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https://www.readbyqxmd.com/read/29715222/alpha-defensin-lateral-flow-test-for-diagnosis-of-periprosthetic-joint-infection-not-a-screening-but-a-confirmatory-test
#1
Nora Renz, Katsiaryna Yermak, Carsten Perka, Andrej Trampuz
BACKGROUND: Determination of alpha defensin in synovial fluid has shown promising results for diagnosing periprosthetic joint infection (PJI). The purposes of our study were to assess the performance of alpha defensin lateral flow (ADLF) test for the diagnosis of acute and chronic PJI using 3 classification systems and to compare its performance with the synovial fluid leukocyte count. METHODS: Patients in whom aspiration of a prosthetic hip or knee joint was performed before revision arthroplasty were prospectively included...
May 2, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29670791/self-resolution-of-a-draining-sinus-tract-in-a-patient-with-chronic-periprosthetic-hip-infection
#2
Trevor J Shelton, Alton W Skaggs, Gavin C Pereira
We report a novel case of a patient who had a draining sinus soon after a total hip arthroplasty that spontaneously resolved. The patient voluntarily discontinued antibiotic suppressive therapy (AST) after 10 years of treatment and paradoxically experienced full resolution of signs of chronic prosthetic joint infection (PJI), including recovery of his left-sided draining sinus tract. Now 8 years after discontinuing AST, the patient has no pain, good function, and no major or minor criteria of joint infection according to the Musculoskeletal Infection Society (MSIS) workgroup...
2018: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29656271/spanish-validation-of-a-specific-measure-to-assess-work-related-problems-in-people-with-multiple-sclerosis-the-multiple-sclerosis-work-difficulties-questionnaire-mswdq-23
#3
María L Martínez-Ginés, Jose M García-Domínguez, Lucía Forero, Neus Canal, Pablo Rebollo, Daniel Prefasi, Cynthia A Honan, Jorge Maurino
INTRODUCTION: Unemployment is a significant problem for people with multiple sclerosis (MS). The MS Work Difficulties Questionnaire (MSWDQ-23) is a self-report tool to assess work-related problems in people with MS across three domains: physical, psychological/cognitive, and external barriers. The aim of this study was to assess the psychometric properties of the Spanish version of the MSWDQ-23. METHODS: A multicentre, non-interventional, cross-sectional study in adult patients with relapsing-remitting multiple sclerosis (RRMS) or primary progressive (PPMS) multiple sclerosis (McDonald 2010 criteria) was conducted...
April 3, 2018: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/29581070/diagnostic-accuracy-of-the-alpha-defensin-lateral-flow-device-synovasure%C3%A2-for-periprosthetic-infections-in-microbiologically-complex-situations-a-study-of-42-cases-in-a-french-referral-centre
#4
B de Saint Vincent, H Migaud, E Senneville, C Loiez, G Pasquier, J Girard, S Putman
BACKGROUND: Joint aspiration is currently the reference standard test for diagnosing periprosthetic joint infection (PJI) despite the high rate of false-negative results, of which a major cause is the fastidious nature of some micro-organisms. A rapid diagnostic test that detects alpha defensin (Synovasure™, Zimmer, Warsaw, IN, USA) in joint fluid can provide the diagnosis of PJI within a few minutes across the full spectrum of causative organisms (including mycobacteria and yeasts)...
March 23, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29572038/high-efficiency-particulate-air-filters-do-not-affect-acute-infection-rates-during-primary-total-joint-arthroplasty-using-forced-air-warmers
#5
Gannon L Curtis, Mhamad Faour, Jaiben George, Alison K Klika, Wael K Barsoum, Carlos A Higuera
BACKGROUND: Studies have suggested that forced-air warmers (FAWs) increase contamination of the surgical site. In response, FAWs with high efficiency particulate air filters (FAW-HEPA) were introduced. This study compared infection rates following primary total joint arthroplasty (TJA) using FAW and FAW-HEPA. METHODS: Primary TJA patients at a single healthcare system were retrospectively reviewed. A total of 5405 THA (n = 2419) and TKA (n = 2986) consecutive cases in 2013 and 2015 were identified...
February 5, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29551303/the-2018-definition-of-periprosthetic-hip-and-knee-infection-an-evidence-based-and-validated-criteria
#6
Javad Parvizi, Timothy L Tan, Karan Goswami, Carlos Higuera, Craig Della Valle, Antonia F Chen, Noam Shohat
BACKGROUND: The introduction of the Musculoskeletal Infection Society (MSIS) criteria for periprosthetic joint infection (PJI) in 2011 resulted in improvements in diagnostic confidence and research collaboration. The emergence of new diagnostic tests and the lessons we have learned from the past 7 years using the MSIS definition, prompted us to develop an evidence-based and validated updated version of the criteria. METHODS: This multi-institutional study of patients undergoing revision total joint arthroplasty was conducted at 3 academic centers...
May 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29496595/inflammatory-disorders-mimicking-periprosthetic-joint-infections-may-result-in-false-positive-%C3%AE-defensin
#7
Andreas Plate, Laura Stadler, Reto Sutter, Alexia Anagnostopoulos, Dario Frustaci, Reinhard Zbinden, Sandro F Fucentese, Annelies S Zinkernagel, Patrick O Zingg, Yvonne Achermann
OBJECTIVES: The antimicrobial peptide α-defensin has recently been introduced as potential "single" biomarker with a high sensitivity and specificity for the preoperative diagnosis of periprosthetic joint infections (PJIs). However, most studies assessed the benefits of the test with exclusion of patients with rheumatic diseases. We aimed to evaluate the α-defensin test in a cohort study without exclusion of cases with inflammatory diseases. METHODS: Between June 2016 and June 2017, we prospectively included cases with a suspected PJI and an available lateral flow test α-defensin (Synovasure®) in synovial fluid...
February 26, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29382603/sonication-of-orthopaedic-implants-a-valuable-technique-for-diagnosis-of-prosthetic-joint-infections
#8
Sujeesh Sebastian, Rajesh Malhotra, Vishnubhatla Sreenivas, Arti Kapil, Rama Chaudhry, Benu Dhawan
INTRODUCTION: Accurate and prompt microbiological diagnosis of prosthetic joint infection (PJI) is crucial for successful antimicrobial treatment. Studies have shown the diagnostic utility of sonication of explanted implants in total joint arthroplasty but all did not use consensus statements for defining PJI. We evaluated the diagnostic utility of culture of samples obtained by sonication of explanted implants compared with periprosthetic tissue cultures (PTC) for the diagnosis of PJI using Musculoskeletal Infection Society (MSIS) consensus criteria...
March 2018: Journal of Microbiological Methods
https://www.readbyqxmd.com/read/29374525/periprosthetic-joint-infection-caused-by-anaerobes-retrospective-analysis-reveals-no-need-for-prolonged-cultivation-time-if-sensitive-supplemented-growth-media-are-used
#9
Heime Rieber, Andre Frontzek, Jörg Jerosch, Michael Alefeld, Thomas Strohecker, Martin Ulatowski, Thomas Morawietz, Stefan Hinsenkamp, Andreas Bell, Dervis Kücükköylü, Lars Frommelt
BACKGROUND: In microbiological diagnosis of periprosthetic joint infection (PJI) culture media and incubation time are controversially discussed, especially if anaerobic bacteria are the causative agent. This study was conducted to demonstrate the influence of sensitive supplemented growth media on the duration of culturing anaerobes. METHODS: Twenty-five consecutive cases were included in this retrospective study. For definition of PJI, the criteria of the Musculoskeletal Infection Society (MSIS) were considered...
April 2018: Anaerobe
https://www.readbyqxmd.com/read/29360804/does-use-of-lidocaine-affect-culture-of-synovial-fluid-obtained-to-diagnose-periprosthetic-joint-infection-pji-an-in-vitro-study
#10
Kan Liu, Liyan Ye, Wei Sun, Libo Hao, Yanping Luo, Jiying Chen
BACKGROUND Synovial fluid culture (SFC) is recommended as one of the major diagnostic criteria by the Musculoskeletal Infection Society (MSIS) for diagnosing periprosthetic joint infection (PJI). Local anesthetic agents are used for anesthesia and analgesia in some clinical settings to relieve pain. As a local anesthetic, lidocaine is safely used in arthrocentesis to obtain synovial fluid. The goal of this study was to determine if infiltration anesthesia with additive-free lidocaine 2% has antibacterial effects that might interfere with subsequent SFC...
January 23, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29305453/synovasure-quick-test-is-not-as-accurate-as-the-laboratory-based-%C3%AE-defensin-immunoassay-a-systematic-review-and-meta-analysis
#11
REVIEW
K Suen, M Keeka, R Ailabouni, P Tran
AIMS: α-defensin is a biomarker which has been described as having a high degree of accuracy in the diagnosis of periprosthetic joint infection (PJI). Current meta-analyses are based on the α-defensin laboratory-based immunoassay rather than the quick on-table lateral flow test kit. This study is the first meta-analysis to compare the accuracy of the α-defensin laboratory-based immunoassay and the lateral flow test kit for the diagnosis of PJI. MATERIALS AND METHODS: A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...
January 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29298259/the-accuracy-of-the-alpha-defensin-lateral-flow-device-for-diagnosis-of-periprosthetic-joint-infection-comparison-with-a-gold-standard
#12
Thorsten Gehrke, Christian Lausmann, Mustafa Citak, Tommaso Bonanzinga, Lars Frommelt, Akos Zahar
BACKGROUND: Alpha defensin is a new biomarker that has been shown to have a very high accuracy to rule out periprosthetic joint infection. Recently, a new rapid lateral flow version of the alpha defensin test was developed and introduced to detect high levels of alpha defensin in synovial fluid quickly and with ease. We conducted a single-center prospective clinical study to compare the results of the Synovasure Alpha Defensin Test with those of the Musculoskeletal Infection Society (MSIS) criteria, which are considered to be the gold standard for diagnosing periprosthetic joint infection...
January 3, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29243060/synovial-aspiration-and-serological-testing-in-two-stage-revision-arthroplasty-for-prosthetic-joint-infection-evaluation-before-reconstruction-with-a-mean-follow-up-of-twenty-seven-months
#13
Heinrich M L Mühlhofer, C Knebel, Florian Pohlig, Susanne Feihl, Norbert Harrasser, Johannes Schauwecker, Rüdiger von Eisenhart-Rothe
INTRODUCTION: The two-stage revision protocol is the gold standard for controlling and treating low-grade prosthetic joint infections of total hip and total knee arthroplasty. The antibiotic pause for diagnostic reasons before reconstruction (stage two) is discussed in relation to the persistence of the infection and the development of resistant bacterial strains. Serological markers and a synovial analysis are commonly used to exclude the persistence of infection. Therefore, we asked (1) is the serological testing of C-reactive protein and leucocytes a valuable tool to predict a persistence of infection? and (2) what is the role of synovial aspiration of Plymethylmethacrylat (PMMA) spacers in hip and knee joints? MATERIALS AND METHODS: One hundred twelve patients who were MSIS criteria-positive for a prosthetic joint infection were studied, including 45 total hip arthroplasties (THA) and 67 total knee artrhoplasties (TKA) patients...
February 2018: International Orthopaedics
https://www.readbyqxmd.com/read/28932957/fluoroscopy-vs-ultrasound-guided-aspiration-techniques-in-the-management-of-periprosthetic-joint-infection-which-is-the-best
#14
COMPARATIVE STUDY
Filippo Randelli, Marco Brioschi, Pietro Randelli, Federico Ambrogi, Silvana Sdao, Alberto Aliprandi
BACKGROUND: Fluid samples obtained from an affected joint still play a central role in the diagnosis of periprosthetic joint infection (PJI). It is the only preoperative test able to discover the causative microbiological agent. In the hip, fluid aspiration can be performed through fluoroscopy, ultrasound, or, less commonly, computed tomography. However, there is still a lack of consensus on which method is preferable in terms of efficacy and costbenefit. PURPOSES: We, therefore, asked whether (1) the benefits in terms of sensitivity and specificity and (2) the costs were comparable between fluoroscopy- and ultrasound-guided joint aspirations in a suspicious of hip PJI...
January 2018: La Radiologia Medica
https://www.readbyqxmd.com/read/28912417/comparison-of-leukocyte-esterase-testing-of-synovial-fluid-with-synovial-histology-for-the-diagnosis-of-periprosthetic-joint-infection
#15
Rui Li, Xiang Li, Baozhan Yu, Xin Li, Xinggui Song, Heng Li, Chi Xu, Jiying Chen
BACKGROUND Periprosthetic joint infection (PJI) is a complication of total joint arthroplasty (TJA). The leukocyte esterase (LE) strip test and histology are diagnostic methods for PJI. The aims of this study were to determine the sensitivity and specificity of the LE strip test and to compare it with histology in the diagnosis of PJI. MATERIAL AND METHODS Between January and December 2015, 93 patients who underwent TJA with PJI were enrolled in the study. Synovial fluid samples were tested with an LE strip, and three synovial tissue samples from each patient underwent frozen section and formalin-fixed histology...
September 15, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28882962/prospective-analysis-of-a-sterile-semi-automated-tissue-biopsy-homogenization-method-in-the-diagnosis-of-prosthetic-joint-infections
#16
Christian Suren, Norbert Harrasser, Florian Pohlig, Ingo J Banke, Ulrich Lenze, Florian Lenze, Carolin Knebel, Rüdiger VON Eisenhart-Rothe, Johannes Schauwecker, Heinrich M L Mühlhofer
BACKGROUND/AIM: Prosthetic joint infection (PJI) remains a serious complication of total joint arthroplasty. To effectively treat PJI, it is essential to identify the microorganism causing it and be able to combine correct surgical and anti-infective treatments. This cannot always be achieved with the currently employed diagnostic methods. The aim of this study was to evaluate a semi-automated tissue biopsy bead milling method (Ultra-TurrAX, Axonlab AG; Reichenbach, Germany) based on the hypothesis that the results are more sensitive for microbe detection and less prone to contamination...
September 2017: In Vivo
https://www.readbyqxmd.com/read/28860397/diagnosis-of-prosthetic-joint-infection-with-alpha-defensin-using-a-lateral-flow-device-a-multicentre-study
#17
MULTICENTER STUDY
P Berger, M Van Cauter, R Driesen, J Neyt, O Cornu, J Bellemans
AIMS: The purpose of this current multicentre study is to analyse the presence of alpha-defensin proteins in synovial fluid using the Synovasure lateral flow device and to determine its diagnostic reliability and accuracy compared with the prosthetic joint infection (PJI) criteria produced by the Musculoskeletal Infection Society (MSIS). PATIENTS AND METHODS: A cohort of 121 patients comprising 85 total knee arthroplasties and 36 total hip arthroplasties was prospectively evaluated between May 2015 and June 2016 in three different orthopaedic centres...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28463919/synovial-fluid-cell-count-for-diagnosis-of-chronic-periprosthetic-hip-infection
#18
MULTICENTER STUDY
Carlos A Higuera, Benjamin Zmistowski, Tennison Malcom, Wael K Barsoum, Scott M Sporer, Philipp Mommsen, Daniel Kendoff, Craig J Della Valle, Javad Parvizi
BACKGROUND: There is a paucity of data regarding the threshold of synovial fluid white blood-cell (WBC) count and polymorphonuclear cell (neutrophil) percentage of the WBC count (PMN%) for the diagnosis of chronic periprosthetic joint infection (PJI) after total hip arthroplasty. Despite this, many organizations have provided guidelines for the diagnosis of PJI that include synovial fluid WBC count and PMN%. We attempted to define a threshold for synovial fluid WBC count and PMN% for the diagnosis of chronic PJI of the hip using a uniform definition of PJI and to investigate any variations in the calculated thresholds among institutions...
May 3, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28321490/c-reactive-protein-may-misdiagnose-prosthetic-joint-infections-particularly-chronic-and-low-grade-infections
#19
Daniel Pérez-Prieto, María E Portillo, Lluís Puig-Verdié, Albert Alier, Santos Martínez, Lluisa Sorlí, Juan P Horcajada, Joan C Monllau
BACKGROUND: Periprosthetic tissue cultures, sonication and synovial fluid cultures remain the gold standard for prosthetic joint infection (PJI) diagnosis. However, some 15-20% culture-negative PJI are still reported. Therefore, there is the need for other diagnostic criteria. One point of concern relative to the different definitions of PJI is as to the inclusion of the c-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR) as diagnostic criteria for PJI despite them being non-specific inflammatory blood tests...
July 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28290115/sonication-of-arthroplasty-implants-improves-accuracy-of-periprosthetic-joint-infection-cultures
#20
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...
July 2017: Clinical Orthopaedics and related Research
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