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Arthroplasty irrigation

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https://www.readbyqxmd.com/read/29221840/a-multicenter-study-of-irrigation-and-debridement-in-total-knee-arthroplasty-periprosthetic-joint-infection-treatment-failure-is-high
#1
Kenneth L Urish, Andrew G Bullock, Alexander M Kreger, Neel B Shah, Kwonho Jeong, Scott D Rothenberger
BACKGROUND: In total knee arthroplasty (TKA) periprosthetic joint infection (PJI), irrigation and debridement (I&D) with component retention is a treatment option with a wide variation in reported failure rates. The purpose of this study was to determine failure rates, outcomes, and factors that predict failure in I&D for TKA PJI. METHODS: A multicenter observational study of patients with a TKA PJI and subsequently undergoing an I&D with retention of components was conducted...
November 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29206802/another-option-in-the-armamentarium-understanding-the-role-of-irrigation-and-debridement-to-treat-hip-periprosthetic-joint-infection-commentary-on-an-article-by-andrew-j-bryan-md-et-al-irrigation-and-debridement-with-component-retention-for-acute-infection
#2
https://www.readbyqxmd.com/read/29206791/irrigation-and-debridement-with-component-retention-for-acute-infection-after-hip-arthroplasty-improved-results-with-contemporary-management
#3
Andrew J Bryan, Matthew P Abdel, Thomas L Sanders, Steven F Fitzgerald, Arlen D Hanssen, Daniel J Berry
BACKGROUND: There are conflicting data on the results of irrigation and debridement with component retention in patients with acute periprosthetic hip infections. The goals of this study were to examine contemporary results of irrigation and debridement with component retention for acute infection after primary hip arthroplasty and to identify host, organism, antibiotic, or implant factors that predict success or failure. METHODS: Ninety hips (57 total hip arthroplasties and 33 hemiarthroplasties) were diagnosed with acute periprosthetic hip infection (using strict criteria) and were treated with irrigation and debridement and component retention between 2000 and 2012...
December 6, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29206787/outpatient-total-knee-arthroplasty-is-associated-with-higher-risk-of-perioperative-complications
#4
Armin Arshi, Natalie L Leong, Anthony D'Oro, Christopher Wang, Zorica Buser, Jeffrey C Wang, Kristofer J Jones, Frank A Petrigliano, Nelson F SooHoo
BACKGROUND: As concerns regarding health-care expenditure in the U.S. remain at the national forefront, outpatient arthroplasty is an appealing option for carefully selected patient populations. The purpose of this study was to determine the nationwide trends and complication rates associated with outpatient total knee arthroplasty (TKA) in comparison with standard inpatient TKA. METHODS: We performed a retrospective review of the Humana subset of the PearlDiver Patient Record Database to identify patients who had undergone TKA (Current Procedural Terminology [CPT] code 27447) as either outpatients or inpatients from 2007 to 2015...
December 6, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29204500/intraoperative-chlorhexidine-irrigation-to-prevent-infection-in-total-hip-and-knee-arthroplasty
#5
Nicholas B Frisch, Omar M Kadri, Troy Tenbrunsel, Abraham Abdul-Hak, Mossub Qatu, Jason J Davis
Background: Surgical site irrigation during total hip (THA) and total knee (TKA) arthroplasty is a routine practice among orthopaedic surgeons to prevent periprosthetic joint infection. The purpose of this study was to evaluate the effect of chlorhexidine gluconate (CHG) irrigation on infection rates following THA and TKA. Methods: Arthroplasties performed before September 2014 served as controls. THA performed before September 2014 (N = 253) underwent intraoperative irrigation with 0...
December 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/29174761/vancomycin-povidone-iodine-protocol-improves-survivorship-of-periprosthetic-joint-infection-treated-with-irrigation-and-debridement
#6
Aldo M Riesgo, Brian K Park, Christina P Herrero, Stephen Yu, Ran Schwarzkopf, Richard Iorio
BACKGROUND: Irrigation and debridement with modular component and liner exchange (IDLE) is a low morbidity procedure for treatment of periprosthetic joint infection (PJI) with reported failure rates exceeding 50%. Dilute povidone-iodine lavage has been shown to be safe and effective in decreasing acute PJI in primary total joint arthroplasty. Vancomycin powder has also shown to be effective in preventing infection in spine surgery. We hypothesize that a vancomycin povidone-iodine protocol (VIP) used in conjunction with IDLE can increase infection-free survivorship after acute PJI...
October 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29107499/clinical-outcome-of-massive-endoprostheses-used-for-managing-periprosthetic-joint-infections-of-the-hip-and-knee
#7
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/28854408/wound-dehiscence-after-total-knee-arthroplasty
#8
Mohammad Ali Sazegari, Fateme Mirzaee, Fateme Bahramian, Zohreh Zafarani, Hamidreza Aslani
INTRODUCTION: Wound dehiscence is one of the most common complications of surgical ulcer, involving the breaking open of the surgical incision along the stitch. This condition is a severe complication of total knee arthroplasty. PRESENTATION OF CASE: We report a case of a 59-year-old female patient with diabetes who underwent a total knee arthroplasty in which all layers of wounds were dehiscence and prosthetic was exposed. DISCUSSION: Wound dehiscence is a complication after total knee arthroplasty especially in diabetic patient...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28842287/determining-potential-of-pmma-as-a-depot-for-rifampin-to-treat-recalcitrant-orthopaedic-infections
#9
Stefanie M Shiels, David J Tennent, Kevin S Akers, Joseph C Wenke
BACKGROUND: Open fractures are often complicated by infection. In cases of severe soft tissue and vascular injury, systemic antibiotics may be ineffective due to their inability to reach and provide direct antimicrobial activity to the zone of injury. High antibiotic concentrations within the wound can be achieved with reduced systemic toxicity by using local antibiotic delivery. As bacteria associated with musculoskeletal injuries frequently form biofilms, antibiotic selection is important...
October 2017: Injury
https://www.readbyqxmd.com/read/28781018/high-early-major-complication-rate-after-revision-for-mechanically-assisted-crevice-corrosion-in-metal-on-polyethylene-total-hip-arthroplasty
#10
Brian J McGrory, Anna H Jorgensen
BACKGROUND: Failed total hip arthroplasty caused by mechanically assisted crevice corrosion (MACC) has serious consequences such as adverse local tissue reaction. Revision is currently indicated for significant hip pain, stiffness, and dysfunction; hip instability; progressive bone loss; and soft tissue destruction. Outcomes of this revision surgery are not yet completely understood. METHODS: We examined the surgical outcomes at a minimum of 6 months (average, 25; range, 7-68 months) in a cohort of 27 consecutive patients who underwent revision total hip arthroplasty for MACC associated with a single implant vendor and taper type...
July 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28751093/two-stage-reimplantation-for-the-treatment-of-deep-infection-after-shoulder-arthroplasty
#11
Andrew T Assenmacher, Eduard Alentorn-Geli, Taylor Dennison, Yaser M K Baghdadi, Robert H Cofield, Joaquín Sánchez-Sotelo, John W Sperling
BACKGROUND: Two-stage reimplantation is the most common treatment modality considered for periprosthetic shoulder infection (PSI). Most studies to date have reported on a relatively small number of shoulders. The purpose of this study was to determine the outcome of 2-stage reimplantation for PSI in terms of both eradication of infection and restoration of function. METHODS: Between 1980 and 2010, 40 shoulders (39 patients) underwent a 2-stage reimplantation for PSI; 35 shoulders (34 patients) met inclusion criteria (10 hemiarthroplasties, 24 anatomic total shoulder arthroplasties, 1 reverse total shoulder arthroplasty)...
July 24, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28735470/staged-reimplantation-of-a-total-hip-prosthesis-after-co-infection-with-candida-tropicalis-and-staphylococcus-haemolyticus-a-case-report
#12
Sujeesh Sebastian, Rajesh Malhotra, Ashish Pande, Deepak Gautam, Immaculata Xess, Benu Dhawan
Fungal prosthetic joint infection is a rare complication in total joint arthroplasty. There are no established guidelines for management of these infections. We present a case of a 53-year-old male with a hip joint prosthesis co-infected with Candida tropicalis and Staphylococcus haemolyticus. A two-stage exchange arthroplasty was performed. The patient underwent implant removal, debridement, irrigation with saline solution and application of cement spacer impregnated with vancomycin followed by aggressive antimicrobial treatment in first stage...
July 22, 2017: Mycopathologia
https://www.readbyqxmd.com/read/28734537/total-elbow-arthroplasty-for-primary-osteoarthritis
#13
Bradley S Schoch, Jean-David Werthel, Joaquín Sánchez-Sotelo, Bernard F Morrey, Mark Morrey
BACKGROUND: Primary osteoarthritis of the elbow is a less common indication for total elbow arthroplasty (TEA). Higher complication rates in younger, active patients may offset short-term improvements in pain and function. The purpose of this study was to determine pain relief, functional outcomes, complications, and survival of TEA in this population. METHODS: Between 1984 and 2011, 20 consecutive TEAs were performed for primary elbow osteoarthritis. Two patients died before the 2-year follow-up...
August 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28670986/-periprosthetic-joint-infection-caused-by-rhodococcus-equi-case-report
#14
Imre Sallai, Nóra Péterfy, Mohammad Sanatkhani, Zoltán Bejek, Imre Antal, Gyula Prinz, Katalin Kristóf, Gábor Skaliczki
Rhodococcus equi is a rare pathogen in humans causing infections mostly in immunocompromised hosts. We present the first case of periprosthetic joint infection caused by Rhodococcus equi. An 88-year-old male patient was referred to our clinic with a history of fever and right hip pain. The patient had multiple hip surgeries including total joint arthroplasty and revision for aseptic loosening on the right side. He was immunocompetent, but his additional medical history was remarkable for diabetes mellitus, diabetic nephropathy and stroke with hemiplegia resulting in immobilization...
July 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28645272/prosthetic-joint-infection-caused-by-granulicatella-adiacens-a-case-series-and-review-of-literature
#15
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
#16
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...
September 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/28543707/viable-bacteria-persist-on-antibiotic-spacers-following-two-stage-revision-for-periprosthetic-joint-infection
#17
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
#18
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
#19
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
#20
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
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