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Periprosthetic infection

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https://www.readbyqxmd.com/read/28932957/fluoroscopy-vs-ultrasound-guided-aspiration-techniques-in-the-management-of-periprosthetic-joint-infection-which-is-the-best
#1
Filippo Randelli, Marco Brioschi, Pietro Randelli, Federico Ambrogi, Silvana Sdao, Alberto Aliprandi
BACKGROUND: Fluid samples obtained from an affected joint still play a central role in the diagnosis of periprosthetic joint infection (PJI). It is the only preoperative test able to discover the causative microbiological agent. In the hip, fluid aspiration can be performed through fluoroscopy, ultrasound, or, less commonly, computed tomography. However, there is still a lack of consensus on which method is preferable in terms of efficacy and costbenefit. PURPOSES: We, therefore, asked whether (1) the benefits in terms of sensitivity and specificity and (2) the costs were comparable between fluoroscopy- and ultrasound-guided joint aspirations in a suspicious of hip PJI...
September 20, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28926381/total-elbow-arthroplasty-for-distal-humeral-fractures-a-ten-year-minimum-follow-up-study
#2
Raul Barco, Philipp N Streubel, Bernard F Morrey, Joaquin Sanchez-Sotelo
BACKGROUND: Total elbow arthroplasty is commonly considered for elderly patients with comminuted distal humeral fractures. Satisfactory short-term outcomes have been reported, but long-term outcomes are unknown. Our purpose was to assess the long-term outcomes of total elbow arthroplasty after distal humeral fracture and to determine differences between elbows with or without inflammatory arthritis at the time of fracture. METHODS: Forty-four total elbow arthroplasties were performed after distal humeral fracture; those patients were followed for a minimum of 10 years and were evaluated with regard to pain, motion, Mayo Elbow Performance Scores, complications, and reoperations...
September 20, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28913404/esr-and-crp-are-useful-between-stages-of-2-stage-revision-for-periprosthetic-joint-infection
#3
Christopher P Lindsay, Christopher W Olcott, Daniel J Del Gaizo
BACKGROUND: Serum erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are important tests in the initial diagnosis of periprosthetic joint infection. Many surgeons also use these tests to determine if infection has resolved between stages of a 2-stage procedure, but little data exist regarding this practice. METHODS: A retrospective review of our institutional total joint databases was conducted to determine sensitivity, specificity, and predictive values of elevated ESR and/or CRP to diagnose persistent infection between stages...
September 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28912417/comparison-of-leukocyte-esterase-testing-of-synovial-fluid-with-synovial-histology-for-the-diagnosis-of-periprosthetic-joint-infection
#4
Rui Li, Xiang Li, Baozhan Yu, Xin Li, Xinggui Song, Heng Li, Chi Xu, Jiying Chen
BACKGROUND Periprosthetic joint infection (PJI) is a complication of total joint arthroplasty (TJA). The leukocyte esterase (LE) strip test and histology are diagnostic methods for PJI. The aims of this study were to determine the sensitivity and specificity of the LE strip test and to compare it with histology in the diagnosis of PJI. MATERIAL AND METHODS Between January and December 2015, 93 patients who underwent TJA with PJI were enrolled in the study. Synovial fluid samples were tested with an LE strip, and three synovial tissue samples from each patient underwent frozen section and formalin-fixed histology...
September 15, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28911945/long-term-follow-up-and-survivorship-of-single-radius-posterior-stabilized-total-knee-arthroplasty
#5
Moon Jong Chang, Sangyeon So, Chan-Deok Park, Jai Gon Seo, Young-Wan Moon
BACKGROUND: We sought to determine the 10-year survivorship of single-radius, posterior-stabilized total knee arthroplasty (TKA) in Asian patients. We also aimed to determine whether the long-term clinical and radiographic results differed between patients with and without patellar resurfacing. METHODS: This retrospective study included 148 (115 patients) consecutive single-radius, posterior-stabilized TKAs. Ten-year survivorship analysis was performed using the Kaplan-Meier method with additional surgery for any reason as the end-point...
September 11, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28900737/the-benefit-of-the-systematic-revision-of-the-acetabular-implant-in-favor-of-a-dual-mobility-articulation-during-the-treatment-of-periprosthetic-fractures-of-the-femur-a-49-cases-prospective-comparative-study
#6
A Perrin, M Saab, S Putman, K Benad, E Drumez, C Chantelot
INTRODUCTION: The SOFCOT symposium (2005) on periprosthetic fractures of the femur (PFFs) highlighted a high rate of dislocation (15.6% at 6 months) after change of prosthesis. So far, no study has ever proved the benefit of dual-mobility articulation during PFFs revisions. We conducted a comparative study on two prospective cohorts in order to (1) assess the influence of systematic acetabular revision in favor of a double mobility on dislocation rate (2) and in order to evaluate the rate of morbidity associated with this extra surgical procedure...
September 12, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28899592/the-american-college-of-surgeons-national-surgical-quality-improvement-program-surgical-risk-calculator-has-a-role-in-predicting-discharge-to-post-acute-care-in-total-joint-arthroplasty
#7
Daniel E Goltz, Billy T Baumgartner, Cary S Politzer, Marcus DiLallo, Michael P Bolognesi, Thorsten M Seyler
BACKGROUND: Patient demand and increasing cost awareness have led to the creation of surgical risk calculators that attempt to predict the likelihood of adverse events and to facilitate risk mitigation. The American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator is an online tool available for a wide variety of surgical procedures, and has not yet been fully evaluated in total joint arthroplasty. METHODS: A single-center, retrospective review was performed on 909 patients receiving a unilateral primary total knee (496) or hip (413) arthroplasty between January 2012 and December 2014...
August 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28894690/management-of-asymptomatic-bacteriuria-urinary-catheters-and-symptomatic-urinary-tract-infections-in-patients-undergoing-surgery-for-joint-replacement-a-position-paper-of-the-expert-group-infection-of-swissorthopaedics
#8
REVIEW
Parham Sendi, Olivier Borens, Peter Wahl, Martin Clauss, Ilker Uçkay
In this position paper, we review definitions related to this subject and the corresponding literature. Our recommendations include the following statements. Asymptomatic bacteriuria, asymptomatic leukocyturia, urine discolouration, odd smell or positive nitrite sediments are not an indication for antimicrobial treatment. Antimicrobial treatment of asymptomatic bacteriuria does not prevent periprosthetic joint infection, but is associated with adverse events, costs and antibiotic resistance development. Urine analyses or urine cultures in asymptomatic patients undergoing orthopaedic implants should be avoided...
2017: Journal of bone and joint infection
https://www.readbyqxmd.com/read/28875344/sweet-s-syndrome-a-clinical-entity-need-to-discriminate-against-acute-haematogenous-periprosthetic-joint-infection
#9
Ju Hong Lee, Ki Bum Kim, Ju Rang Lee, Myougn Ja Chung, Sung Il Wang
Sweet's syndrome (SS) or acute febrile neutrophilic dermatosis is an uncommon condition. It is characterized by fever, polymorphonuclear leukocytosis, painful erythematous cutaneous plaques, and dense dermal infiltrate of neutrophils without vasculitis at the site of skin lesions. Lesions in SS might enlarge and coalesce with increasing dermal oedema, resulting in pseudo-vesicular appearance mimicking joint infections. Here, a rare case of SS mimicking acute haematogenous periprosthetic infection in a 74-year-old woman with a history of total knee arthroplasty is reported...
September 5, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28873059/traction-assisted-internal-negative-pressure-wound-therapy-with-bridging-retention-sutures-to-facilitate-staged-closure-of-high-risk-wounds-under-tension
#10
Michael V DeFazio, James M Economides, Ersilia L Anghel, Ryan K Mathis, John R Barbour, Christopher E Attinger
BACKGROUND/OBJECTIVE: Loss of domain often complicates attempts at delayed wound closure in regions of high tension. Wound temporization with traction-assisted internal negative pressure wound therapy (NPWT), using bridging retention sutures, can minimize the effects of edema and elastic recoil that contribute to progressive tissue retraction over time. The investigators evaluated the safety and efficacy of this technique for complex wound closure. MATERIALS AND METHODS: Between May 2015 and November 2015, 18 consecutive patients underwent staged reconstruction of complex and/or contaminated soft tissue defects utilizing either conventional NPWT or modified NPWT with instillation and continuous dermatotraction via bridging retention sutures...
July 26, 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28872523/serum-d-dimer-test-is-promising-for-the-diagnosis-of-periprosthetic-joint-infection-and-timing-of-reimplantation
#11
Alisina Shahi, Michael M Kheir, Majd Tarabichi, Hamid R S Hosseinzadeh, Timothy L Tan, Javad Parvizi
BACKGROUND: Despite the availability of a battery of tests, the diagnosis of periprosthetic joint infection (PJI) continues to be challenging. Serum D-dimer assessment is a widely available test that detects fibrinolytic activities that occur during infection. We hypothesized that patients with PJI may have a high level of circulating D-dimer and that the presence of a high level of serum D-dimer may be a sign of persistent infection in patients awaiting reimplantation. METHODS: This prospective study was initiated to enroll patients undergoing primary and revision arthroplasty...
September 6, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28871407/in-vitro-antimicrobial-susceptibility-testing-methods-agar-dilution-to-3d-tissue-engineered-models
#12
REVIEW
A Schumacher, T Vranken, A Malhotra, J J C Arts, P Habibovic
In the field of orthopaedic surgery, bacterial invasion of implants and the resulting periprosthetic infections are a common and unresolved problem. Antimicrobial susceptibility testing methods help to define the optimal treatment and identify antimicrobial resistance. This review discusses proven gold-standard techniques and recently developed models for antimicrobial susceptibility testing, while also providing a future outlook. Conventional, gold-standard methods, such as broth microdilution, are still widely applied in clinical settings...
September 4, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28869114/multidrug-resistant-organisms-in-the-setting-of-periprosthetic-joint-infection-diagnosis-prevention-and-treatment
#13
REVIEW
Matthew P Siljander, Ali H Sobh, Kevin C Baker, Erin A Baker, Lige M Kaplan
BACKGROUND: Periprosthetic joint infection (PJI) is a rare yet challenging problem in total hip and knee arthroplasties. The management of PJI remains difficult primarily due to the evolution of resistance by the infecting organisms. METHODS: This review profiles acquired mechanisms of bacterial resistance and summarizes established and emerging techniques in PJI diagnosis, prevention, and treatment. RESULTS: New techniques in PJI diagnosis and prevention continue to be explored...
August 3, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28865964/routine-cultures-for-seemingly-aseptic-revision-shoulder-arthroplasty-are-they-necessary
#14
REVIEW
Tyler J Brolin, Daniel J Hackett, Joseph A Abboud, Jason E Hsu, Surena Namdari
Propionibacterium acnes has recently gained attention as the leading cause of periprosthetic joint infections (PJIs) after shoulder arthroplasty. Unlike PJIs in the lower extremity, PJIs after shoulder arthroplasty usually have an indolent course and are notoriously difficult to diagnose. Most of the time, the diagnosis is made after positive intraoperative cultures are taken at the time of revision surgery. Adding even more complexity to the diagnosis is the high rate of P acnes-positive cultures taken at the time of primary shoulder surgery...
August 30, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28865425/silver-coated-modular-megaendoprostheses-in-salvage-revision-arthroplasty-after-periimplant-infection-with-extensive-bone-loss-a-pilot-study-of-34-patients
#15
Dirk Zajonz, Undine Birke, Mohamed Ghanem, Torsten Prietzel, Christoph Josten, Andreas Roth, Johannes K M Fakler
BACKGROUND: Hip and knee replacements in patients with bone defects after infection correlates with high rates of reinfection. In this vulnerable patient population, the prevention of reinfection is to be considered superordinate to the functionality and defect bridging. The use of silver coating of aseptic implants as an infection prophylaxis is already proven; however, the significance of these coatings in septic reimplantation of large implants is still not sufficiently investigated...
September 2, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28859063/bmi-is-a-key-risk-factor-for-early-periprosthetic-joint-infection-following-total-hip-and-knee-arthroplasty
#16
Patrick Jung, Arthur J Morris, Mark Zhu, Sally A Roberts, Chris Frampton, Simon W Young
AIM: To identify patient and surgical risk factors that are associated with periprosthetic joint infection (PJI), especially whether obesity is a risk factor following total hip arthroplasty (THA) and total knee arthroplasty (TKA). METHODS: New Zealand Surgical Site Infection Improvement Programme data was analysed using deep infection within 90 days of the index procedure as the outcome. This was tested against surgical and patient factors for statistical associations in a multivariate model...
September 1, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28854762/efficacy-of-open-debridement-and-polyethylene-exchange-in-strictly-selected-patients-with-infection-after-total-knee-arthroplasty
#17
Whee Sung Son, Oog-Jin Shon, Dong-Chul Lee, Sang-Jin Park, Han Seok Yang
Purpose: To assess the efficacy of open debridement and polyethylene exchange (ODPE) combined with proper antibiotic therapy in strictly selected patients with infection after total knee arthroplasty (TKA) and analyze factors associated with treatment failure. Materials and Methods: From January 2010 to January 2014, 25 cases that underwent ODPE under the diagnosis of infection within four weeks after TKA or acute hematogenous infection within five days of symptom onset were reviewed in this study...
September 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28854760/a-review-of-the-literature-on-culture-negative-periprosthetic-joint-infection-epidemiology-diagnosis-and-treatment
#18
REVIEW
Hong-Kwon Yoon, Seong-Hee Cho, Dong-Yeong Lee, Byeong-Hun Kang, Sang-Hyuk Lee, Dong-Gyu Moon, Dong-Hee Kim, Dae-Cheol Nam, Sun-Chul Hwang
Purpose: The prevalence of periprosthetic joint infection (PJI) has increased with the increasing incidence of arthroplasty surgery. Considering identification of causative microorganisms is crucial for treatment of PJI, culture-negative (CN) PJI is a significant clinical issue. The purpose of the present study is to describe epidemiology, diagnosis and treatment of CN PJI based on review of the literature to help prevent delayed diagnosis and improve clinical outcomes of CN PJI. Methods: MEDLINE, EMBASE, Cochrane Library and Scopus databases were searched for articles on CN PJI...
September 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28852333/perioperative-considerations-when-treating-isolated-periprosthetic-distal-femur-fractures
#19
Michael S Reich, Mindy Duong, Mary A Breslin, Mai P Nguyen, Heather A Vallier
BACKGROUND: Periprosthetic distal femur (PPDF) fractures occur most frequently via low energy mechanisms in elderly patients. This population is often frail and ill-suited to the physiologic burden of trauma and surgery. Here, we describe the perioperative and early hospital course for patients with PPDF fractures, and identify risk factors for poor outcomes. METHODS: Consecutive patients with isolated PPDF fractures from 2005 - 2015 were treated operatively at a Level I trauma center...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28844629/total-hip-arthroplasty-after-in-situ-fixation-of-minimally-displaced-femoral-neck-fractures-in-elderly-patients
#20
Nicholas M Hernandez, Brian P Chalmers, Kevin I Perry, Daniel J Berry, Brandon J Yuan, Matthew P Abdel
BACKGROUND: In situ screw fixation remains the most common treatment for minimally displaced femoral neck fractures (FNFs). Total hip arthroplasty (THA) can be used as a salvage procedure, but the results of conversion THA in this population have not been evaluated. The goals of this study were to evaluate (1) unique complications associated with conversion THA, (2) implant survivorship free of revision and reoperation, (3) radiographic results, and (4) clinical outcomes in patients undergoing conversion THA after in situ fixation of nondisplaced FNFs...
July 29, 2017: Journal of Arthroplasty
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