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https://www.readbyqxmd.com/read/28737619/revision-total-elbow-arthroplasty
#1
Miguel A Ramirez, Emilie V Cheung, Anand M Murthi
Despite recent technologic advances, total elbow arthroplasty has complication rates higher than that of total joint arthroplasty in other joints. With new antirheumatic treatments, the population receiving total elbow arthroplasty has shifted from patients with rheumatoid arthritis to those with posttraumatic arthritis, further compounding the high complication rate. The most common reasons for revision include infection, aseptic loosening, fracture, and component failure. Common mechanisms of total elbow arthroplasty failure include infection, aseptic loosening, fracture, component failure, and instability...
August 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28735804/effect-of-type-2-diabetes-on-in-hospital-postoperative-complications-and-mortality-after-primary-total-hip-and-knee-arthroplasty
#2
Maria A Martínez-Huedo, Rodrigo Jiménez-García, Isabel Jiménez-Trujillo, Valentín Hernández-Barrera, Benito Del Rio Lopez, Ana López-de-Andrés
BACKGROUND: We aimed to compare in-hospital postoperative complications (IHPC) and in-hospital mortality between patients with and without type 2 diabetes mellitus (T2DM) undergoing primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). METHODS: We analyzed data from the Spanish National Hospital Discharge Database, 2010-2014. We selected patients who had undergone THA (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code 81...
July 5, 2017: Journal of Arthroplasty
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
#3
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/28733672/trainee-surgeons-affect-operative-time-but-not-outcome-in-minimally-invasive-total-hip-arthroplasty
#4
Markus Weber, Achim Benditz, Michael Woerner, Daniela Weber, Joachim Grifka, Tobias Renkawitz
Training of young surgeons in total hip arthroplasty (THA) is crucial, but might affect operative time and outcome especially in minimally invasive (MIS) THA. We asked whether the learning curve of orthopaedic residents trained on MIS THA has an impact on (1) operative time (2) complication rates and (3) early postoperative outcome. In a retrospective analysis of over 1000 MIS THAs from our institutional joint registry, operative time, complication rates, patient reported outcome measures (Western Ontario and McMaster Universities Arthritis Index [WOMAC] and Euro-Qol 5D-5L [EQ-5D]) within the first year and responder rates for positive outcome as defined by the Outcome Measures in Rheumatology and Osteoarthritis Research Society International consensus responder (OMERACT-OARSI) criteria were compared between trainee and senior surgeons...
July 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28731488/contamination-risk-of-synovial-biopsy-cultures-in-total-hip-arthroplasty-a-prospective-review-of-100-cases
#5
Christophe Pattyn, Thomas De Bo, Joris Anthonissen, Philippe Willekens, Geert Claeys, Emmanuel A Audenaert
INTRODUCTION: Cultures of deep synovial biopsies remain an important tool in diagnosing periprosthetic joint infection, a devastating complication following total hip arthroplasty (THA). Recent reports of unexpected positive intraoperative cultures in aseptic revision arthroplasty, however, challenge the validity and interpretation of these cultures. The aim of this study was to evaluate the contamination risk of synovial biopsy cultures collected intraoperatively during primary THA of healthy subjects...
July 19, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28724376/sonication-contribution-to-identifying-prosthetic-joint-infection-with-ralstonia-pickettii-a-case-report-and-review-of-the-literature
#6
Rares Mircea Birlutiu, Mihai Dan Roman, Razvan Silviu Cismasiu, Sorin Radu Fleaca, Crina Maria Popa, Manuela Mihalache, Victoria Birlutiu
BACKGROUND: In the context of an increase number of primary and revision total hip and total knee arthroplasty performed yearly, an increased risk of complication is expected. Prosthetic joint infection (PJI) remains the most common and feared arthroplasty complication. Ralstonia pickettii is a Gram-negative bacterium, that has also been identified in biofilms. It remains an extremely rare cause of PJI. There is no report of an identification of R. pickettii on an extracted spacer loaded with antibiotic...
July 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28723791/arthritis-secondary-to-meningococcal-disease-a-case-series-of-7-patients
#7
Vanina Masson-Behar, Hervé Jacquier, Pascal Richette, Jean-Marc Ziza, Valérie Zeller, Christophe Rioux, Baptiste Coustet, Philippe Dieudé, Sébastien Ottaviani
Arthritis secondary to invasive meningococcemia is rare and has been described as a direct result of bacteremia or as immunoallergic-type arthritis, related to the immune complex. Only a few case series have been reported.This multicenter study aimed to describe the clinical characteristics and therapeutic outcomes of arthritis secondary to meningococcal infection.We performed a 5-year retrospective study. We included all patients with inflammatory joint symptoms and proven meningococcal disease defined by the identification of Neisseria meningitidis in blood, cerebrospinal fluid, or synovial fluid...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28715055/risk-of-surgical-site-infections-following-hip-and-knee-arthroplasty-results-of-the-ischia-gisio-study
#8
A Agodi, F Auxilia, M Barchitta, M L Cristina, D D'Alessandro, I Mura, M Nobile, C Pasquarella, Gisio Gisio-SItI
BACKGROUND: Surgical Site Infection (SSI) is one of the major complications following insertion of hip or knee prosthesis. The aim of the present study was to describe rates of SSIs and associated risk factors during hip and knee prosthesis procedures in Italian hospitals. METHODS: Italian hospitals were invited to join the ISChIA (Surgical Site Infections in Arthroplasty Surgery) project and participated in the study on a voluntary basis. SSI surveillance was performed according to the Hospitals in Europe Link for Infection Control through Surveillance (HELICS) -SSI protocol...
September 2017: Annali di Igiene: Medicina Preventiva e di Comunità
https://www.readbyqxmd.com/read/28711272/the-infection-of-mycoplasma-hominis-after-total-knee-replacement-case-report-and-literature-review
#9
Hong-Jiu Qiu, Wei-Ping Lu, Min Li, Zi-Ming Wang, Quan-Yin Du, Ai-Min Wang, Yan Xiong
The Mycoplasma hominis infection is a rare postoperative complication after joint replacement. Based on our knowledge, there were only two cases reported by Korea all over the world currently. A case of postoperative Mycoplasma hominis infection after total knee replacement in our hospital was reported in this article. It was confirmed through mass spectrometer and Mycoplasma cultivation and treated by the first stage debridement, polyethylene insert replacement, and then drainage and irrigation combined with sensitive antibiotics after the operation...
June 22, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28707831/-prevention-of-perioperative-infections-in-orthopaedic-surgery-role-of-general-practitioner
#10
Olivier Borens, Éric Thein, Christophe Tissot, Anne-Sophie Brunel
Total joint replacement comes with a high success rate and has been shown to have a very positive impact on our patients suffering from arthritis. Against all efforts about 2 % of our patients will suffer an implant related infection. As the treatment of infected arthroplasties is difficult and expensive the knowledge of risk factors is becoming more and more important for the treatment team in order to improve our preventive measures. Prevention must be performed pre-, intra- and postoperatively. Preoperative optimization of blood sugar levels, nutritional status and correction of general anaemia for example are paramount and the general practitioner as well as the surgeon should be aware of these and other modifiable risk factors in order to operate on the patient in the best possible conditions...
December 14, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28706395/salmonella-typhimurium-infection-in-total-knee-arthroplasty-a-case-report-with-review-of-literature
#11
Sujeesh Sebastian, Benu Dhawan, Rajesh Malhotra, Deepak Gautam, Arti Kapil
Salmonella enterica serotype Typhimurium is a rare cause of prosthetic joint infection (PJI). The recognized predisposing risk factors for Salmonella septic arthritis include diabetes mellitus, renal failure, human immunodeficiency virus infection and chronic corticosteroid use. We describe a case of PJI of the knee in a 74-year-old lady who was on antitubercular treatment. The patient presented with discharging sinus and raised inflammatory markers. She was successfully treated by the removal of prosthesis and debridement followed by ciprofloxacin therapy for 6 weeks...
July 2017: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/28705547/closed-incision-negative-pressure-therapy-effects-on-postoperative-infection-and-surgical-site-complication-after-total-hip-and-knee-arthroplasty
#12
Roberta E Redfern, Claire Cameron-Ruetz, Simone K O'Drobinak, John T Chen, Karl J Beer
BACKGROUND: The aim of this study is to determine whether negative pressure wound therapy, used prophylactically in clean surgical incisions, reduces surgical site infection, hematoma, and seroma after total joint replacement. METHODS: A single center, open-label study with a prospective cohort of patients undergoing primary total knee arthroplasty or total hip arthroplasty treated with closed incision negative pressure therapy (ciNPT) of clean surgical wounds was conducted...
June 17, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28698316/description-of-the-rates-trends-and-surgical-burden-associated-with-revision-for-prosthetic-joint-infection-following-primary-and-revision-knee-replacements-in-england-and-wales-an-analysis-of-the-national-joint-registry-for-england-wales-northern-ireland-and
#13
Erik Lenguerrand, Michael R Whitehouse, Andrew D Beswick, Andrew D Toms, Martyn L Porter, Ashley W Blom
OBJECTIVES: To describe the prevalence rates of revision surgery for the treatment of prosthetic joint infection (PJI) for patients undergoing knee replacement, their time trends, the cumulative incidence function of revision for PJI and estimate the burden of PJI at health service level. DESIGN: We analysed revision knee replacements performed due to a diagnosis of PJI and the linked index procedures recorded in the National Joint Registry from 2003 to 2014 for England and Wales...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28697866/quality-initiative-programs-can-decrease-total-joint-arthroplasty-transfusion-rates-a-multicenter-study-using-the-marcqi-total-joint-registry-database
#14
David C Markel, Mark W Allen, Richard E Hughes, Bonita M Singal, Brian R Hallstrom
BACKGROUND: The Michigan Arthroplasty Registry Collaborative Quality Initiative (MARCQI) noted wide variability between member hospitals in blood transfusion rates after primary total hip and knee arthroplasty (THA and TKA). Blood transfusion has substantial risks and accepted recommendations exist to guide transfusion practices. MARCQI began an initiative to decrease unnecessary transfusions by identifying/reporting outliers, discussing conservative transfusion practices, and recommending transfusion guidelines...
June 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28697082/primary-posterior-blade-plate-tibiotalar-arthrodesis-a-salvage-procedure-for-complex-nonreconstructable-pilon-fractures
#15
Ermias Abebe, Dana J Farrell, Boris Zelle, Gary Gruen
A subset of C2/C3 pilon fractures, open pilon injuries, metaphyseal bone comminution, and those involving substantial soft tissue or vascular injury may be nonreconstructable. Such injuries are at risk of progress to nonunion and failing open reduction internal fixation (ORIF). The risk of infection, malunion, and nonunion is relatively high with such injury patterns. In such cases, tibiotalar arthrodesis is performed after ORIF fails as a salvage procedure. Overall, the literature agrees that all pilon fractures will develop posttraumatic osteoarthritis, and these patients are ultimately treated with an arthrodesis or in narrow population with total ankle arthroplasty...
August 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28695187/infection-burden-in-total-hip-and-knee-arthroplasties-an-international-registry-based-perspective
#16
Bryan D Springer, September Cahue, Caryn D Etkin, David G Lewallen, Brian J McGrory
BACKGROUND: Infection remains a leading cause of failure of hip and knee replacements. Infection burden is the ratio of implants revised for infection to the total number of arthroplasties in a specific period, measuring the steady state of infection in a registry. We hypothesized infection burden would be similar among arthroplasty registries. METHODS: We evaluated publicly reported data from 6 arthroplasty registries (Australian Orthopaedic Association National Joint Replacement Registry [AOANJRR], New Zealand Joint Registry, Swedish Hip Arthroplasty Register, Swedish Knee Arthroplasty Register, National Joint Registry of England, Wales, Northern Ireland, and the Isle of Man, and the American Joint Replacement Registry) for revisions performed with an infection diagnosis over the last 6 years...
June 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28695182/adolescent-total-knee-arthroplasty
#17
John R Martin, Alan K Sutak, Todd A Milbrandt, Valerie A Martin, Robert T Trousdale
BACKGROUND: Management of adolescent patients with end-stage arthritis is challenging. Nonoperative treatments may be ineffective and total knee arthroplasty (TKA) is rarely performed. Currently, minimal long-term data are available on the outcomes in this patient population. Our goal was to describe TKA for patients with end-stage arthritis who were aged 20 years and younger. METHODS: The Joint Registry at our institution was used to identify 19 patients (29 TKAs) aged 20 years and younger that underwent a primary TKA...
June 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28691456/genetic-correlation-between-rheumatoid-arthritis-and-periodontal-disease-the-role-of-sex-and-il-10
#18
L Azzi, S Rania, F Spadari, R Vinci, M Manfredini, F Croveri, A Boggio, L Tettamanti, A Tagliabue, J Silvestre-Rangil, C Bellintani
The chronic stimulation of the immune system due to the presence of bacterial antigens within periodontal tissues has been associated with several autoimmune diseases, like diabetes mellitus, infective endocarditis or cardiovascular atherosclerosis. The current study aims at evaluating the correlation between Rheumatoid Arthritis (RA) and Periodontal Disease (PD) with special attention to genetic polymorphisms in cytokine expression. A total number of 34 patients affected by RA were recruited. Each of them underwent haematochemical analysis and data were collected for Rheumatoid Factor (RF), Anti-Citrullinated Protein’s Antibody (CCP) and HLA-BDR1...
April 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28690466/propionibacterium-acnes-host-inflammatory-response-during-periprosthetic-infection-is-joint-specific
#19
Scott R Nodzo, K Keely Boyle, Samrath Bhimani, Thomas R Duquin, Andy O Miller, Geoffrey H Westrich
BACKGROUND: Propionibacterium acnes (P. acnes) has become increasingly recognized as a cause of periprosthetic joint infection (PJI). QUESTIONS/PURPOSES: It is not currently known if the clinical presentation of P. acnes varies depending on the joint being infected. METHODS: We retrospectively reviewed patients infected with P. acnes after total hip, knee, and shoulder arthroplasty from two institutions. Patients were classified as having a PJI based on the Musculoskeletal Infection Society criteria and were excluded if they had a polymicrobial culture...
July 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28690039/retained-antibiotic-spacers-after-total-hip-and-knee-arthroplasty-resections-high-complication-rates
#20
Stephen M Petis, Kevin I Perry, Mark W Pagnano, Daniel J Berry, Arlen D Hanssen, Matthew P Abdel
BACKGROUND: Prolonged retention of an antibiotic spacer is occasionally chosen during treatment of periprosthetic joint infections after total hip arthroplasty (THA) and total knee arthroplasty (TKA). The purpose of our study was to evaluate the outcome of extended spacer retention. METHODS: We reviewed 1106 cases of periprosthetic joint infection after THA (n = 308) and TKA (n = 798) and identified 17 (5.5%) retained hip and 34 (4.3%) retained knee spacers. Most patients (35 of 51, 69%) underwent spacer retention because they were medically unfit for further surgery...
June 8, 2017: Journal of Arthroplasty
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