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Arthroplasty irrigation

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https://www.readbyqxmd.com/read/28645272/prosthetic-joint-infection-caused-by-granulicatella-adiacens-a-case-series-and-review-of-literature
#1
Fanny Quénard, Piseth Seng, Jean-Christophe Lagier, Florence Fenollar, Andreas Stein
BACKGROUND: Bone and joint infection involving Granulicatella adiacens is rare, and mainly involved in cases of bacteremia and infectious endocarditis. Here we report three cases of prosthetic joint infection involving G. adiacens that were successfully treated with surgery and prolonged antimicrobial treatment. We also review the two cases of prosthetic joint infection involving G. adiacens that are reported in the literature. CASE PRESENTATION: Not all five cases of prosthetic joint infection caused by G...
June 23, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28598492/use-of-2-octyl-cyanoacrylate-adhesive-and-polyester-mesh-for-wound-closure-in-primary-knee-arthroplasty
#2
Andrew J Holte, Josef N Tofte, Greta J Dahlberg, Nicolas Noiseux
Wound closure in primary knee arthroplasty is important both for surgical success, by minimizing the risk of wound complications and infection, and for patient satisfaction with wound care and cosmesis. This article reports the use of a topical self-adhering, pressure-sensitive polyester mesh combined with 2-octyl cyanoacrylate adhesive for final skin closure of primary knee arthroplasty without external staples or sutures. During a 2.5-year period, 360 consecutive primary knee arthroplasty procedures (321 total knee arthroplasty procedures and 39 partial knee arthroplasty procedures) performed by 1 surgeon at 1 institution were reviewed...
June 9, 2017: Orthopedics
https://www.readbyqxmd.com/read/28543707/viable-bacteria-persist-on-antibiotic-spacers-following-two-stage-revision-for-periprosthetic-joint-infection
#3
Dongzhu Ma, Robert M Q Shanks, Charles M Davis, David W Craft, Thomas K Wood, Brian R Hamlin, Kenneth L Urish
Treatment in periprosthetic joint infection (PJI) remains challenging. The failure rate of two-stage revision and irrigation and debridement with component retention in PJI suggests that biofilm cells have a high tolerance to antibiotic chemotherapy. Previous work has demonstrated that biofilm cells have high antibiotic tolerance in vitro, but there is little clinical evidence to support these observations. The aim of this study was to determine if retrieved antibiotic spacers from two-stage revision total knee arthroplasty for PJI have evidence of remaining viable bacteria...
May 19, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28537349/effects-of-topical-antiseptic-solutions-used-during-total-knee-arthroplasty-on-suture-tensile-strength
#4
Jared M Newman, Jaiben George, Jeffery T Shepherd, Alison K Klika, Carlos A Higuera, Viktor E Krebs
INTRODUCTION: Irrigating a surgical wound with an antiseptic solution is commonly performed while suturing following a total knee arthroplasty (TKA) to help prevent wound complications. The purpose of this study was to: 1) evaluate the mean load to failure of different sutures, and 2) compare the mean load to failure of the sutures after soaking in four different antiseptic solutions. MATERIALS AND METHODS: Load-to-failure tests were conducted on four sets of comparable sutures (eight sutures) from two different companies Ethicon Inc...
May 24, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28529860/use-of-chlorhexidine-preparations-in-total-joint-arthroplasty
#5
REVIEW
Jaiben George, Alison K Klika, Carlos A Higuera
Prosthetic joint infection (PJI) is a serious complication after total joint arthroplasty (TJA). Chlorhexidine is a widely used antiseptic because of its rapid and persistent action. It is well tolerated and available in different formulations at various concentrations. Chlorhexidine can be used for pre-operative skin cleansing, surgical site preparation, hand antisepsis of the surgical team and intra-articular irrigation of infected joints. The optimal intra-articular concentration of chlorhexidine gluconate in irrigation solution is 2%, to provide a persistent decrease in biofilm formation, though cytotoxicity might be an issue...
2017: Journal of bone and joint infection
https://www.readbyqxmd.com/read/28529859/treatment-of-periprosthetic-joint-infection-using-antimicrobials-dilute-povidone-iodine-lavage
#6
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: Journal of bone and joint infection
https://www.readbyqxmd.com/read/28529858/hydrogen-peroxide-wound-irrigation-in-orthopaedic-surgery
#7
REVIEW
Min Lu, Erik Nathan Hansen
As the burden of deep hardware infections continues to rise in orthopaedics, there is increasing interest in strategies for more effective debridement of colonized tissues and biofilm. Hydrogen peroxide has been used medically for almost a century, but its applications in orthopaedic surgery have yet to be fully determined. The basic science and clinical research on the antiseptic efficacy of hydrogen peroxide have demonstrated its efficacy against bacteria, and it has demonstrated potential synergy with other irrigation solutions such as chlorhexidine and povidone-iodine...
2017: Journal of bone and joint infection
https://www.readbyqxmd.com/read/28455469/management-of-massive-acetabular-bone-defects-in-revision-arthroplasty-of-the-hip-using-a-reconstruction-cage-and-porous-metal-augment
#8
T J Mäkinen, M Abolghasemian, E Watts, S G Fichman, P Kuzyk, O A Safir, A E Gross
AIMS: It may not be possible to undertake revision total hip arthroplasty (THA) in the presence of massive loss of acetabular bone stock using standard cementless hemispherical acetabular components and metal augments, as satisfactory stability cannot always be achieved. We aimed to study the outcome using a reconstruction cage and a porous metal augment in these patients. PATIENTS AND METHODS: A total of 22 acetabular revisions in 19 patients were performed using a combination of a reconstruction cage and porous metal augments...
May 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28434697/poor-outcomes-of-irrigation-and-debridement-in-acute-periprosthetic-joint-infection-with-antibiotic-impregnated-calcium-sulfate-beads
#9
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
#10
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/28361019/results-of-single-stage-exchange-arthroplasty-with-retention-of-well-fixed-cement-less-femoral-component-in-management-of-infected-total-hip-arthroplasty
#11
Wael A Rahman, Hussain A Kazi, Jeffery D Gollish
AIM: To investigate success of one stage exchange with retention of fixed acetabular cup. METHODS: Fifteen patients treated by single stage acetabular component exchange with retention of well-fixed femoral component in infected total hip arthroplasty (THA) were retrospectively reviewed. Inclusion criteria were patients with painful chronic infected total hip. The patient had radiologically well fixed femoral components, absence of major soft tissue or bone defect compromising, and infecting organism was not poly or virulent micro-organism...
March 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28335753/leuconostoc-mesenteroides-periprosthetic-knee-infection-an-unusual-fastidious-gram-positive-bacteria-a-case-report
#12
Rafael Franco-Cendejas, Claudia A Colín-Castro, Melissa Hernández-Durán, Luis E López-Jácome, Silvestre Ortega-Peña, Guillermo Cerón-González, Samuel Vanegas-Rodríguez, Jaime A Mondragón-Eguiluz, Eduardo Acosta-Rodríguez
BACKGROUND: Periprosthetic joint infections are mainly caused by Gram-positive cocci. Leuconostoc mesenteroides is a rare microorganism mainly causing bloodstream infections. At times, it might be confused with another type of cocci and give rise to misdiagnosed infections. Molecular diagnosis and biofilm production comprise important techniques to guide antibiotic treatment. CASE PRESENTATION: A 68-year-old Hispanic female with a previous history of bilateral knee arthroplasty presented with acute right-knee inflammation and gait impairment...
March 23, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28222649/a-randomized-control-trial-to-evaluate-the-effectiveness-of-intravenous-intra-articular-and-topical-wash-regimes-of-tranexamic-acid-in-primary-total-knee-arthroplasty
#13
Jatin Prakash, Jong-Keun Seon, Yong Jin Park, Cheng Jin, Eun-Kyoo Song
BACKGROUND: The efficacy of tranexamic acid to decrease post-operative blood loss and blood transfusion is well established in literature. However, the ideal mode of administration is debatable. Limited literature has compared all the available modes of administration including intravenous (IV), topical irrigation and retrograde through drain. We hypothesized that no difference would be present in either form of administration of tranexamic acid. METHODS: Fifty patients in four groups were enrolled for study...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28222211/the-learning-curve-for-the-direct-anterior-approach-for-total-hip-arthroplasty-a-single-surgeon-s-first-500-cases
#14
James M Hartford, Michael J Bellino
BACKGROUND: Concerns arise over the early complications encountered during the learning curve for the direct anterior approach for total hip arthroplasty. PURPOSE: The purpose of this study is to examine the learning experience of a single surgeon in adapting this approach. METHODS: The 1st 500 primary total hip arthroplasties are reviewed. The patients were evaluated out to 3 months. Rates of major complications, reoperations, periprosthetic fractures, heterotopic ossification, leg length discrepancies and lateral femoral cutaneous nerve deficits were identified for each of 100 patients...
February 17, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28163947/scedosporium-prolificans-septic-arthritis-and-osteomyelitis-of-the-hip-joints-in-an-immunocompetent-patient-a-case-report-and-literature-review
#15
Luca Daniele, Michael Le, Adam Franklin Parr, Lochlin Mark Brown
Scedosporium prolificans, also known as Scedosporium inflatum, is a fungus widespread in soil, sewage, and manure. This species is highly virulent and is an emerging opportunistic pathogen found in penetrating injuries in immunocompromised patients. Here we report on an immunocompetent patient with bilateral hip S. prolificans-associated osteomyelitis and septic arthritis caused by intentional penetrating trauma. The condition was refractory to initial antimicrobial suppression and surgical irrigation and debridement...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28032700/management-of-acute-hematogenous-infection-following-total-knee-arthroplasty-a-case-series-of-11-patients
#16
Rui He, Liu Yang, Lin Guo, Hao Chen, Ying Zhang, Dian-Ming Jiang
OBJECTIVE: Acute hematogenous infection is a devastating complication that can occur after total knee arthroplasty (TKA). The best strategies for management of this infection remain controversial. Two-stage revision has been well described as the gold standard for the management of chronic late infections. However, there is a paucity of information presently available on the management and outcomes of patients treated for acute hematogenous infections. The purpose of the present study was to report the outcome of acute hematogenous infections following TKA with the treatment of irrigation, debridement, and retention of the prosthetic components...
November 2016: Orthopaedic Surgery
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/27911455/functional-outcomes-of-infected-hip-arthroplasty-a-comparison-of-different-surgical-treatment-options
#18
Benjamin V Herman, Mark Nyland, Lyndsay Somerville, Steven J MacDonald, Brent A Lanting, James L Howard
BACKGROUND: Periprosthetic joint infection (PJI) following total hip arthroplasty (THA) can be treated with irrigation and debridement with head and polyethylene exchange (IDHPE) or 2-stage revision (2SR). Few studies have compared patient-reported outcome measures (PROMs) in patients managed with these treatments. METHODS: A retrospective review identified 137 patients who had an infected primary THA between 1986-2013. Control cohorts were matched according to age and Charlton Comorbidity Index (CCI)...
November 28, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27876465/is-there-still-a-role-for-irrigation-and-debridement-with-liner-exchange-in-acute-periprosthetic-total-knee-infection
#19
Andrés F Duque, Zachary D Post, Rex W Lutz, Fabio R Orozco, Sergio H Pulido, Alvin C Ong
BACKGROUND: Periprosthetic joint infection (PJI) is an important cause of failure in total knee arthroplasty. Irrigation and debridement including liner exchange (I&D/L) success rates have varied for acute PJI. The purpose of this study is to present results of a specific protocol for I&D/L with retention of total knee arthroplasty components. METHODS: Sixty-seven consecutive I&D/L patients were retrospectively evaluated. Inclusion criteria for I&D/L were as follows: fewer than 3 weeks of symptoms, no immunologic compromise, intact soft tissue sleeve, and well-fixed components...
April 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27789094/periprosthetic-joint-infections-caused-by-enterococci-have-poor-outcomes
#20
Michael M Kheir, Timothy L Tan, Carlos Higuera, Jaiben George, Craig J Della Valle, Mary Shen, Javad Parvizi
BACKGROUND: The definitive treatment and outcome of periprosthetic joint infection (PJI) caused by Enterococcus species is unknown. We performed a multi-institutional study to analyze the characteristics and treatment outcomes of patients with enterococcal PJI and to define an effective treatment protocol. METHODS: We retrospectively reviewed all PJIs at 3 institutions between 1999 and 2014 using an electronic query followed by manual chart review. We included patients who met the Musculoskeletal Infection Society's criteria for PJI and had at least 1 positive intraoperative culture for any Enterococcus species...
September 28, 2016: Journal of Arthroplasty
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