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PJI prevention

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https://www.readbyqxmd.com/read/28878512/comparison-of-postoperative-complications-after-total-hip-arthroplasty-among-patients-receiving-aspirin-enoxaparin-warfarin-and-factor-xa-inhibitors
#1
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
#2
REVIEW
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...
August 3, 2017: 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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28760710/the-impact-of-preoperative-bacteriuria-on-the-risk-of-periprosthetic-joint-infection-after-primary-knee-or-hip-replacement-a-retrospective-study-with-a-one-year-follow-up
#6
Meeri Honkanen, Esa Jämsen, Matti Karppelin, Reetta Huttunen, Heini Huhtala, Antti Eskelinen, Jaana Syrjänen
OBJECTIVES: Patients who undergo elective joint replacement are traditionally screened and treated for preoperative bacteriuria in order to prevent periprosthetic joint infection (PJI). More recently, this practice has been questioned. The purpose of this study was to determine whether preoperative bacteriuria is associated with an increased risk of PJI. METHODS: Patients who had undergone a primary hip or knee replacement in a tertiary care hospital between September 2002 and December 2013 were identified from the hospital database (23 171 joint replacements, 10 200 hips, and 12 971 knees)...
July 28, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28623686/temporomandibular-prosthetic-joint-infections-associated-with-propionibacterium-acnes-a-case-series-and-a-review-of-the-literature
#7
Ruba Khader, Joseph Tingey, Steven Sewall
PURPOSE: The orthopedic literature has shown an increasing incidence of prosthetic joint infections (PJIs) associated with Propionibacterium acnes (P acnes). These infections present serious diagnostic and management challenges to the treating surgeons. In this review, the authors report on cases of P acnes-related temporomandibular joint (TMJ) PJIs that have been diagnosed and treated at their institution. MATERIALS AND METHODS: After approval by the institutional review board, information was obtained through a retrospective chart review...
May 24, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28573549/periprosthetic-joint-infection-is-the-main-cause-of-failure-for-modern-knee-arthroplasty-an-analysis-of-11-134-knees
#8
Chuan Kong Koh, Irene Zeng, Saiprassad Ravi, Mark Zhu, Kelly G Vince, Simon W Young
BACKGROUND: Although large series from national joint registries may accurately reflect indications for revision TKAs, they may lack the granularity to detect the true incidence and relative importance of such indications, especially periprosthetic joint infections (PJI). QUESTIONS/PURPOSES: Using a combination of individual chart review supplemented with New Zealand Joint Registry data, we asked: (1) What is the cumulative incidence of revision TKA? (2) What are the common indications for revising a contemporary primary TKA? (3) Do revision TKA indications differ at various followup times after primary TKA? METHODS: We identified 11,134 primary TKAs performed between 2000 and 2015 in three tertiary referral hospitals...
September 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28543702/microencapsulation-of-rifampicin-a-technique-to-preserve-the-mechanical-properties-of-bone-cement
#9
Pablo Sanz-Ruiz, Esther Carbó-Laso, Juan Carlos Del Real-Romero, Francisca Arán-Ais, Yolanda Ballesteros-Iglesias, Eva Paz-Jiménez, Magdalena Sánchez-Navarro, María Ángeles Pérez-Limiñana, Javier Vaquero-Martín
Two-stage exchange with antibiotic-loaded bone cement spacers remains the gold standard for chronic periprosthetic joint infection (PJI). Rifampicin is highly efficient on stationary-phase staphylococci in biofilm; however, its addition to PMMA to manufacture spacers prevents polymerization and reduces mechanical properties. Isolation of rifampicin during polymerization by microencapsulation could allow manufacturing rifampicin-loaded bone cement maintaining elution and mechanical properties. Microcapsules of rifampicin with alginate, polyhydroxybutyratehydroxyvalerate (PHBV), ethylcellulose and stearic acid (SA) were synthesized...
May 23, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28529860/use-of-chlorhexidine-preparations-in-total-joint-arthroplasty
#10
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/28461965/total-knee-arthroplasty-and-infection-how-surgeons-can-reduce-the-risks
#11
REVIEW
Nicola Ratto, Chiara Arrigoni, Federica Rosso, Matteo Bruzzone, Federico Dettoni, Davide Edoardo Bonasia, Roberto Rossi
Total joint arthroplasty (TJA) is one of the most common orthopaedic procedures. Nevertheless, several complications can lead to implant failure.Peri-prosthetic joint infections (PJI) certainly represent a significant challenge in TJA, constituting a major cause of prosthetic revision. The surgeon may have an important role in reducing the PJI rate by limiting the impact of significant risk factors associated to either the patient, the operative environment or the post-operative care.In the pre-operative period, several preventive measures may be adopted to manage reversible medical comorbidities...
September 2016: EFORT open reviews
https://www.readbyqxmd.com/read/28448204/future-research-opportunities-in-peri-prosthetic-joint-infection-prevention
#12
Elie Berbari, John Segreti, Javad Parvizi, Sandra I Berríos-Torres
Peri-prosthetic joint infection (PJI) is a serious complication of prosthetic joint arthroplasty. A better understanding and reversal of modifiable risk factors may lead to a reduction in the incidence of incisional (superficial and deep) and organ/space (e.g., PJI) surgical site infections (SSI). Recently, the Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC) published the Guideline for Prevention of Surgical Site Infection. This targeted update applies evidence-based methodology in drafting recommendations for potential strategies to reduce the risk of SSI both across surgical procedures and specifically in prosthetic joint arthroplasty...
May 2017: Surgical Infections
https://www.readbyqxmd.com/read/28419033/oral-only-linezolid-rifampin-is-highly-effective-compared-with-other-antibiotics-for-periprosthetic-joint-infection-study-of-a-mouse-model
#13
John M Thompson, Vikram Saini, Alyssa G Ashbaugh, Robert J Miller, Alvaro A Ordonez, Roger V Ortines, Yu Wang, Robert S Sterling, Sanjay K Jain, Lloyd S Miller
BACKGROUND: The medical treatment of periprosthetic joint infection (PJI) involves prolonged systemic antibiotic courses, often with suboptimal clinical outcomes including increased morbidity and health-care costs. Oral and intravenous monotherapies and combination antibiotic regimens were evaluated in a mouse model of methicillin-resistant Staphylococcus aureus (MRSA) PJI. METHODS: Oral linezolid with or without oral rifampin, intravenous vancomycin with oral rifampin, intravenous daptomycin or ceftaroline with or without oral rifampin, oral doxycycline, or sham treatment were administered at human-exposure doses for 6 weeks in a mouse model of PJI...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28407472/introduction-to-the-centers-for-disease-control-and-prevention-and-healthcare-infection-control-practices-advisory-committee-guideline-for-prevention-of-surgical-site-infection-prosthetic-joint-arthroplasty-section
#14
John Segreti, Javad Parvizi, Elie Berbari, Philip Ricks, Sandra I Berríos-Torres
Peri-prosthetic joint infection (PJI) is a severe complication of total joint arthroplasty that appears to be increasing as more of these procedures are performed. Numerous risk factors for incisional (superficial and deep) and organ/space (e.g., PJI) surgical site infections (SSIs) have been identified. A better understanding and reversal of modifiable risk factors may lead to a reduction in the incidence of incisional SSI and PJI. The Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC) recently updated the national Guideline for Prevention of Surgical Site Infection...
May 2017: Surgical Infections
https://www.readbyqxmd.com/read/28378243/prolonged-suppressive-antibiotic-therapy-for-prosthetic-joint-infection-in-the-elderly-a-national-multicentre-cohort-study
#15
V Prendki, T Ferry, P Sergent, E Oziol, E Forestier, T Fraisse, S Tounes, S Ansart, J Gaillat, S Bayle, O Ruyer, F Borlot, G Le Falher, B Simorre, F-A Dauchy, S Greffe, T Bauer, E N Bell, B Martha, M Martinot, M Froidure, M Buisson, A Waldner, X Lemaire, A Bosseray, M Maillet, V Charvet, A Barrelet, B Wyplosz, M Noaillon, E Denes, E Beretti, M Berlioz-Thibal, V Meyssonnier, E Fourniols, L Tliba, A Eden, M Jean, C Arvieux, K Guignery-Kadri, C Ronde-Oustau, Y Hansmann, A Belkacem, F Bouchand, G Gavazzi, F Herrmann, J Stirnemann, A Dinh
During prosthetic joint infection (PJI), optimal surgical management with exchange of the device is sometimes impossible, especially in the elderly population. Thus, prolonged suppressive antibiotic therapy (PSAT) is the only option to prevent acute sepsis, but little is known about this strategy. We aimed to describe the characteristics, outcome and tolerance of PSAT in elderly patients with PJI. We performed a national cross-sectional cohort study of patients >75 years old and treated with PSAT for PJI...
April 4, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28343826/diagnosis-of-periprosthetic-joint-infection-an-algorithm-based-approach
#16
Nicholas T Ting, Craig J Della Valle
BACKGROUND: Periprosthetic joint infection (PJI) remains one of the most challenging and devastating modes of failure after total hip and knee arthroplasties. Despite the profound urgency and impact of PJI on an individual and societal basis, historically, there have not been standardized definitions of and diagnostic algorithms for infection after total joint arthroplasty. METHODS: In a recent symposium, the American Academy of Hip and Knee Surgeons put forth a standardized approach to the prevention, diagnosis, and management of the patient with a suspected PJI...
July 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28326413/antibiotic-prophylaxis-for-dental-treatment-after-prosthetic-joint-replacement-exploring-the-orthopaedic-surgeon-s-opinion
#17
Clare M McNally, Renuka Visvanathan, Sharon Liberali, Robert J Adams
BACKGROUND: Antibiotic prophylaxis before dental treatment is routinely recommended by orthopaedic surgeons to prevent prosthetic joint infection (PJI). This recommendation is at odds with current guidelines. METHODS: A postal survey of 9 checkbox or short-answer questions was completed by 633 orthopaedic surgeons. RESULTS: The majority of respondents (n = 186 of 260, 72%) believe that antibiotic prophylaxis is required indefinitely for dental treatment...
September 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28264756/systematic-review-of-risk-prediction-scores-for-surgical-site-infection-or-periprosthetic-joint-infection-following-joint-arthroplasty
#18
REVIEW
S K Kunutsor, M R Whitehouse, A W Blom, A D Beswick
Accurate identification of individuals at high risk of surgical site infections (SSIs) or periprosthetic joint infections (PJIs) influences clinical decisions and development of preventive strategies. We aimed to determine progress in the development and validation of risk prediction models for SSI or PJI using a systematic review. We searched for studies that have developed or validated a risk prediction tool for SSI or PJI following joint replacement in MEDLINE, EMBASE, Web of Science and Cochrane databases; trial registers and reference lists of studies up to September 2016...
July 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28236084/increased-mortality-after-prosthetic-joint-infection-in-primary-tha
#19
Per Hviid Gundtoft, Alma Becic Pedersen, Claus Varnum, Søren Overgaard
BACKGROUND: Revision for prosthetic joint infection (PJI) has a major effect on patients' health but it remains unclear if early PJI after primary THA is associated with a high mortality. QUESTIONS/PURPOSES: (1) Do patients with a revision for PJI within 1 year of primary THA have increased mortality compared with patients who do not undergo revision for any reason within 1 year of primary THA? (2) Do patients who undergo a revision for PJI within 1 year of primary THA have an increased mortality risk compared with patients who undergo an aseptic revision? (3) Are there particular bacteria among patients with PJI that are associated with an increased risk of death? METHODS: This population-based cohort study was based on the longitudinally maintained Danish Hip Arthroplasty Register on primary THA performed in Denmark from 2005 to 2014...
February 24, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28040397/should-preoperative-antibiotics-be-tailored-according-to-patient-s-comorbidities-and-susceptibility-to-organisms
#20
Timothy L Tan, Miguel M Gomez, Michael M Kheir, Mitchell G Maltenfort, Antonia F Chen
BACKGROUND: Preoperative antibiotic prophylaxis remains one of the most important strategies for preventing periprosthetic joint infection (PJI). Current guidelines recommend giving universal antibiotic prophylaxis to all total joint arthroplasty patients regardless of their medical conditions or immune status; however, no studies have evaluated the individualizing of antibiotics. The aims of this study were (1) to determine if comorbidities influence the organism profile of PJIs, and (2) to investigate if the efficacy of two different perioperative antibiotics (cefazolin or vancomycin) for preventing PJI is affected by patient's comorbidities...
November 23, 2016: Journal of Arthroplasty
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