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https://www.readbyqxmd.com/read/29715553/development-and-validation-of-baseline-perioperative-and-at-discharge-predictive-models-for-postsurgical-prosthetic-joint-infection
#1
María Dolores Del Toro, Cecilia Peñas, Ana Conde Albarracín, Julián Palomino, Francisco Brun, Santiago Sánchez, Jesús Rodríguez-Baño
OBJECTIVES: To develop and validate baseline, perioperative and at-discharge risk-scoring systems for postsurgical prosthetic joint infection (PJI) in patients undergoing arthroplasty. PATIENTS AND METHODS: A multicentre, prospective cohort study of patients undergoing hip and knee arthroplasty was performed. Patients were randomly assigned (2:1) to a derivation cohort (DC) or a validation cohort (VC). Multivariable predictive models of PJI were constructed at baseline (preoperative period), perioperative (adding perioperative variables), and at-discharge (adding wound state at-discharge)...
April 28, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29715226/development-and-evaluation-of-a-preoperative-risk-calculator-for-periprosthetic-joint-infection-following-total-joint-arthroplasty
#2
Timothy L Tan, Mitchell G Maltenfort, Antonia F Chen, AliSina Shahi, Carlos A Higuera, Marcelo Siqueira, Javad Parvizi
BACKGROUND: Preoperative identification of patients at risk for periprosthetic joint infection (PJI) following total hip arthroplasty (THA) or total knee arthroplasty (TKA) is important for patient optimization and targeted prevention. The purpose of this study was to create a preoperative PJI risk calculator for assessing a patient's individual risk of developing (1) any PJI, (2) PJI caused by Staphylococcus aureus, and (3) PJI caused by antibiotic-resistant organisms. METHODS: A retrospective review was performed of 27,717 patients (12,086 TKAs and 31,167 THAs), including 1,035 with confirmed PJI, who were treated at a single institution from 2000 to 2014...
May 2, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29713837/current-options-and-emerging-biomaterials-for-periprosthetic-joint-infection
#3
REVIEW
Ashley E Levack, Erika L Cyphert, Mathias P Bostrom, Christopher J Hernandez, Horst A von Recum, Alberto V Carli
PURPOSE OF REVIEW: Infection in the setting of total joint arthroplasty, referred to as periprosthetic joint infection (PJI), is a devastating complication requiring prolonged and costly treatment. The unique environment around an artificial joint and ability of surrounding tissues to sequester bacteria collectively make prevention, diagnosis, and treatment of this condition challenging. In light of the unique pathogenesis of PJI, this review explores the limitations of contemporary treatments and discusses novel treatment options...
April 30, 2018: Current Rheumatology Reports
https://www.readbyqxmd.com/read/29663554/implant-associated-bacterial-biofilm-and-quorum-sensing-in-periprosthetic-joint-infections
#4
Jake A Mooney, Eric M Pridgen, Robert Manasherob, Gina Suh, Helen E Blackwell, Annelise E Barron, Paul L Bollyky, Stuart B Goodman, Derek F Amanatullah
Periprosthetic joint infection (PJI) continues to be a common complication after total knee arthroplasty and total hip arthroplasty leading to severe morbidity and mortality. With an aging population and increasing prevalence of total joint replacement procedures, the burden of PJI will be felt not only by individual patients, but in increased healthcare costs. Current treatment of PJI is inadequate resulting in incredibly high failure rates. This is believed to be largely mediated by the presence of bacterial biofilms...
April 16, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29629518/atypical-presentation-of-pneumocystis-jirovecii-infection-in-hiv-infected-patients-three-different-manifestations
#5
Bongyoung Kim, Jieun Kim, Seung Sam Paik, Hyunjoo Pai
Advances in the treatment and prevention of Pneumocystis jirovecii infection (PJI) in human immunodeficiency virus (HIV) patients decreased incidence and mortality dramatically, however, it may be associated with an increased frequency of unusual manifestation such as cystic formation, pneumothorax, focal infiltration, nodular formation, or extrapulmonary lesions. We report three cases of PJI with atypical manifestations. Each case demonstrates different clinical features: multiple nodular pulmonary lesion (32-year-old man with abnormal chest X-ray finding), subpleural mass-like lesion (43-year-old man with left visual loss and right pleuritic chest pain), and extrapulmonary mass-like lesions in the liver, lymph nodes, and small bowel (39-year-old man with cough, sputum, and dyspnea)...
April 9, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29628696/do-local-antibiotics-reduce-periprosthetic-joint-infections-a-retrospective-review-of-744-cases
#6
Craig Winkler, Joel Dennison, Adam Wooldridge, Eneko Larumbe, Cyrus Caroom, Mark Jenkins, George Brindley
Periprosthetic joint infections (PJI) are uncommon but not rare and have significant morbidity and financial implications. Local antibiotics have been used successfully in other areas of orthopedics to reduce postoperative infections, but this method has not been proven in total joint arthroplasty (TJA). Beginning January 1, 2014, our primary investigators began using surgical site lavage with providone-iodine solution and administering 2 g of vancomcyin powder in the surgical wound prior to capsule closure for all primary and revision total hip and knee arthroplasties...
March 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29564296/intrawound-vancomycin-powder-in-primary-total-hip-arthroplasty-increases-rate-of-sterile-wound-complications
#7
Brian L Dial, Alexander J Lampley, Cynthia L Green, Rhett Hallows
Purpose: Total hip arthroplasty (THA) is a successful surgery for the treatment of hip osteoarthritis; however, the risk of a post-operative prosthetic joint infection (PJI) remains at 1% to 2%. The purpose of this study was to investigate the safety profile of using vancomycin powder (VP) to reduce infection rates by reviewing acute postoperative complications. Materials and Methods: A retrospective review of 265 consecutive patients undergoing THA was performed...
March 2018: Hip & Pelvis
https://www.readbyqxmd.com/read/29544969/cutibacterium-formerly-propionibacterium-avidum-a-rare-but-avid-agent-of-prosthetic-hip-infection
#8
Valérie A Zeller, Valérie-Anne Letembet, Vanina A Meyssonnier, Beate Heym, Jean-Marc Ziza, Simon D Marmor
BACKGROUND: Cutibacterium spp. (formerly Propionibacterium) are slow-growing cutaneous anaerobic commensals, rarely reported in prosthetic joint infections (PJIs). We describe epidemiological, clinical, biological, and radiological characteristics of 15 Cutibacterium avidum PJIs, their treatments, and outcomes. METHODS: This study is an observational, monocenter study (January 2004 to April 2017), with comparison of C avidum vs Cutibacterium acnes (n = 40) PJI characteristics...
February 12, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29415309/-the-economic-challenge-of-centralised-treatment-of-patients-with-periprosthetic-infections
#9
Michael Müller, Andrej Trampuz, Tobias Winkler, Carsten Perka
INTRODUCTION: Periprosthetic infection (PJI) is one of the most severe complications in joint arthroplasty. Correct diagnosis and adequate therapy represent an enormous interdisciplinary challenge. The necessary interdisciplinarity and complexity of treatment require therapy in centres. However, the high costs have not yet been analysed or discussed and are problematic. The aim of this work is therefore to compare the costs within a year of treatment in a department specialised in the treatment of periprosthetic infections...
February 7, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29340736/risk-factors-for-early-infection-following-hemiarthroplasty-in-elderly-patients-with-a-femoral-neck-fracture
#10
Dirk Zajonz, Alexander Brand, Christian Lycke, Orkun Özkurtul, Jan Theopold, Ulrich J A Spiegl, Andreas Roth, Christoph Josten, Johannes K M Fakler
PURPOSE: Periprosthetic joint infections (PJI) after hemiarthroplasty for geriatric femoral neck fractures are a devastating complication that results in serious morbidity and increased mortality. Identifying risk factors associated with early infection after HA for hip fractures may offer an opportunity to address and prevent this complication in many patients. The aim of this study was to evaluate preoperative risk factors for early PJI after HA in hip fracture patients. METHODS: From January 2010 to December 2015, 312 femoral neck fractures (AO/OTA 31-B) in 305 patients were included in this single-center, retrospective study...
January 16, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29193440/mid-term-outcomes-and-complications-of-total-knee-arthroplasty-in-haemophilic-arthropathy-a-review-of-consecutive-131-knees-between-2006-and-2015-in-a-single-institute
#11
S J Song, J K Bae, C H Park, M C Yoo, D K Bae, K I Kim
INTRODUCTION: Although total knee arthroplasty (TKA) in haemophilic arthropathy can reduce severe joint pain and improve functional disability, it is technically demanding. AIM: To evaluate mid-term outcomes and complications of TKA in haemophilic arthropathy. METHODS: This study retrospectively reviewed 131 consecutive primary TKAs in a single institute. The mean age was 41.0 years old, and the mean follow-up period was 6.8 years. Clinical and radiographic results were evaluated...
November 29, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/29174761/vancomycin-povidone-iodine-protocol-improves-survivorship-of-periprosthetic-joint-infection-treated-with-irrigation-and-debridement
#12
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...
March 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29139571/human-prosthetic-joint-infections-are-associated-with-myeloid-derived-suppressor-cells-mdscs-implications-for-infection-persistence
#13
Cortney E Heim, Debbie Vidlak, Jessica Odvody, Curtis W Hartman, Kevin L Garvin, Tammy Kielian
Prosthetic joint infection (PJI) is a devastating complication of joint arthroplasty surgery typified by biofilm formation. Currently, mechanisms whereby biofilms persist and evade immune-mediated clearance in immune competent patients remain largely ill-defined. Therefore, the current study characterized leukocyte infiltrates and inflammatory mediator expression in tissues from patients with PJI compared to aseptic loosening. CD33+ HLA-DR- CD66b+ CD14-/low granulocytic myeloid-derived suppressor cells (G-MDSCs) were the predominant leukocyte population at sites of human PJI compared to aseptic tissues...
November 15, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29079156/septic-arthritis-and-prosthetic-joint-infections-in-older-adults
#14
REVIEW
Rajeshwari Nair, Marin L Schweizer, Namrata Singh
Older adults are at increased risk for septic arthritis and prosthetic joint infections (PJI), owing at least in part to comorbid conditions and frailty. An increasing number of older adults undergo total joint arthroplasty to improve their quality of life. Infections in older adults differ from younger populations by the causative organisms, a great proportion of which are Staphylococcal infections. Targeting important modifiable and nonmodifiable risk factors may prevent or reduce the burden of joint infections in older adults...
December 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/29040138/vitamin-d-supplementation-a-low-risk-high-gain-therapy-to-prevent-pji-commentary-on-an-article-by-vishal-hegde-md-et-al-single-dose-preoperative-vitamin-d-supplementation-decreases-infection-in-a-mouse-model-of-periprosthetic-joint-infection
#15
https://www.readbyqxmd.com/read/28878512/comparison-of-postoperative-complications-after-total-hip-arthroplasty-among-patients-receiving-aspirin-enoxaparin-warfarin-and-factor-xa-inhibitors
#16
Perez Agaba, Beau J Kildow, Herman Dhotar, Thorsten M Seyler, Michael Bolognesi
Optimal prophylaxis for prevention of venous thromboembolism (VTE) after total joint arthroplasty (TJA) remains debated. The purpose of this study was to compare postoperative complications in patients receiving different VTE chemoprophylactic regimens. Using a nationwide healthcare database, 72,670 THA patients without a history of VTE were identified. Study cohorts received VTE prophylaxis within 30 days postoperatively. Odds ratios and 95% confidence intervals were used to assess 30-day and 90-day postoperative complications (hematoma, hemorrhage, transfusion, pulmonary embolism (PE), VTE, prosthetic joint infection (PJI), and incision/drainage (I&D))...
December 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28869114/multidrug-resistant-organisms-in-the-setting-of-periprosthetic-joint-infection-diagnosis-prevention-and-treatment
#17
Matthew P Siljander, Ali H Sobh, Kevin C Baker, Erin A Baker, Lige M Kaplan
BACKGROUND: Periprosthetic joint infection (PJI) is a rare yet challenging problem in total hip and knee arthroplasties. The management of PJI remains difficult primarily due to the evolution of resistance by the infecting organisms. METHODS: This review profiles acquired mechanisms of bacterial resistance and summarizes established and emerging techniques in PJI diagnosis, prevention, and treatment. RESULTS: New techniques in PJI diagnosis and prevention continue to be explored...
January 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28865425/silver-coated-modular-megaendoprostheses-in-salvage-revision-arthroplasty-after-periimplant-infection-with-extensive-bone-loss-a-pilot-study-of-34-patients
#18
Dirk Zajonz, Undine Birke, Mohamed Ghanem, Torsten Prietzel, Christoph Josten, Andreas Roth, Johannes K M Fakler
BACKGROUND: Hip and knee replacements in patients with bone defects after infection correlates with high rates of reinfection. In this vulnerable patient population, the prevention of reinfection is to be considered superordinate to the functionality and defect bridging. The use of silver coating of aseptic implants as an infection prophylaxis is already proven; however, the significance of these coatings in septic reimplantation of large implants is still not sufficiently investigated...
September 2, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28854760/a-review-of-the-literature-on-culture-negative-periprosthetic-joint-infection-epidemiology-diagnosis-and-treatment
#19
REVIEW
Hong-Kwon Yoon, Seong-Hee Cho, Dong-Yeong Lee, Byeong-Hun Kang, Sang-Hyuk Lee, Dong-Gyu Moon, Dong-Hee Kim, Dae-Cheol Nam, Sun-Chul Hwang
Purpose: The prevalence of periprosthetic joint infection (PJI) has increased with the increasing incidence of arthroplasty surgery. Considering identification of causative microorganisms is crucial for treatment of PJI, culture-negative (CN) PJI is a significant clinical issue. The purpose of the present study is to describe epidemiology, diagnosis and treatment of CN PJI based on review of the literature to help prevent delayed diagnosis and improve clinical outcomes of CN PJI. Methods: MEDLINE, EMBASE, Cochrane Library and Scopus databases were searched for articles on CN PJI...
September 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28799523/bactericidal-activity-of-the-ti-13nb-13zr-alloy-against-different-species-of-bacteria-related-with-implant-infection
#20
John-Jairo Aguilera-Correa, Ana Conde, Maria-Angeles Arenas, Juan-Jose de-Damborenea, Miguel Marin, Antonio L Doadrio, Jaime Esteban
The Ti-6Al-4V alloy is one of the most commonly used in orthopedic surgery. Despite its advantages, there is an increasing need to use new titanium alloys with no toxic elements and improved biomechanical properties, such as Ti-13Nb-13Zr. Prosthetic joint infections (PJI) are mainly caused by Gram-positive bacteria; however, Gram-negative bacteria are a growing problem due to associated multidrug resistance. In this study, the bacterial adherence and viability on the Ti-13Nb-13Zr alloy have been compared to that of the Ti-6Al-4V alloy using 16 collection and clinical strains of bacterial species related to PJI: Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, and Pseudomonas aeruginosa...
August 11, 2017: Biomedical Materials
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