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Total joint infection

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https://www.readbyqxmd.com/read/28324232/reducing-surgical-site-infections-following-total-hip-and-knee-arthroplasty-an-israeli-experience
#1
R Finkelstein, O Eluk, T Mashiach, D Levin, B Peskin, G Nirenberg, S Karkabi, M Soudri
PURPOSE: To assess the changes observed in surgical site infection (SSI) rates following total joint arthroplasty (TJA) after the introduction of an infection control programme and evaluate the risk factors for the development of these infections. DESIGN: Prospective cohort study. SETTING: Large tertiary medical centre in Israel. METHODS: Data about SSIs and potential prophylaxis-, patient-, and procedure-related risk factors were collected for all patients who underwent elective total hip and total knee arthroplasty during the study period...
March 21, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28318868/management-of-periprosthetic-joint-infection-the-more-we-learn-the-less-we-know
#2
Robert A Henderson, Matthew S Austin
BACKGROUND: Despite the tremendous and long-standing success of total hip arthroplasty and total knee arthroplasty as treatments for end-stage arthritis, periprosthetic joint infection (PJI) remains a rare but feared complication of these procedures. METHODS: This review highlights some of the difficulties inherent to studying PJI. These include the difficulty in powering studies to capture this relatively uncommon complication, as well as the heterogeneity in clinical presentation and manifestations associated with the diagnosis and treatment of PJI...
February 23, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28318862/have-periprosthetic-hip-infection-rates-plateaued
#3
Dean C Perfetti, Matthew R Boylan, Qais Naziri, Carl B Paulino, Steven M Kurtz, Michael A Mont
BACKGROUND: Periprosthetic joint infection (PJI) is a serious complication of total hip arthroplasty (THA). Although the number of revision cases is increasing, the prevalence of PJI as an indication for revision surgery, and the variability of this indication among surgeons and hospitals, is unclear. METHODS: The New York Statewide Planning and Research Cooperative System was used to identify 33,582 patients undergoing revision THA between 2000 and 2013. PJI was identified using International Classification of Diseases, Ninth Revision diagnosis codes...
February 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28316960/lower-urinary-tract-infection-and-periprosthetic-joint-infection-after-elective-primary-total-hip-arthroplasty
#4
Chan Ho Park, Young-Kyun Lee, Kyung-Hoi Koo
PURPOSE: Periprosthetic joint infection (PJI) after total hip arthroplasty (THA) is a grave complication. Urinary tract infection (UTI) as a source for PJI is controversial. Our purposes were, (1) to evaluate the incidence of PJI after elective primary THA and (2) to determine whether UTI was associated with a risk of PJI after elective primary THA. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 527 patients who underwent elective primary THA by using universal aseptic technique from May 2003 to October 2007...
March 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/28303585/the-effect-of-depth-of-centrifuged-synovial-fluid-on-leukocyte-esterase-test-for-periprosthetic-joint-infection
#5
Pakpoom Ruangsomboon, Sriprapa Chinprasertsuk, Varanya Khejonnit, Keerati Chareancholvanich
Centrifugation of aspirated synovial fluid before leukocytes esterase (LE) testing for diagnosing periprosthetic joint infection (PJI) may make blood tinged specimens interpretable. We aimed to establish the proper sampling depth of centrifuged specimens for LE testing as one diagnostic criterion and also AS-D chloroacetate esterase (CAE) staining testing as an adjunctive tool. A definite PJI knee joint group and an aseptic primary total knee arthroplasty control group were studied quasi-experimentally (N = 46)...
March 17, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28295126/gluteus-maximus-advancement-flap-procedure-for-reconstruction-of-posterior-soft-tissue-deficiency-in-revision-total-hip-arthroplasty
#6
Benjamin F Ricciardi, Peter W Henderson, Alexander S McLawhorn, Geoffrey H Westrich, Mathias P Bostrom, Lloyd B Gayle
The current study describes the surgical technique and early outcomes of a gluteus maximus advancement flap procedure for the treatment of posterior soft tissue insufficiency among patients with complex revision total hip arthroplasty. This retrospective case series was conducted with a prospective, single-institution arthroplasty registry. Patients who underwent a gluteus maximus advancement flap procedure in the setting of revision total hip arthroplasty between January 2012 and January 2016 were eligible for inclusion (N=7)...
March 14, 2017: Orthopedics
https://www.readbyqxmd.com/read/28293333/percutaneous-cannulated-compression-screw-osteosynthesis-in-phalanx-fractures-the-surgical-technique-the-indications-and-the-results
#7
Eirini Liodaki, Tobias Kisch, Eike Wenzel, Peter Mailänder, Felix Stang
Objective: Fractures of metacarpals and phalanges are very common fractures, and there are a lot of treatment modalities. The purpose of the study was to describe the technique of percutaneous fixation of phalangeal fractures using a cannulated compression screw fixation system and its results. Methods: We conducted a prospective clinical study on 43 patients with different types of phalangeal fractures undergoing a percutaneous cannulated compression screw osteosynthesis. Parameters such as average operation time and clinical outcome were evaluated postoperatively...
2017: Eplasty
https://www.readbyqxmd.com/read/28292539/prevention-of-infection-in-orthopedic-prosthetic-surgery
#8
REVIEW
Ioana Chirca, Camelia Marculescu
Total joint arthroplasty is a generally safe orthopedic procedure; however, infection is a potentially devastating complication. Multiple risk factors have been identified for development of prosthetic joint infections. Identification of patients at risk and preoperative correction of known risk factors, such as smoking, diabetes mellitus, anemia, malnutrition, and decolonization of Staphylococcus carriers, represent well-established actions to decrease the infection risk. Careful operative technique, proper draping and skin preparation, and appropriate selection and dosing of antimicrobials for perioperative prophylaxis are also very important in prevention of infection...
March 11, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28291188/quantification-of-peri-implant-bacterial-load-and-in-vivo-biofilm-formation-in-an-innovative-clinically-representative-mouse-model-of-periprosthetic-joint-infection
#9
Alberto V Carli, Samrath Bhimani, Xu Yang, Matthew B Shirley, Karen L de Mesy Bentley, F Patrick Ross, Mathias P G Bostrom
BACKGROUND: Periprosthetic joint infection (PJI) is a devastating complication following total joint arthroplasty. Current animal models of PJI are limited because of a lack of quantitative methods and failure to effectively recreate the periprosthetic space. We therefore developed a murine PJI model involving a 3-dimensionally printed Ti-6Al-4V implant capable of bearing weight and permitting quantitative analysis of periprosthetic bacterial load and evaluation of biofilm. METHODS: Twenty-five 12-week-old C57BL/6 mice received a unilateral proximal tibial implant and intra-articular injection of either 3 × 10 colony forming units (CFUs) of Staphylococcus aureus Xen 36 or saline solution...
March 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28290115/sonication-of-arthroplasty-implants-improves-accuracy-of-periprosthetic-joint-infection-cultures
#10
REVIEW
Adam C Rothenberg, Alan E Wilson, John P Hayes, Michael J O'Malley, Brian A Klatt
BACKGROUND: There is evidence that sonication of explanted prosthetic hip and knee arthroplasty components with culture of the sonication fluid may enhance diagnostic sensitivity. Previous studies on the use of implant sonicate cultures have evaluated diagnostic thresholds but did not elaborate on the clinical importance of positive implant sonicate cultures in the setting of presumed aseptic revisions and did not utilize consensus statements on periprosthetic joint infection (PJI) diagnosis when defining their gold standard for infection...
March 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28283902/what-is-the-ideal-route-of-administration-of-tranexamic-acid-in-tka-a-randomized-controlled-trial
#11
Sung Yup Lee, Suri Chong, Dhanasekaraprabu Balasubramanian, Young Gon Na, Tae Kyun Kim
BACKGROUND: TKA commonly involves substantial blood loss and tranexamic acid has been used to reduce blood loss after TKA. Numerous clinical trials have documented the efficacy and safety of intravenous (IV) or intraarticular (IA) use of tranexamic acid. Combined administration of tranexamic acid also has been suggested; however, there is no consensus regarding the ideal route of tranexamic acid administration. QUESTIONS/PURPOSES: (1) To compare the efficacy of tranexamic acid in terms of total blood loss and the allogeneic transfusion rate among three routes of administration: IV alone, IA alone, and combined IV and IA...
March 10, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28280708/evaluation-of-postoperative-complications-according-to-treatment-of-third-molars-in-mandibular-angle-fracture
#12
Hye-Youn Lim, Tae-Young Jung, Sang-Jun Park
OBJECTIVES: The aim of this study was to evaluate the implication of third molars in postoperative complications of mandibular angle fracture with open reduction and internal fixation (ORIF). MATERIALS AND METHODS: Data were collected on patients who presented with mandibular angle fracture at our Department of Oral and Maxillofacial Surgery between January 2011 and December 2015. Of the 63 total patients who underwent ORIF and perioperative intermaxillary fixation (IMF) with an arch bar, 49 patients were identified as having third molars in the fracture line and were followed up with until plate removal...
February 2017: Journal of the Korean Association of Oral and Maxillofacial Surgeons
https://www.readbyqxmd.com/read/28280641/prosthetic-joint-infection-due-to-mycobacterium-avium-intracellulare-in-a-patient-with-rheumatoid-arthritis-a-case-report-and-review-of-the-literature
#13
Nicholas E Ingraham, Brenton Schneider, Jonathan D Alpern
Nontuberculous mycobacteria (NTM) are a rare cause of prosthetic joint infections (PJI). However, the prevalence of NTM infections may be increasing with the rise of newer immunosuppressive medications such as biologics. In this case report, we describe a rare complication of immunosuppressive therapies and highlight the complexity of diagnosing and treating PJI due to NTM. The patient is a 79-year-old Caucasian male with a history of severe destructive rheumatoid arthritis on several immunosuppressive agents and right hip osteoarthritis s/p total hip arthroplasty 15 years previously with several complex revisions, presenting with several weeks of worsening right hip and abdominal pain...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28277466/early-results-of-surgical-management-of-camptodactyly
#14
Brady T Evans, Peter M Waters, Donald S Bae
BACKGROUND: We hypothesize that surgery for moderate-to-severe camptodactyly (>50 degrees) results in modest gains in range of motion and improved digital position. METHODS: A retrospective analysis of patients undergoing surgery for camptodactyly at a tertiary children's hospital between 2000 and 2014 was performed. Surgery was indicated for patients with persistent, functionally limiting flexion contractures despite observation, therapy, and splinting. Data were collected on demographics, clinical history and presentation, nonoperative management, surgery, and clinical follow-up, focusing on range of motion at the involved joint...
March 8, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28277419/complications-after-continuous-posterior-lumbar-plexus-blockade-for-total-hip-arthroplasty-a-retrospective-cohort-study
#15
Catherine W Njathi, Rebecca L Johnson, Ruple S Laughlin, Darrell R Schroeder, Adam K Jacob, Sandra L Kopp
BACKGROUND AND OBJECTIVES: While benefits of regional anesthesia in total hip arthroplasty (THA) are well documented, data describing the incidence of complications related to the use of posterior lumbar plexus blockade for THA remain limited. Our primary aim was to evaluate the incidence of infectious, bleeding, and neurological complications related specifically to the use of continuous posterior lumbar plexus block for elective THA. METHODS: We reviewed the electronic medical records of all adult patients who underwent elective THA with continuous posterior lumbar plexus blockade between December 1, 2004, and April 30, 2015, using the Mayo Clinic Total Joint Registry...
March 8, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28274250/prosthetic-joint-infection-development-of-an-evidence-based-diagnostic-algorithm
#16
Heinrich M L Mühlhofer, Florian Pohlig, Karl-Georg Kanz, Ulrich Lenze, Florian Lenze, Andreas Toepfer, Sarah Kelch, Norbert Harrasser, Rüdiger von Eisenhart-Rothe, Johannes Schauwecker
BACKGROUND: Increasing rates of prosthetic joint infection (PJI) have presented challenges for general practitioners, orthopedic surgeons and the health care system in the recent years. The diagnosis of PJI is complex; multiple diagnostic tools are used in the attempt to correctly diagnose PJI. Evidence-based algorithms can help to identify PJI using standardized diagnostic steps. METHODS: We reviewed relevant publications between 1990 and 2015 using a systematic literature search in MEDLINE and PUBMED...
March 9, 2017: European Journal of Medical Research
https://www.readbyqxmd.com/read/28271919/prosthetic-joint-infection-a-devastating-complication-of-hemiarthroplasty-for-hip-fracture
#17
Ellen Guren, Wender Figved, Frede Frihagen, Leiv Otto Watne, Marianne Westberg
Background and purpose - Hemiarthroplasty is the most common treatment in elderly patients with displaced femoral neck fracture. Prosthetic joint infection (PJI) is a feared complication. The infection rate varies in the literature, and there are limited descriptive data available. We investigated the characteristics and outcome of PJI following hemiarthroplasty over a 15-year period. Patients and methods - Patients with PJI were identified among 519 patients treated with hemiarthroplasty for a femoral neck fracture at Oslo University Hospital between 1998 and 2012...
March 8, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28266601/incomplete-removal-of-wolbachia-with-tetracycline-has-two-edged-reproductive-effects-in-the-thelytokous-wasp-encarsia-formosa-hymenoptera-aphelinidae
#18
Xiao-Xiang Wang, Lan-Da Qi, Rui Jiang, Yu-Zhou Du, Yuan-Xi Li
Wolbachia pipientis are intracellular endosymbionts that induce parthenogenesis in the parasitoid Encarsia formosa. Previous studies that focused on effects of Wolbachia on the wasp usually used tetracycline to remove Wolbachia without concern for the joint influences of tetracycline and Wolbachia. Here we treated the wasps (F0 lines) with tetracycline to produce offspring (F1 lines) which were not fed tetracycline to avoid antibiotic influence. The quantitative data and fluorescence in situ hybridization showed that Wolbachia titers were reduced but not totally removed...
March 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28264689/rapid-diagnostic-tests-failing-to-detect-plasmodium-falciparum-infections-in-eritrea-an-investigation-of-reported-false-negative-rdt-results
#19
Araia Berhane, Mulugeta Russom, Iyassu Bahta, Filmon Hagos, Michael Ghirmai, Selam Uqubay
BACKGROUND: Relatively large number of false-negative malaria rapid diagnostic test (RDT) results for microscopically confirmed Plasmodium falciparum cases were reported from five of the six administrative regions of Eritrea in 2015. This activated the Ministry of Health to conduct an initial exploratory investigation. The main objective of the investigation was to confirm the sensitivity of the RDTs in the field in microscopically confirmed malaria cases, identify the possible causes of the failure and recommend further actions to be taken...
March 6, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28260595/a-danish-nationwide-questionnaire-study-of-hepatitis-b-virus-screening-before-immunosuppressive-therapy
#20
Kristine Ifigenia Bunyoz, Henrik Krarup, Nina Weis
INTRODUCTION: Difficulty in identifying patients who are at risk for hepatitis B virus (HBV) reactivation makes it import-ant to screen for HBV before initiating immunosuppressive therapy. The aim of this study was to investigate screening procedures for HBV infection before initiation of immunosuppressive therapy and to explore HBV treatment strategies. METHODS: All Danish units of haematology, oncology, dermatology, rheumatology and gastroenterology using immunosuppressive agents were invited to fill out a questionnaire for The Danish Database for Hepatitis B and C...
March 2017: Danish Medical Journal
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