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parvizi periprosthetic infection

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https://www.readbyqxmd.com/read/27816369/in-hospital-mortality-in-patients-with-periprosthetic-joint-infection
#1
Alisina Shahi, Timothy L Tan, Antonia F Chen, Mitchell G Maltenfort, Javad Parvizi
BACKGROUND: While periprosthetic joint infection (PJI) has a huge impact on patient function and health, only a few studies have investigated its impact on mortality. The purpose of this large-scale study was to (1) determine the rate and trends of in-hospital mortality for PJI and (2) compare the in-hospital mortality rate of patients with PJI and those undergoing revision arthroplasty for aseptic failure and patients undergoing other nonorthopedic major surgical procedures. METHODS: Data from the Nationwide Inpatient Sample from 2002 to 2010 were analyzed to determine the risk of in-hospital mortality for PJI patients compared with aseptic revision arthroplasty...
September 30, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27789094/periprosthetic-joint-infections-caused-by-enterococci-have-poor-outcomes
#2
Michael M Kheir, Timothy L Tan, Carlos Higuera, Jaiben George, Craig J Della Valle, Mary Shen, Javad Parvizi
BACKGROUND: The definitive treatment and outcome of periprosthetic joint infection (PJI) caused by Enterococcus species is unknown. We performed a multi-institutional study to analyze the characteristics and treatment outcomes of patients with enterococcal PJI and to define an effective treatment protocol. METHODS: We retrospectively reviewed all PJIs at 3 institutions between 1999 and 2014 using an electronic query followed by manual chart review. We included patients who met the Musculoskeletal Infection Society's criteria for PJI and had at least 1 positive intraoperative culture for any Enterococcus species...
September 28, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27489323/positive-culture-during-reimplantation-increases-the-risk-of-subsequent-failure-in-two-stage-exchange-arthroplasty
#3
Timothy L Tan, Miguel M Gomez, Jorge Manrique, Javad Parvizi, Antonia F Chen
BACKGROUND: It is strongly recommended that tissue and synovial fluid culture samples be obtained during reimplantation performed as part of a 2-stage exchange arthroplasty. The rate of positive cultures during reimplantation and the influence of positive cultures on subsequent outcomes, to our knowledge, are unknown. This study was designed to determine the rate of positive cultures during reimplantation and to investigate the association between positive cultures at reimplantation and subsequent outcomes...
August 3, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27387759/the-mark-coventry-md-award-oral-antibiotics-reduce-reinfection-after-two-stage-exchange-a-multicenter-randomized-controlled-trial
#4
Jonathan M Frank, Erdan Kayupov, Mario Moric, John Segreti, Erik Hansen, Curtis Hartman, Kamil Okroj, Katherine Belden, Brian Roslund, Randi Silibovsky, Javad Parvizi, Craig J Della Valle
BACKGROUND: Many patients develop recurrent periprosthetic joint infection after two-stage exchange arthroplasty of the hip or knee. One potential but insufficiently tested strategy to decrease the risk of persistent or recurrent infection is to administer additional antibiotics after the second-stage reimplantation. QUESTIONS/PURPOSES: (1) Does a 3-month course of oral antibiotics decrease the risk of failure secondary to infection after a two-stage exchange? (2) Are there any complications related to the administration of oral antibiotics after a two-stage exchange? (3) In those patients who develop a reinfection, is the infecting organism different from the initial infection? METHODS: Patients at seven centers randomized to receive 3 months of oral antibiotics or no further antibiotic treatment after operative cultures after the second-stage reimplantation were negative...
July 7, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27341974/incidence-of-infection-and-inhospital-mortality-in-patients-with-chronic-renal-failure-after-total-joint-arthroplasty
#5
Omer F Erkocak, Joanne Y Yoo, Camilo Restrepo, Mitchell G Maltenfort, Javad Parvizi
BACKGROUND: Patients with chronic renal failure (CRF) may require total joint arthroplasty (TJA) to treat degenerative joint disease, fractures, osteonecrosis, or amyloid arthropathy. There have been conflicting results, however, regarding outcomes of TJA in patients with chronic renal disease. The aim of this case-controlled study was to determine the outcome of TJA in patients with CRF, with particular interest in the incidence of infections and inhospital mortality. METHODS: We queried our electronic database to determine which patients among the 29,389 TJAs performed at our institution between January 2000 and June 2012 had a diagnosis of CRF...
May 6, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27241375/diagnosis-of-periprosthetic-joint-infection-following-hip-and-knee-arthroplasty
#6
REVIEW
Javad Parvizi, Safa Cyrus Fassihi, Mohammad A Enayatollahi
The diagnosis of periprosthetic joint infection (PJI) following total hip arthroplasty and total knee arthroplasty has been one of the major challenges in orthopedic surgery. As there is no single absolute test for diagnosis of PJI, diagnostic criteria for PJI have been proposed that include using several diagnostic modalities. Focused history, physical examination, plain radiographs, and initial serologic tests should be followed by joint aspiration and synovial analysis. Newer diagnostic techniques, such as alpha-defensin and interleukin-6, hold great promise in the future diagnosis of equivocal infections...
July 2016: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/27131415/human-immunodeficiency-virus-and-total-joint-arthroplasty-the-risk-for-infection-is-reduced
#7
Mohammad Ali Enayatollahi, Dermot Murphy, Mitchell G Maltenfort, Javad Parvizi
BACKGROUND: Highly active antiretroviral therapy (HAART) has changed the face of human immunodeficiency virus (HIV) and allowed patients to live for many decades. HIV and HAART are known risk factors for osteonecrosis of bone, osteopenia, and osteoporosis. Therefore, the demand for total joint arthroplasty (TJA) in HIV-infected patients is on the rise. We attempted to determine whether modern treatments for HIV have impacted the rate of periprosthetic joint infection (PJI). METHODS: Conducting a systematic review, 25 studies with a total of 722 TJAs were identified...
October 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27094243/leukocyte-esterase-metal-on-metal-failure-and-periprosthetic-joint%C3%A2-infection
#8
Eric H Tischler, Darren R Plummer, Antonia F Chen, Craig J Della Valle, Javad Parvizi
BACKGROUND: Adverse local tissue reactions (ALTRs) and periprosthetic joint infection can occur after metal-on-metal total hip arthroplasty (THA), both potentially generating purulent synovial fluid (SF) and elevated white cell count. This makes it difficult to distinguish between diagnoses; therefore, we evaluated leukocyte esterase (LE) strip test's reliability in ruling out periprosthetic joint infection in ALTR revision THA. METHODS: Sixty-one patients with ALTRs and an LE strip test were evaluated, excluding 15 cases with SF metallic debris...
October 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27094242/aspirin-is-as-effective-as-and-safer-than-warfarin-for-patients-at-higher-risk-of-venous-thromboembolism-undergoing-total-joint-arthroplasty
#9
Ronald C Huang, Javad Parvizi, William J Hozack, Antonia F Chen, Matthew S Austin
BACKGROUND: There is continued controversy regarding the optimal venous thromboembolism (VTE) prophylaxis, particularly for total joint arthroplasty (TJA) patients at higher risk. The purpose of this study was to compare the efficacy of aspirin (ASA) to warfarin in patients with higher risk of VTE. METHODS: This retrospective study examined 30,270 patients who received ASA or warfarin for VTE prophylaxis after TJA. Using a previously developed risk stratification model, patients were classified into low or high VTE risk categories...
September 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/26864855/the-alpha-defensin-test-for-periprosthetic-joint-infections-is-not-affected-by-prior-antibiotic-administration
#10
Alisina Shahi, Javad Parvizi, Gregory S Kazarian, Carlos Higuera, Salvatore Frangiamore, Joshua Bingham, Christopher Beauchamp, Craig Della Valle, Carl Deirmengian
BACKGROUND: Previous studies have demonstrated that the administration of antibiotics to patients before performing diagnostic testing for periprosthetic joint infection (PJI) can interfere with the accuracy of test results. Although a single-institution study has suggested that alpha-defensin maintains its concentration and sensitivity even after antibiotic treatment, this has not yet been demonstrated in a larger multiinstitutional study. QUESTIONS/PURPOSES: (1) For the evaluation of PJI, is prior antibiotic administration associated with decreased alpha-defensin levels? (2) When prior antibiotics are given, is alpha-defensin a better screening test for PJI than the traditional tests (erythrocyte sedimentation rate [ESR], C-reactive protein [CRP], fluid white blood cells, fluid polymorphonuclear cells [PMNs], and fluid culture)? METHODS: This retrospective study included data from 106 hip and knee arthroplasties with Musculoskeletal Infection Society-defined PJI from four centers...
July 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/26777546/increased-risk-of-periprosthetic-joint-infections-in-patients-with-hypothyroidism-undergoing-total-joint-arthroplasty
#11
Timothy L Tan, Haran Rajeswaran, Sleiman Haddad, Alisina Shahi, Javad Parvizi
BACKGROUND: Although thyroxine has an important role in modulating the immune system, it has not been associated with periprosthetic joint infection. This study was conceived to examine the association between hypothyroidism and periprosthetic joint infection (PIJ). METHODS: Using an institutional database, the preoperative comorbidities of 32,289 total joint arthroplasties performed between 2000 and 2013 were identified using an International Classification of Diseases, Ninth Revision-based comorbidity index...
April 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/26614915/diagnosis-of-periprosthetic-infection-novel-developments
#12
REVIEW
Laura Matsen Ko, Javad Parvizi
The diagnosis of periprosthetic joint infection (PJI) has been performed by obtaining a history and physical examination, blood tests, and analysis of the synovial fluid and tissue samples. The measurement of serum biomarkers are routinely used to diagnose PJI. These markers may be elevated in other inflammatory conditions, necessitating the need for more specific biomarkers to diagnose PJI. Serum biomarkers may be more specific to PJI. Synovial CRP, α-defensin, human β-defensin-2 and -3, leukocyte esterase, and cathelicidin LL-37 biomarkers hold promise for the diagnosis of PJI...
January 2016: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/26430083/the-management-of-an-infected-total-knee-arthroplasty
#13
REVIEW
T Gehrke, P Alijanipour, J Parvizi
Periprosthetic joint infection (PJI) is one of the most feared and challenging complications following total knee arthroplasty. We provide a detailed description of our current understanding regarding the management of PJI of the knee, including diagnostic aids, pre-operative planning, surgical treatment, and outcome.
October 2015: Bone & Joint Journal
https://www.readbyqxmd.com/read/26378265/the-fate-of-spacers-in-the-treatment-of-periprosthetic-joint-infection
#14
COMPARATIVE STUDY
Miguel M Gomez, Timothy L Tan, Jorge Manrique, Gregory K Deirmengian, Javad Parvizi
BACKGROUND: Two-stage exchange arthroplasty remains the preferred method to treat periprosthetic joint infection. The aim of this study was to investigate the clinical course of periprosthetic joint infection following resection arthroplasty and insertion of a spacer. METHODS: Our institutional database was used to identify 504 cases of periprosthetic joint infection (326 knees and 178 hips) treated with resection arthroplasty and spacer insertion as part of a two-stage exchange arthroplasty...
September 16, 2015: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/26330578/periprosthetic-joint-infection-the-last-frontier
#15
EDITORIAL
J Parvizi, F S Haddad
No abstract text is available yet for this article.
September 2015: Bone & Joint Journal
https://www.readbyqxmd.com/read/26304510/projected-increase-in-periprosthetic-joint-infections-secondary-to-rise-in-diabetes-and-obesity
#16
Patrick O'Toole, Mitchell G Maltenfort, Antonia F Chen, Javad Parvizi
Total joint arthroplasties (TJAs) are projected to increase, along with increased complications like periprosthetic joint infections (PJIs). However, no study has projected TJAs secondary to PJI and how these relate to comorbidities in these patients. The NIS database was assessed from 1993 to 2000 to evaluate primary and revision TJAs, and projections were made until 2028. ICD-9 codes were used to identify patients with obesity, diabetes, and PJI. Rates of diabetes and adult obesity are predicted to increase for both genders, and patients receiving revision surgery for PJI are predicted to increase over time; males had higher rates than females...
January 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/26182982/administration-of-aspirin-as-a-prophylaxis-agent-against-venous-thromboembolism-results-in-lower-incidence-of-periprosthetic-joint-infection
#17
Ronald Huang, Patrick S Buckley, Benjamin Scott, Javad Parvizi, James J Purtill
The efficacy and safety of aspirin (ASA) for prevention of venous thromboembolism (VTE) following total joint arthroplasty (TJA) have been demonstrated. Our hypothesis was that postoperative ASA compared to warfarin lowers the incidence of periprosthetic joint infection (PJI). Between January 2006 and December 2012, 1456 patients received ASA and 1700 patients received warfarin following primary TJA as standard VTE prophylaxis. Logistic regression was utilized to identify independent risk factors of PJI. Incidence of PJI was significantly lower at 0...
September 2015: Journal of Arthroplasty
https://www.readbyqxmd.com/read/26110171/prevention-of-periprosthetic-joint-infection
#18
REVIEW
Alisina Shahi, Javad Parvizi
Prosthetic joint infection (PJI) is a calamitous complication with high morbidity and substantial cost. The reported incidence is low but it is probably underestimated due to the difficulty in diagnosis. PJI has challenged the orthopaedic community for several years and despite all the advances in this field, it is still a real concern with immense impact on patients, and the healthcare system. Eradication of infection can be very difficult. Therefore, prevention remains the ultimate goal. The medical community has executed many practices with the intention to prevent infection and treat it effectively when it encounters...
April 2015: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/26084851/erratum-to-is-neuraxial-anesthesia-safe-in-patients-undergoing-surgery-for-treatment-of-periprosthetic-joint-infection
#19
Mohammad R Rasouli, Priscilla K Cavanaugh, Camilo Restrepo, Hasan Huseyin Ceylan, Mitchell G Maltenfort, Eugene R Viscusi, Javad Parvizi
No abstract text is available yet for this article.
September 2015: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/26044538/diagnosis-of-infected-total-hip-arthroplasty
#20
REVIEW
Mohammad A Enayatollahi, Javad Parvizi
Despite the battery of available tests, the diagnosis of periprosthetic joint infection (PJI) remains a challenge. A comprehensive medical history and physical examination with appropriate radiographs followed by erythrocyte sedimentation rate and serum C-reactive protein are the first-line screening test for patients with suspected hip PJI. The second line of investigation of patients with abnormal serology or a strong suspicion for PJI, is joint aspiration. Aspirates should be sent for assessment of white blood cell count, polymorphonuclear percentage, leukocyte esterase strip test, and microbiology...
July 2015: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
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