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https://www.readbyqxmd.com/read/27672013/what-is-the-diagnostic-accuracy-of-aspirations-performed-on-hips-with-antibiotic-cement-spacers
#1
Jared M Newman, Jaiben George, Alison K Klika, Stephen F Hatem, Wael K Barsoum, W Trevor North, Carlos A Higuera
BACKGROUND: Periprosthetic joint infection is a serious complication after THA and commonly is treated with a two-stage revision. Antibiotic-eluting cement spacers are placed for local delivery of antibiotics. Aspirations may be performed before the second-stage reimplantation for identification of persistent infection. However, limited data exist regarding the diagnostic parameters of synovial fluid aspiration with or without saline lavage from a hip with an antibiotic-loaded cement spacer...
September 26, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27495236/are-the-current-notification-criteria-for-lyme-borreliosis-in-norway-suitable-results-of-an-evaluation-of-lyme-borreliosis-surveillance-in-norway-1995-2013
#2
Emily MacDonald, Didrik Frimann Vestrheim, Richard A White, Kirstin Konsmo, Heidi Lange, Audun Aase, Karin Nygård, Pawel Stefanoff, Ingeborg Aaberge, Line Vold
BACKGROUND: The approach to surveillance of Lyme borreliosis varies between countries, depending on the purpose of the surveillance system and the notification criteria used, which prevents direct comparison of national data. In Norway, Lyme borreliosis is notifiable to the Surveillance System for Communicable Diseases (MSIS). The current notification criteria include a combination of clinical and laboratory results for borrelia infection (excluding Erythema migrans) but there are indications that these criteria are not followed consistently by clinicians and by laboratories...
2016: BMC Public Health
https://www.readbyqxmd.com/read/27449715/intraoperative-frozen-section-histology-matched-for-musculoskeletal-infection-society-criteria
#3
Grzegorz Kwiecien, Jaiben George, Alison K Klika, Yaxia Zhang, Thomas W Bauer, Carlos A Higuera Rueda
BACKGROUND: The current gold standard to diagnose periprosthetic joint infection (PJI)-the Musculoskeletal Infection Society (MSIS) criteria, requires a battery of tests, the results of which may not be available at the time of decision-making. Thus, surgeons often rely on intraoperative frozen section histology. However, the accuracy of frozen sections has not been determined when matched for the MSIS criteria. We aimed to (1) assess the value of intraoperative histology in the diagnosis of PJI and (2) evaluate discrepancy rate between frozen and permanent section analysis...
June 23, 2016: Journal of Arthroplasty
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/27235328/the-diagnosis-of-infection-in-metal-on-metal-hip-arthroplasties
#5
George Grammatopoulos, Mitsuru Munemoto, Yusuke Inagaki, Yasuhito Tanaka, Nicholas A Athanasou
BACKGROUND: Distinction of aseptic from septic hip arthroplasty failure can be challenging. Some studies report an increased incidence of septic failure with metal-on-metal (MoM) hip arthroplasties. The Musculoskeletal Infection Society (MSIS) have formulated criteria to facilitate the diagnosis of periprosthetic joint infection (PJI). In this study, we determined the prevalence and histologic features of septic MoM hip failure. METHODS: Overall, 104 cases of failed MoM hip arthroplasty, classified as septic or aseptic by MSIS microbiological criteria, were analyzed...
April 12, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27132530/quantification-of-neutrophil-polymorphs-in-infected-and-noninfected-second-stage-revision-hip-arthroplasties
#6
Mitsuru Munemoto, Yusuke Inagaki, Yasuhito Tanaka, George Grammatopoulos, Nicholas A Athanasou
AIMS: In the diagnosis of periprosthetic joint infection (PJI), a heavy neutrophil polymorph (NP) infiltrate (>5 per high-power field [HPF] by MSIS criteria) is characteristically seen in periprosthetic tissues. PJI is commonly treated by a two-stage procedure with surgical clearance of infected tissues followed by intensive antibiotic treatment before re-implantation; tissues are sampled at the time of second stage but whether MSIS histological criteria can be used to diagnose the presence or absence of infection in second stage samples has not been established...
July 25, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27084714/erratum-to-synovial-cytokines-and-the-msis-criteria-are-not-useful-for-determining-infection-resolution-after-periprosthetic-joint-infection-explantation
#7
Salvatore J Frangiamore, Marcelo B P Siqueira, Anas Saleh, Thomas Daly, Carlos A Higuera, Wael K Barsoum
No abstract text is available yet for this article.
April 15, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/26911975/corr-insights-%C3%A2-synovial-cytokines-and-the-msis-criteria-are-not-useful-for-determining-infection-resolution-after-periprosthetic-joint-infection-explantation
#8
Elie Berbari
No abstract text is available yet for this article.
July 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/26821163/synovial-cytokines-and-the-msis-criteria-are-not-useful-for-determining-infection-resolution-after-periprosthetic-joint-infection-explantation
#9
Salvatore J Frangiamore, Marcelo B P Siqueira, Anas Saleh, Thomas Daly, Carlos A Higuera, Wael K Barsoum
BACKGROUND: Diagnosing periprosthetic joint infection (PJI) requires a combination of clinical and laboratory parameters, which may be expensive and difficult to interpret. Synovial fluid cytokines have been shown to accurately differentiate septic from aseptic failed total knee (TKA) and hip (THA) arthroplasties. However, after first-stage explantation, there is still no reliable test to rule out PJI before a second-stage reimplantation procedure. QUESTIONS/PURPOSES: (1) Which synovial fluid cytokines have the highest diagnostic accuracy for PJI? (2) Which cytokine shows the greatest decrease associated with the resolution of infection in the same patient between explantation and subsequent reimplantation of an infected arthroplasty? (3) What is the accuracy of synovial fluid cytokines and the Musculoskeletal Infection Society (MSIS) criteria to rule out PJI after first-stage explantation? (4) What are the most studied synovial fluid cytokines for diagnosing PJI as reported in the literature and what are their cumulative diagnostic accuracy? METHODS: Between May 2013 and March 2014, 104 patients with painful THA and TKA evaluated for possible PJI were included in our study...
July 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/26769618/corr-insights-%C3%A2-are-frozen-sections-and-msis-criteria-reliable-at-the-time-of-reimplantation-of-two-stage-revision-arthroplasty
#10
Craig J Della Valle
No abstract text is available yet for this article.
July 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/26689583/are-frozen-sections-and-msis-criteria-reliable-at-the-time-of-reimplantation-of-two-stage-revision-arthroplasty
#11
Jaiben George, Grzegorz Kwiecien, Alison K Klika, Deepak Ramanathan, Thomas W Bauer, Wael K Barsoum, Carlos A Higuera
BACKGROUND: Frozen section histology is widely used to aid in the diagnosis of periprosthetic joint infection at the second stage of revision arthroplasty, although there are limited data regarding its utility. Moreover, there is no definitive method to assess control of infection at the time of reimplantation. Because failure of a two-stage revision can have serious consequences, it is important to identify the cases that might fail and defer reimplantation if necessary. Thus, a reliable test providing information about the control of infection and risk of subsequent failure is necessary...
July 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/26686786/a-quality-adjusted-life-year-measure-for-multiple-sclerosis-developing-a-patient-reported-health-state-classification-system-for-a-multiple-sclerosis-specific-preference-based-measure
#12
Elizabeth Goodwin, Colin Green
BACKGROUND: Increasingly, generic preference-based measures of health-related quality of life (HRQOL) are used to estimate quality-adjusted life-years to inform resource allocation decisions. Evidence suggests that generic measures may not be appropriate for multiple sclerosis (MS). OBJECTIVES: To report the first stage in the development of an MS-specific preference-based measure to quantify the impact of MS and its treatment: deriving a health state classification system, which is amenable to valuation, from the 29-item Multiple Sclerosis Impact Scale (MSIS-29), a widely used patient-reported outcome measure in MS...
December 2015: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/26279499/leukocyte-esterase-in-the-diagnosis-of-shoulder-periprosthetic-joint-infection
#13
Gregory N Nelson, E Scott Paxton, Alexa Narzikul, Gerald Williams, Mark D Lazarus, Joseph A Abboud
BACKGROUND: Shoulder periprosthetic joint infection (PJI) is difficult to diagnose with traditional methods. Leukocyte esterase (LE) has recently proven to be reliable in knee arthroplasty; however, its value in the shoulder has not been explored. We hypothesized that LE would display high sensitivity and specificity in shoulder PJI. METHODS: Two groups were prospectively evaluated: 45 primary and 40 revision shoulder arthroplasties. Synovial fluid and soft tissue cultures were obtained at surgery...
September 2015: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/26013149/intraoperative-synovial-c-reactive-protein-is-as-useful-as-frozen-section-to-detect-periprosthetic-hip-infection
#14
COMPARATIVE STUDY
Martin A Buttaro, Gabriel Martorell, Mauricio Quinteros, Fernando Comba, Gerardo Zanotti, Francisco Piccaluga
BACKGROUND: Synovial quantification of C-reactive protein (SCRP) has been recently published with high sensitivity and specificity in the diagnosis of periprosthetic joint infection. However, to our knowledge, no studies have compared the use of this test with intraoperative frozen section, which is considered by many to be the best intraoperative test now available. QUESTIONS/PURPOSES: We asked whether intraoperative SCRP could lead to comparable sensitivity, specificity, and predictive values as intraoperative frozen section in revision total hip arthroplasty...
December 2015: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/25728568/how-accurate-are-orthopedic-surgeons-in-diagnosing-periprosthetic-joint-infection-after-total-knee-arthroplasty-a-multicenter-study
#15
MULTICENTER STUDY
In Jun Koh, Woo-Shin Cho, Nam Yong Choi, Javad Parvizi, Tae Kyun Kim
BACKGROUND: The lack of standardized diagnostic criteria for periprosthetic joint infection (PJI) poses a challenge to accurate diagnosis of PJI. Recently, the Musculoskeletal Infection Society (MSIS) proposed diagnostic criteria for PJI. However, it is not known how well these proposed criteria accommodate real clinical scenarios. We determined what proportion of patients satisfied the MSIS criteria, and if MSIS criteria were not met, what other rationales were used to diagnose PJI. METHODS: We retrospectively reviewed the records of 303 patients who underwent two-stage exchange arthroplasty for treatment of PJI of the knee at 17 institutions...
June 2015: Knee
https://www.readbyqxmd.com/read/25687172/use-of-chloroacetate-esterase-staining-for-the-histological-diagnosis-of-prosthetic-joint-infection
#16
T G Kashima, Y Inagaki, G Grammatopoulos, N A Athanasou
A heavy neutrophil polymorph infiltrate [>5 per high-power field (HPF) after examination of at least 5 HPF by Musculoskeletal Infection Society (MSIS) criteria] is characteristically seen in peri-implant tissues of infected prosthetic hip and knee joints. We determined whether chloroacetate esterase (CAE) staining facilitated the identification of neutrophil polymorphs in peri-implant tissues in cases of hip and knee arthroplasty infection and reassessed MSIS criteria in the light of our findings. Frozen and paraffin sections of peri-prosthetic tissues of 76 cases of failed hip and knee arthroplasties classified as septic or aseptic loosening microbiologically were analysed histologically by both haematoxylin-eosin and CAE staining...
May 2015: Virchows Archiv: An International Journal of Pathology
https://www.readbyqxmd.com/read/25604877/premature-therapeutic-antimicrobial-treatments-can-compromise-the-diagnosis-of-late-periprosthetic-joint-infection
#17
Alisina Shahi, Carl Deirmengian, Carlos Higuera, Antonia Chen, Camilo Restrepo, Benjamin Zmistowski, Javad Parvizi
BACKGROUND: In the absence of positive cultures and draining sinuses, the diagnosis of periprosthetic joint infection (PJI) relies on laboratory values. It is unknown if administration of antibiotics within 2 weeks before diagnostic evaluations can affect these tests in patients with PJI. QUESTIONS/PURPOSES: The purpose of this study was to investigate the correlation of antibiotic administration with (1) fluctuations in the synovial fluid and serology laboratory values; and (2) sensitivity of the diagnostic tests in patients with late PJI (per Musculoskeletal Infection Society [MSIS] criteria)...
July 2015: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/25410511/leukocyte-esterase-strip-test-matched-for-musculoskeletal-infection-society-criteria
#18
Eric H Tischler, Priscilla K Cavanaugh, Javad Parvizi
BACKGROUND: The presence of leukocyte esterase in the synovial fluid has recently been proposed as a marker for periprosthetic joint infection. However, the sensitivity and specificity of leukocyte esterase has not been determined when matched for the current, most inclusive Musculoskeletal Infection Society (MSIS) criteria for periprosthetic joint infection. METHODS: The presence of leukocyte esterase was prospectively evaluated in synovial joint aspirates from hips and knees from May 2009 to May 2013...
November 19, 2014: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/25256621/the-alpha-defensin-1-biomarker-assay-can-be-used-to-evaluate-the-potentially-infected-total-joint-arthroplasty
#19
COMPARATIVE STUDY
Joshua Bingham, Henry Clarke, Mark Spangehl, Adam Schwartz, Christopher Beauchamp, Brynn Goldberg
BACKGROUND: Diagnosing a periprosthetic joint infection (PJI) requires a complex approach using various laboratory and clinical criteria. A novel approach to diagnosing these infections uses synovial fluid biomarkers. Alpha defensin-1 (AD-1) is one such synovial-fluid biomarker. However little is known about the performance of the AD-1 assay in the diagnosis of PJI. QUESTIONS/PURPOSES: We sought to (1) determine the sensitivity and specificity of the AD-1 assay in a population of patients being evaluated for PJI, using the Musculoskeletal Infection Society (MSIS) criteria as the reference standard, and (2) compare the AD-1 assay with other currently available clinical tests, specifically cell count, culture, erythrocyte sedimentation rate, and C-reactive protein...
December 2014: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/25187582/combined-measurement-of-synovial-fluid-%C3%AE-defensin-and-c-reactive-protein-levels-highly-accurate-for-diagnosing-periprosthetic-joint-infection
#20
COMPARATIVE STUDY
Carl Deirmengian, Keith Kardos, Patrick Kilmartin, Alexander Cameron, Kevin Schiller, Javad Parvizi
BACKGROUND: The diagnosis of periprosthetic joint infection remains a challenge. The purpose of this study was to evaluate the combined measurement of the levels of two synovial fluid biomarkers, α-defensin and C-reactive protein (CRP), for the diagnosis of periprosthetic joint infection. METHODS: One hundred and forty-nine synovial fluid aspirates, including 112 from patients with an aseptic diagnosis and thirty-seven from patients with periprosthetic joint infection, met the inclusion criteria for this prospective study...
September 3, 2014: Journal of Bone and Joint Surgery. American Volume
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