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https://www.readbyqxmd.com/read/28463919/synovial-fluid-cell-count-for-diagnosis-of-chronic-periprosthetic-hip-infection
#1
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
#2
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...
March 21, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28290115/sonication-of-arthroplasty-implants-improves-accuracy-of-periprosthetic-joint-infection-cultures
#3
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...
March 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28283110/access-delivery-and-perceived-efficacy-of-physiotherapy-and-use-of-complementary-and-alternative-therapies-by-people-with-progressive-multiple-sclerosis-in-the-united-kingdom-an-online-survey
#4
Evan Campbell, Elaine Coulter, Paul Mattison, Angus McFadyen, Linda Miller, Lorna Paul
INTRODUCTION: All people with progressive MS in the United Kingdom should have access to physiotherapy through the National Health Service (NHS). However levels of access and delivery are unknown. Furthermore there is no research on perceived efficacy of physiotherapy or the use of complementary and alternative medicine in people with progressive MS in the United Kingdom. METHODS: An online survey was carried out via the UK MS Register. Inclusion criteria were diagnosis of progressive MS, a member of UK MS Register and 18 years or older...
February 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/28215967/leukocyte-esterase-strip-test-can-predict-subsequent-failure-following-reimplantation-in-patients-with-periprosthetic-joint-infection
#5
Michael M Kheir, Colin T Ackerman, Timothy L Tan, Andrea Benazzo, Eric H Tischler, Javad Parvizi
BACKGROUND: Leukocyte esterase (LE) strip test is an accurate marker for diagnosing periprosthetic joint infection (PJI). This study aims to determine if LE is a good predictor of persistent infection and/or subsequent failure in patients undergoing reimplantation. METHODS: This single-institution study prospectively recruited and retrospectively analyzed 109 patients who underwent two-stage exchange treatment of PJI, from 2009-2016, and had an LE test performed at time of reimplantation...
January 26, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28108745/leukocyte-esterase-as-a-biomarker-in-the-diagnosis-of-periprosthetic-joint-infection
#6
Chi Wang, Rui Li, Qi Wang, Jinyan Duan, Chengbin Wang
BACKGROUND Total joint arthroplasty (TJA) has been one of the most rewarding interventions for treating patients suffering from joint disorders. However, periprosthetic joint infection (PJI) is a serious complication that frequently accompanies TJA. Our study aimed to investigate the application of the leukocyte esterase (LE) strip in the diagnosis of PJI. MATERIAL AND METHODS From October 2014 to July 2015, 72 patients who had undergone joint puncture after arthroplasty in our hospital were enrolled in this trial...
January 21, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28053259/qualitative-%C3%AE-defensin-test-synovasure-for-the-diagnosis-of-periprosthetic-infection-in-revision-total-joint-arthroplasty
#7
COMPARATIVE STUDY
I K Sigmund, J Holinka, J Gamper, K Staats, C Böhler, B Kubista, R Windhager
AIMS: The diagnosis of periprosthetic joint infection (PJI) remains demanding due to limitations of all the available diagnostic tests. The synovial fluid marker, α-defensin, is a promising adjunct for the assessment of potential PJI. The purpose of this study was to investigate the qualitative assessment of α-defensin, using Synovasure to detect or exclude periprosthetic infection in total joint arthroplasty. PATIENTS AND METHODS: We studied 50 patients (28 women, 22 men, mean age 65 years; 20 to 89) with a clinical indication for revision arthroplasty who met the inclusion criteria of this prospective diagnostic study...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28032700/management-of-acute-hematogenous-infection-following-total-knee-arthroplasty-a-case-series-of-11-patients
#8
Rui He, Liu Yang, Lin Guo, Hao Chen, Ying Zhang, Dian-Ming Jiang
OBJECTIVE: Acute hematogenous infection is a devastating complication that can occur after total knee arthroplasty (TKA). The best strategies for management of this infection remain controversial. Two-stage revision has been well described as the gold standard for the management of chronic late infections. However, there is a paucity of information presently available on the management and outcomes of patients treated for acute hematogenous infections. The purpose of the present study was to report the outcome of acute hematogenous infections following TKA with the treatment of irrigation, debridement, and retention of the prosthetic components...
November 2016: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28009676/effectiveness-of-meaningful-occupation-interventions-for-people-living-with-dementia-in-residential-aged-care-a-systematic-review
#9
Catherine Travers, Deborah Brooks, Sonia Hines, Maria O'Reilly, Mitchell McMaster, Wei He, Margaret MacAndrew, Elaine Fielding, Lina Karlsson, Elizabeth Beattie
BACKGROUND: The ability to participate in valued activities, whether for work, leisure or family, is an important aspect of personal identity. In dementia, progressive memory loss means that abilities developed over a lifetime begin to be lost as well, contributing to the loss of self and identity. Some studies have reported that activities or interventions tailored to be meaningful to the person with dementia (defined as any activity important to the individual) are more effective in addressing behavioral and psychological symptoms of dementia (BPSD) and improving quality of life (QoL) than those that are not so tailored...
December 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/27672013/what-is-the-diagnostic-accuracy-of-aspirations-performed-on-hips-with-antibiotic-cement-spacers
#10
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...
January 2017: 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
#11
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
#12
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...
January 2017: 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
#13
RANDOMIZED CONTROLLED TRIAL
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...
January 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27235328/the-diagnosis-of-infection-in-metal-on-metal-hip-arthroplasties
#14
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...
November 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27132530/quantification-of-neutrophil-polymorphs-in-infected-and-noninfected-second-stage-revision-hip-arthroplasties
#15
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
#16
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
#17
COMMENT
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
#18
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
#19
COMMENT
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
#20
COMPARATIVE STUDY
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
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