-in-the-or-outcome-and-surgeons-experience-the-use-of-patient-matched-instruments-in-arthroplasty-of-the-knee
#10
Christoph Schulze, Cem Kai Inan, Claudia Hacke, Alexander Kaltenborn, André Gutcke
Background Arthrosis of the knee is a common problem in Germany that is often treated with arthroplasty. To support the orthopaedic surgeon, person-matched instruments (PMI) are available from several providers. In this study we investigated the clinical and radiological outcome of the use of the PMI Visionaire(™) (Smith&Nephew). Furthermore, we investigated the influence of operative experience of the orthopaedic surgeon on the clinical and radiological results. Time in the operating room (OR) was identified as a parameter for cost effectiveness even during training to become an orthopaedic surgeon...
May 18, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28516223/two-stage-revision-hip-arthroplasty-in-periprosthetic-joint-infection-comparison-study-with-or-without-the-use-of-a-spacer
#11
Dariusz Marczak, Marek Synder, Marcin Sibiński, Michał Polguj, Julian Dudka, Jacek Kowalczewski
PURPOSE: The aim of this study was to compare two methods of two-stage surgery for PJI (periprosthetic joint infection) after THA (total hip arthroplasty): one with and one without the use of an antibiotic-loaded cement spacer. METHODS: This retrospective study was performed on 99 consecutive patients (99 hips) with a minimum follow-up of 24 months. Patients were divided into two groups: (1) in whom the operation was performed using a spacer, and (2) for whom a spacer was not used...
May 18, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28509828/modular-fluted-tapered-stems-in-aseptic-revision-total-hip-arthroplasty
#12
Matthew P Abdel, Umberto Cottino, Dirk R Larson, Arlen D Hanssen, David G Lewallen, Daniel J Berry
BACKGROUND: Modular fluted tapered stems have become the most commonly employed category of femoral component in revision hip arthroplasty in North America as a result of favorable early results and simplicity of use. Despite wide adoption, the majority of published data are limited to relatively small series with modest follow-up. The goal of the current study was to determine the success rate and factors associated with success, failure, and complications of the use of modular fluted tapered stems in aseptic revision total hip arthroplasties (THAs) in a large patient cohort...
May 17, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28507783/periprosthetic-shoulder-infection-an-overview
#13
REVIEW
Nicolas Bonnevialle, Florence Dauzères, Julien Toulemonde, Fanny Elia, Jean-Michel Laffosse, Pierre Mansat
Periprosthetic shoulder infection (PSI) is rare but potentially devastating. The rate of PSI is increased in cases of revision procedures, reverse shoulder implants and co-morbidities. One specific type of PSI is the occurrence of low-grade infections caused by non-suppurative bacteria such as Propionibacterium acnes or Staphylococcus epidemermidis.Success of treatment depends on micro-organism identification, appropriate surgical procedures and antibiotic administration efficiency. Post-operative early PSI can be treated with simple debridement, while chronic PSI requires a one- or two-stage revision procedure...
April 2017: EFORT Open Rev
https://www.readbyqxmd.com/read/28506674/removal-of-an-infected-hip-arthroplasty-is-a-high-risk-surgery-putting-morbidity-into-context-with-other-major-nonorthopedic-operations
#14
James A Browne, Jourdan M Cancienne, Wendy M Novicoff, Brian C Werner
BACKGROUND: Two-stage revision remains the most common approach to periprosthetic joint infection of total hip arthroplasty (THA) in the United States. The postoperative risks associated with removal of an infected prosthesis and placement of a spacer have not been thoroughly studied. METHODS: Patients who underwent THA implant removal and spacer placement for infection were identified in a large administrative database. Morbidity and mortality rates were assessed for the 90-day postoperative period and readmission rates were assessed at 30 days postoperatively...
April 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28502355/how-to-diagnose-and-treat-infection-in-total-ankle-arthroplasty
#15
REVIEW
Yousef Alrashidi, Ahmed E Galhoum, Martin Wiewiorski, Mario Herrera-Pérez, Raymond Y Hsu, Alexej Barg, Victor Valderrabano
Periprosthetic infection after total ankle arthroplasty (TAA) is a serious complication, often requiring revision surgery, including revision arthroplasty, conversion to ankle arthrodesis, or even amputation. Risk factors for periprosthetic ankle infection include prior surgery at the site of infection, low functional preoperative score, diabetes, and wound healing problems. The clinical presentation of patients with periprosthetic ankle joint infection can be variable and dependent on infection manifestation: acute versus chronic...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28493210/in-search-of-the-optimal-wound-dressing-material-following-total-hip-and-knee-arthroplasty-a-systematic-review-and-meta-analysis
#16
REVIEW
Gaurav Sharma, Sang Wook Lee, Oliver Atanacio, Javad Parvizi, Tae Kyun Kim
BACKGROUND: Various types of dressing materials are available for wound care following hip and knee arthroplasty. However, it is unclear if one material is more beneficial than the others in terms of wound complications and fluid handling capacity. RESEARCH QUESTIONS: We performed a meta-analysis of randomized controlled trials comparing alternative wound dressing materials for the post-operative management of wounds following THA and TKA with respect to (1) incidence of wound complications including infection and (2) fluid handling capacity...
May 11, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28490492/molecular-diagnosis-of-orthopaedic-device-infection-direct-from-sonication-fluid-by-metagenomic-sequencing
#17
Teresa L Street, Nicholas D Sanderson, Bridget L Atkins, Andrew J Brent, Kevin Cole, Dona Foster, Martin A McNally, Sarah Oakley, Leon Peto, Adrian Taylor, Tim E A Peto, Derrick W Crook, David W Eyre
Culture of multiple periprosthetic tissue samples is the current gold-standard for microbiological diagnosis of prosthetic joint infections (PJI). Additional diagnostic information may be obtained through sonication fluid culture of explants. However, current techniques can have relatively low sensitivity, with prior antimicrobial therapy and infection by fastidious organisms influencing results. We assessed if metagenomic sequencing of total DNA extracts obtained direct from sonication fluid can provide an alternative rapid and sensitive tool for diagnosis of PJI...
May 10, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28488254/corr-insights-%C3%A2-sonication-of-arthroplasty-implants-improves-accuracy-of-periprosthetic-joint-infection-cultures
#18
Martin Clauss
No abstract text is available yet for this article.
May 9, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28488017/c-reactive-protein-course-during-the-first-5-days-after-total-knee-arthroplasty-cannot-predict-early-prosthetic-joint-infection
#19
Christoph Windisch, Steffen Brodt, Eric Roehner, Georg Matziolis
INTRODUCTION: Periprosthetic joint infection (PJI) is one of the most devastating major complications after total knee arthroplasty (TKA). The laboratory value C-reactive protein (CRP) is the inflammatory biomarker most suitable for detecting a potential postoperative (p.o.) early infection in orthopaedic surgery. However, on the basis of multiple receiver operating characteristic (ROC) analyses, CRP only has limited sensitivity and specificity. The objective of the present study was to test the hypothesis that, besides the absolute preoperative CRP value, also the absolute postoperative CRP value and its course over the first 5 days after TKA are valid indicators of periprosthetic early infection...
May 9, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28484708/activity-of-fosfomycin-and-daptomycin-containing-bone-cement-on-selected-bacterial-species-being-associated-with-orthopedic-infections
#20
Sigrun Eick, Kevin Hofpeter, Anton Sculean, Claudia Ender, Susann Klimas, Sebastian Vogt, Sandor Nietzsche
The purpose of this study was to determine activity of fosfomycin/gentamicin and daptomycin/gentamicin-containing PMMA bone-cement against Staphylococcus aureus (MRSA, MSSA), Staphylococcus epidermidis, Enterococcus faecium (VRE), and E. coli (ESBL; only fosfomycin). Test specimens of the bone cement were formed and bacteria in two concentrations were added one time or repeatedly up to 96 h. All fosfomycin-containing cement killed ultimately all MSSA, Staphylococcus epidermidis, and E. coli within 24 h; growth of MRSA was suppressed up to 48 h...
2017: BioMed Research International
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