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Periprosthetic infection

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https://www.readbyqxmd.com/read/28099298/low-dose-aspirin-is-effective-chemoprophylaxis-against-clinically-important-venous-thromboembolism-following-total-joint-arthroplasty-a-preliminary-analysis
#1
Javad Parvizi, Ronald Huang, Camilo Restrepo, Antonia F Chen, Matthew S Austin, William J Hozack, Jess H Lonner
BACKGROUND: Aspirin is a safe and effective prophylaxis for the prevention of venous thromboembolism following total joint arthroplasty. The optimal dose of aspirin prophylaxis is unknown. Our hypothesis was that lower-dose aspirin is as effective as higher-dose aspirin for the prevention of venous thromboembolism and is associated with fewer gastrointestinal side effects. METHODS: In a prospective, crossover study, we analyzed 4,651 primary total joint arthroplasty cases performed from July 2013 to June 2015...
January 18, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28097116/kikuchi-fujimoto-disease-misdiagnosed-as-relapse-of-the-infection-after-treatment-of-periprosthetic-hip-joint-infection
#2
Kyung-Keun Min, Byung-Woo Min, Kyung-Jae Lee, Jung-Hoon Choi
Periprosthetic joint infection (PJI) of the hip can be difficult to treat and can lead to a number of problems including: i) severe functional decline of the hip joint and ii) increasing financial burden for patients due to long treatment periods and the need for repeated surgical interventions. Because there is risk of inadequate control of infection or relapse of a preexisting infection following the treatment of PJI through surgery, it is important to closely observe clinical symptoms such as systemic fever...
December 2016: Hip & Pelvis
https://www.readbyqxmd.com/read/28094191/functional-results-of-bilateral-reverse-total-shoulder-arthroplasty
#3
Chris R Mellano, Robert Thorsness, Peter N Chalmers, Terrence F Feldheim, Patrick O'Donnell, Brian J Cole, Nikhil N Verma, Anthony A Romeo, Gregory P Nicholson
BACKGROUND: The purpose of this study was to analyze a population of patients with bilateral reverse total shoulder arthroplasty (RTSA) to evaluate their ability to perform activities of daily living and personal hygiene tasks. METHODS: At a minimum 2-year follow-up, we retrospectively reviewed 50 patients (100 shoulders) with a mean age of 72 years who underwent staged bilateral RTSA. The average follow-up period was 61 months (range, 24-121 months), with a minimum 2-year follow-up after the second surgical procedure...
January 13, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28091802/increased-risk-of-revision-reoperation-and-implant-constraint-in-tka-after-multiligament-knee-surgery
#4
Steven I Pancio, Paul L Sousa, Aaron J Krych, Matthew P Abdel, Bruce A Levy, Diane L Dahm, Michael J Stuart
BACKGROUND: The risk of major complications and revision arthroplasty after TKA in patients who previously underwent multiligament knee surgery have been poorly characterized. QUESTIONS/PURPOSES: Is multiligament knee surgery before TKA associated with (1) worse implant survival, (2) increased use of TKA design constraint, (3) a greater risk for major complications, and (4) poorer scores for pain and function compared with similar patients receiving TKA for primary osteoarthritis? METHODS: Fifty-nine TKAs were performed at our institution between 1985 and 2014 in 59 patients (36 men, 23 women; mean age, 53 years) with a history of previous multiligament knee surgery (≥ two ligaments)...
January 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28091766/pre-operative-intra-articular-deep-tissue-sampling-with-novel-retrograde-forceps-improves-the-diagnostics-in-periprosthetic-joint-infection
#5
Matthias D Wimmer, Milena M Ploeger, Max J Friedrich, Thomas Hügle, Sascha Gravius, Thomas M Randau
BACKGROUND: Histopathological tissue analysis is a key parameter within the diagnostic algorithm for suspected periprosthetic joint infections (PJIs), conventionally acquired in open surgery. In 2014, Hügle and co-workers introduced novel retrograde forceps for retrograde synovial biopsy with simultaneous fluid aspiration of the knee joint. We hypothesised that tissue samples acquired by retrograde synovial biopsy are equal to intra-operatively acquired deep representative tissue samples regarding bacterial detection and differentiation of periprosthetic infectious membranes...
January 14, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28089261/is-previous-nonarthroplasty-surgery-a-risk-factor-for-periprosthetic-infection-in-primary-shoulder-arthroplasty
#6
Jean-David Werthel, Taku Hatta, Bradley Schoch, Robert Cofield, John W Sperling, Bassem T Elhassan
BACKGROUND: The purpose of this study was to determine the risk of periprosthetic infection after primary shoulder arthroplasty (SA) in patients undergoing previous nonarthroplasty shoulder surgery compared with those without previous surgery. MATERIALS AND METHODS: All patients undergoing primary SA at our institution between 1970 and 2012 were included in this study. The cohort consisted of 4577 patients treated with 2890 total SAs, 1233 hemiarthroplasties, and 454 reverse SAs; 813 (18%) patients had undergone prior nonarthroplasty shoulder surgery on the operative side...
January 12, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28087408/effects-of-loading-concentration-blood-and-synovial-fluid-on-antibiotic-release-and-anti-biofilm-activity-of-bone-cement-beads
#7
Devendra Dusane, Scott Diamond, Cory Knecht, Nicholas Farrar, Casey Peters, Robert Howlin, Matthew Swearingen, Jason Calhoun, Roger D Plaut, Tanya Nocera, Jeffrey Granger, Paul Stoodley
Antibiotic loaded cement beads are commonly used for the treatment of biofilm related orthopaedic periprosthetic infections; however the effects of antibiotic loading and exposure of beads to body fluids on release kinetics are unclear. The purpose of this study was to determine the effects of (i) antibiotic loading density (ii) loading amount (iii) material type and (iv) exposure to body fluids (blood or synovial fluid) on release kinetics and efficacy of antibiotics against planktonic and lawn biofilm bacteria...
January 10, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/28065627/revision-total-hip-and-knee-arthroplasties-after-solid-organ-transplant
#8
Cameron K Ledford, Joseph M Statz, Brian P Chalmers, Kevin I Perry, Arlen D Hanssen, Matthew P Abdel
BACKGROUND: As solid organ transplant (SOT) patients' survival improves, the number undergoing total hip (THA) and total knee arthroplasty (TKA) is increasing. Accordingly, the number of revision procedures in this higher-risk group is also increasing. The goals of this study were to identify the most common failure mechanisms, associated complications, clinical outcomes, and patient survivorship of SOT patients after revision THA or TKA. METHODS: A retrospective review identified 39 revision procedures (30 revision THAs and 9 revision TKAs) completed in 37 SOT patients between 2000 and 2013...
December 11, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28064219/active-and-passive-immunization-against-staphylococcus-aureus-periprosthetic-osteomyelitis-in-rats
#9
Niels H Søe, Nina Vendel Jensen, Asger Lundorff Jensen, Janne Koch, Steen Seier Poulsen, Gerald B Pier, Helle Krogh Johansen
BACKGROUND/AIM: Staphylococcus aureus infection associated with orthopedic implants cannot always be controlled. We used a knee prosthesis model with implant-related osteomyelitis in rats to explore induction of an effective immune response with active and passive immunization. MATERIALS AND METHODS: Fifty-two Sprague-Dawley rats were divided into active (N=28) and passive immunization groups (N=24). A bacterial inoculum of 10(3) S. aureus MN8 was injected into the tibia and the femur marrow before insertion of a non-constrained knee prosthesis in each rat...
January 2017: In Vivo
https://www.readbyqxmd.com/read/28060229/repeat-two-stage-exchange-arthroplasty-for-periprosthetic-knee-infection-is-dependent-on-host-grade
#10
Keith A Fehring, Matthew P Abdel, Matthieu Ollivier, Tad M Mabry, Arlen D Hanssen
BACKGROUND: Two-stage exchange arthroplasty after a previous, failed 2-stage exchange procedure is fraught with difficulties, and there are no clear guidelines for treatment or prognosis given the heterogeneous group of patients in whom this procedure has been performed. The Musculoskeletal Infection Society (MSIS) staging system was developed in an attempt to stratify patients according to infection type, host status, and local soft-tissue status. The purpose of this study was to report the results of 2-stage exchange arthroplasty following a previous, failed 2-stage exchange protocol for periprosthetic knee infection as well as to identify risk factors for failure...
January 4, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28053259/qualitative-%C3%AE-defensin-test-synovasure-for-the-diagnosis-of-periprosthetic-infection-in-revision-total-joint-arthroplasty
#11
I K Sigmund, J Holinka, J Gamper, K Staats, C Böhler, B Kubista, R Windhager
AIMS: The diagnosis of periprosthetic joint infection (PJI) remains demanding due to limitations of all the available diagnostic tests. The synovial fluid marker, α-defensin, is a promising adjunct for the assessment of potential PJI. The purpose of this study was to investigate the qualitative assessment of α-defensin, using Synovasure to detect or exclude periprosthetic infection in total joint arthroplasty. PATIENTS AND METHODS: We studied 50 patients (28 women, 22 men, mean age 65 years; 20 to 89) with a clinical indication for revision arthroplasty who met the inclusion criteria of this prospective diagnostic study...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28053254/the-synergy-cementless-femoral-stem-in-primary-total-hip-arthroplasty-at-a-minimum-follow-up-of-15-years
#12
I De Martino, V De Santis, R D' Apolito, P K Sculco, M B Cross, G Gasparini
AIMS: We report on the outcome of the Synergy cementless femoral stem with a minimum follow-up of 15 years (15 to 17). PATIENTS AND METHODS: A retrospective review was undertaken of a consecutive series of 112 routine primary cementless total hip arthroplasties (THAs) in 102 patients (112 hips). There were 60 female and 42 male patients with a mean age of 61 years (18 to 82) at the time of surgery. A total of 78 hips in the 69 patients remain in situ; nine hips in eight patients died before 15 years, and 16 hips in 16 patients were revised...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28050818/what-is-the-accuracy-of-nuclear-imaging-in-the-assessment-of-periprosthetic-knee-infection-a-meta-analysis
#13
REVIEW
Steven J Verberne, Remko J A Sonnega, Olivier P P Temmerman, Pieter G Raijmakers
BACKGROUND: In the assessment of possible periprosthetic knee infection, various imaging modalities are used without consensus regarding the most accurate technique. QUESTIONS/PURPOSES: To perform a meta-analysis to compare the accuracy of various applied imaging modalities in the assessment of periprosthetic knee infection. METHODS: A systematic review and meta-analysis was conducted with a comprehensive search of MEDLINE and Embase(®) in accordance with the PRISMA and Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) recommendations to identify clinical studies in which periprosthetic knee infection was investigated with different imaging modalities...
January 3, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28050817/phosphatidylcholine-coatings-deliver-local-antimicrobials-and-reduce-infection-in-a-murine-model-a-preliminary-study
#14
Michael A Harris, Karen E Beenken, Mark S Smeltzer, Warren O Haggard, J Amber Jennings
BACKGROUND: Phosphatidylcholine coatings have been shown to elute antibiotics for several days. A recently developed biofilm inhibitor, cis-2-decenoic acid (C2DA), has been shown to exhibit synergistic activity with several common antibiotics. This study aims to evaluate the effectiveness of C2DA and amikacin dual drug delivery from a phosphatidylcholine coating. QUESTIONS/PURPOSES: (1) What are the in vitro elution profiles of amikacin and C2DA from phosphatidylcholine-coated coupons in incubated phosphate-buffered saline? (2) Does the presence of C2DA in eluate samples lower the amount of amikacin needed for bacterial inhibition in overnight bacterial turbidity assays? (3) Does addition of amikacin and C2DA result in decreased colony-forming units (CFUs) on wire implants and bone when compared with phosphatidylcholine coatings alone in a mouse model of periprosthetic joint infection? METHODS: Effects of loading concentrations were assessed during 7-day in vitro elution studies for coatings containing all mixtures of 0%, 5%, 15%, and 25% wt of amikacin and C2DA (n = 4) through quantitative high-performance liquid chromatography concentration determination and plotting concentration eluted over time...
January 3, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28043711/total-hip-arthroplasty-with-a-fully-hydroxyapatite-coated-stem-a-cohort-study-during-23-28-years
#15
Olav Reikerås
BACKGROUND: Long-term results of a hydroxyapatite (HA)-coated stem are sparse. We have followed a cohort of patients operated with a grit-blasted titanium stem designed for press-fit insertion and entirely plasma-sprayed with HA up to 28 years. METHODS: In the years 1988-1993, we performed 323 primary total hip arthroplasties in 276 patients (189 women). Their mean age was 48 (15-79) years. During the following years, 83 patients with 88 hips have died, and 18 patients did not attend the follow-up examination, but had no major symptoms according to telephone interviews and control examination...
December 18, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28040397/should-preoperative-antibiotics-be-tailored-according-to-patient-s-comorbidities-and-susceptibility-to-organisms
#16
Timothy L Tan, Miguel M Gomez, Michael M Kheir, Mitchell G Maltenfort, Antonia F Chen
BACKGROUND: Preoperative antibiotic prophylaxis remains one of the most important strategies for preventing periprosthetic joint infection (PJI). Current guidelines recommend giving universal antibiotic prophylaxis to all total joint arthroplasty patients regardless of their medical conditions or immune status; however, no studies have evaluated the individualizing of antibiotics. The aims of this study were (1) to determine if comorbidities influence the organism profile of PJIs, and (2) to investigate if the efficacy of two different perioperative antibiotics (cefazolin or vancomycin) for preventing PJI is affected by patient's comorbidities...
November 23, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28027829/complications-of-total-hip-arthroplasty-following-solid-organ-transplantation
#17
Mitchell R Klement, Colin T Penrose, Abiram Bala, Cynthia L Green, Richard C Mather, Samuel S Wellman, Michael P Bolognesi, Thorsten M Seyler
PURPOSE: Solid organ transplants (SOT) continue to increase with recipients living longer than ever before. The lifelong immunosuppression in these patients also may place them at increased risk for postoperative complications. The efficacy of total hip arthroplasty (THA) in this patient population is undisputed but previous studies investigating the complication profiles in these patients often are underpowered to identify rare complications as well as make comparisons between individual organs...
December 24, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28027814/outcome-of-total-hip-and-total-knee-revision-arthroplasty-with-minor-infection-criteria-a-retrospective-matched-pair-analysis
#18
Kevin Staats, Paul Kolbitsch, Irene K Sigmund, Gerhard M Hobusch, Johannes Holinka, Reinhard Windhager
BACKGROUND: Although diagnostic modalities for the detection of periprosthetic joint infection have improved, some infectious revision cases may still be diagnosed as aseptic complications. We raised the question whether patients with positive Musculoskeletal Infection Society minor infection criteria differ in their outcome parameters (revision-free survival, revision rate) when compared to patients with "true" aseptic complications. Additionally, we asked whether the indication for revision surgery (eg, loosening) might have an influence on possible outcome discrepancies...
November 19, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28018510/spontaneous-evacuation-of-a-vascular-metallic-stent-through-a-graft-duodenal-fistula-with-concomitant-non-surgical-fistula-closure
#19
Shunya Shindo, Hidenori Inoue, Shinya Motohashi, Hirotomo Uchiyama, Junetsu Akasaka
We report a patient who developed ileus caused by vascular stent migration into the duodenum with periprosthetic retroperitoneal abscess. The patient previously underwent removal of an infected abdominal aortic aneurysm with concomitant axillobifemoral arterial reconstruction. An occlusion of the graft leg was treated by a unilateral aortoiliac bypass where endovascular surgery with a metallic stent was later needed. The abscess and ileus were vigorously drained. Following the spontaneous evacuation of the metallic stent via the digestive tract, the abscess was completely drained and fistula closure was achieved without surgical intervention...
2016: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/28018092/prosthetic-hip-infection-with-edwardsiella-tarda-in-sickle-cell-beta-thalassemia-disease-a-case-report
#20
David B Frumberg, Samantha E Epstein, Julio J Jauregui, Robert Pivec, Aditya V Maheshwari
Periprosthetic infection following total hip arthroplasty is a devastating complication that has been reported to occur in up to 1.6% of all primary total hip arthroplasties. We report a previously unrecognized gram-negative bacillus as the infecting agent in a patient with bilateral total hip arthroplasties for stage IV osteonecrosis. A 22-year-old male with combined sickle cell disease and beta thalassemia with a prior history of unknown hip surgeries and treatment for distal tibial osteomyelitis in Africa developed a periprosthetic joint infection; intra-operative cultures confirmed the infecting organism to be Edwardsiella tarda which was sensitive to late-generation cephalosporins and vancomycin...
October 2016: Journal of Clinical Orthopaedics and Trauma
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