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Prosthetic AND Joint AND infection

Zida Huang, Chongjing Zhang, Wenbo Li, Xinyu Fang, Qijin Wang, Li Xing, Yingzhen Li, Xifang Nie, Bin Yang, Wenming Zhang
Identifying fastidious pathogens in patients with prosthetic joint infection (PJI) by culture is challenging. Metagenomic next-generation sequencing (mNGS) is a novel culture-independent approach that is associated with a higher likelihood for identifying pathogens. We present a case where mNGS was implemented to identify Parvimonas micra , a rarely reported and difficult-to-culture PJI pathogen.
2019: Journal of Bone and Joint Infection
Merit P George, Floranne C Ernste, Aaron Tande, Douglas Osmon, Tad Mabry, Elie F Berbari
Introduction: Calcium pyrophosphate deposition disease (CPPD), or pseudogout, is rare in prosthetic joints, but can mimic prosthetic joint infection (PJI) according to case reports. The purpose of this case series is to describe the demographics, presentation, management, and outcomes of a cohort of these patients seen at our academic medical center. Methods: Patients with post-implant pseudogout, who were evaluated at our medical center between January 1, 2000 and June 30, 2016, were identified from our EHR...
2019: Journal of Bone and Joint Infection
Staffan Tevell, Sharmin Baig, Åsa Nilsdotter-Augustinsson, Marc Stegger, Bo Söderquist
In current diagnostic criteria for implant-associated bone- and joint infections, phenotypically identical low-virulence bacteria in two intraoperative cultures are usually required. Using whole-genome sequencing, we have further characterized three phenotypically different Staphylococcus capitis isolated from one prosthetic joint infection, highlighting the challenges in defining microbiological criteria for low-virulence prosthetic joint infections.
2019: Journal of Bone and Joint Infection
Cornelis M Vincenten, Brenda L Den Oudsten, Pieter K Bos, Stefan B T Bolder, Taco Gosens
Introduction: The Girdlestone resection arthroplasty (GRA) is a salvage procedure for a recurrent or persistent prosthetic joint infection of the hip. This procedure negatively impacts the functional outcome and presumably also diminishes health status (HS) and quality of life (QOL). However, studies investigating the QOL after GRA are lacking. This cross-sectional study compares patients with a Girdlestone situation after an infected total hip prosthesis with a normative population with regard to HS and QOL...
2019: Journal of Bone and Joint Infection
Hiba K Anis, Deepak Ramanathan, Nipun Sodhi, Alison K Klika, Nicolas S Piuzzi, Michael A Mont, Carlos A Higuera, Robert M Molloy
The ongoing debate on fixation in total knee arthroplasty (TKA) has become increasingly relevant with its increased use in a younger patient population and the advent of novel cementless prostheses. Recent literature suggests modern cementless implants are comparable to their cemented counterparts in terms of survivorship and functional outcomes. What has not been well-assessed is whether the two modalities differ with respect to infection rates which was the purpose of this study. Specifically, a propensity score matched study population was used to compare: (1) overall infection; (2) prosthetic joint infection (PJI); and (3) surgical site infection (SSI) rates between cementless and cemented TKAs...
February 12, 2019: Journal of Knee Surgery
Benjamin Tk Ding, Kelvin Guoping Tan, Chung Yuan Kau, Henry Ying Ho Chan, Muhd Farhan Bin Mohd Fadil
OBJECTIVE: This study aimed to test the accuracy of the Synovasure®, α-defensin lateral flow test kit, in diagnosing periprosthetic joint infections (PJIs) in a predominantly Asian population and to evaluate whether other patient or disease factors may affect its results. METHODS: 61 Asian patients comprising 70 hip or knee prosthetic joints, performed between November 2015 and November 2018, were retrospectively evaluated. Cases were categorized as infected or not infected using Musculoskeletal Infection Society (MSIS) Criteria...
January 2019: Journal of Orthopaedic Surgery
Stefanie Hirsiger, Michael Betz, Dimitrios Stafylakis, Tobias Götschi, Daniel Lew, Ilker Uçkay
Background: The management of prosthetic joint infections (PJI) with debridement and retention of the implant (DAIR) has its rules. Some authors claim that lacking the exchange of mobile prosthetic parts is doomed to failure, while others regard it as optional. Methods: Single-center retrospective cohort in PJIs treated with DAIR. Results: We included 112 PJIs (69 total hip arthroplasties, 9 medullary hip prostheses, 41 total knee arthroplasties, and 1 total shoulder arthroplasty) in 112 patients (median age 75 years, 52 females (46%), 31 (28%) immune-suppressed) and performed a DAIR procedure in all cases-48 (43%) with exchange of mobile parts and 64 without...
February 9, 2019: Journal of Clinical Medicine
Bernadette G Pfang, Joaquín García-Cañete, Julia García-Lasheras, Antonio Blanco, Álvaro Auñón, Raul Parron-Cambero, Alicia Macías-Valcayo, Jaime Esteban
INTRODUCTION: Orthopedic implant-associated infections caused by multidrug-resistant Enterobacteriaceae are a growing challenge for healthcare providers due to their increasing incidence and the difficulties of medical and surgical treatment. MATERIAL AND METHODS: A retrospective observational study of all cases of multidrug resistant Enterobacteriaceae orthopedic implant-associated infection diagnosed in a tertiary European hospital from December 2011 to November 2017 was carried out...
February 8, 2019: Journal of Clinical Medicine
Michael D George, Joshua F Baker, Kevin Winthrop, Evo Alemao, Lang Chen, Sean Connolly, Jesse Y Hsu, Teresa A Simon, Qufei Wu, Fenglong Xie, Shuo Yang, Jeffrey R Curtis
OBJECTIVES: Guidelines recommend holding biologic therapies before hip and knee arthroplasty, yet evidence to inform optimal timing is limited. We aimed to determine whether holding abatacept infusions is associated with lower risk of adverse post-operative outcomes. METHODS: This retrospective cohort study using U.S. Medicare and Truven MarketScan administrative data from 2006-September 2015 evaluated adults with RA who received intravenous abatacept (precisely dated in claims data) within 6 months of elective primary or revision hip or knee arthroplasty...
February 11, 2019: Arthritis Care & Research
Laure Flurin, Kerryl E Greenwood-Quaintance, Robin Patel
Prosthetic joint infection (PJI) is a rare but challenging complication of arthroplasty. Herein, we describe the epidemiology and microbiology of PJI, with a focus on analyzing differences between the microbiology of polymicrobial versus monomicrobial infection of hip, knee, and shoulder prostheses. In addition, we report the most frequent co-pathogens in polymicrobial infections, as detected by culture. A total of 373 patients diagnosed with PJI at Mayo Clinic were studied. For hip and knee arthroplasties, a higher proportion of fractures (P = 0...
January 15, 2019: Diagnostic Microbiology and Infectious Disease
Alberto Signore, Luca Maria Sconfienza, Olivier Borens, Andor W J M Glaudemans, Victor N Cassar-Pullicino, Andrej Trampuz, Heinz Winkler, Olivier Gheysens, Filip M H M Vanhoenacker, Nicola Petrosillo, Paul C Jutte
The authors regret to inform the readers that one of the author's name in the original publication of this article was spelled incorrectly as Victor Casar-Pullicino. The correct spelling is Victor N. Cassar-Pullicino and is now presented correctly in this article.
February 9, 2019: European Journal of Nuclear Medicine and Molecular Imaging
Ralf Dieckmann, Tom Schmidt-Braekling, Georg Gosheger, Christoph Theil, Jendrik Hardes, Burkhard Moellenbeck
BACKGROUND: Despite very good prosthesis retention times, the growing numbers of primary implantations of hip endoprostheses are leading to increasing numbers of revision operations. Periprosthetic infection, particularly in revision implants, often leads to a massive loss of bone stock, so that in a two-stage exchange the only option left is implantation of a megaendoprosthesis. This retrospective study investigated the clinical and functional outcome for patients who received megaendoprostheses in the proximal femur in two-stage exchange procedures...
February 8, 2019: BMC Musculoskeletal Disorders
Obada Hasan, Shahryar Noordin, Riaz Lakdawala, Vickash Kumar, Faisal Mahmood
Tuberculosis continues to be one of the most challenging health problems more prevalent in developing countries. Pakistan ranks 5th in tuberculosis prevalence among the high-burden countries. Prosthetic joint infection of the knee by acid fast bacilli is a rare and distressing complication, occurring in nearly 1% of primary joint arthroplasties requiring prolonged medical treatment and multiple surgeries. A recent publication extensively reviewed English literature from 1952 to 2016, and repor ted only 64 prosthetic joint infec tion with tuberculosis, of which 27 cases involved the knee...
February 2019: JPMA. the Journal of the Pakistan Medical Association
Chloé Jamakorzyan, Vanina Meyssonnier, Younes Kerroumi, Benoit Villain, Beate Heym, Luc Lhotellier, Valérie Zeller, Jean-Marc Ziza, Simon Marmor
OBJECTIVE: Prosthetic joint infection (PJI) is a serious complication of joint replacement surgery. The major pharmacological and surgical treatments required by PJI increase the risk of peri-operative complications in elderly patients. The increase in life expectancy combined with procedural advances make these treatments possible even in the oldest patients. Here, our objective was to compare the characteristics and outcomes of curative PJI treatment in patients <80 years vs. ≥ 80 years...
February 5, 2019: Joint, Bone, Spine: Revue du Rhumatisme
William Scully, Nicolas S Piuzzi, Nipun Sodhi, Assem A Sultan, Jaiben George, Anton Khlopas, George F Muschler, Carlos A Higuera, Michael A Mont
BACKGROUND: Evaluating body mass index (BMI) as a continuous variable eliminates the potential pitfalls of only considering BMI as a binary or categorical variable, as most studies do when correlating BMI and total hip arthroplasty (THA) outcomes. Therefore, the objective of this study was to correlate the effect of continuous BMI on 30-day complications post-THA. Specifically, we correlated BMI to: (1) 30-day readmissions and reoperations; (2) medical complications; and (3) surgical complications in: (a) normal-weight; (b) over-weight; (c) obese; and (d) morbidly obese patients...
February 5, 2019: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Marcel-Philipp Henrichs, Dennis Liem, Georg Gosheger, Arne Streitbuerger, Markus Nottrott, Dimosthenis Andreou, Jendrik Hardes
BACKGROUND: The distal humerus is a rare location of bone tumors. Because of the complexity of the elbow joint, poor soft-tissue coverage, and proximity of nerves and vessels, resection and endoprosthetic reconstruction are demanding. METHODS: This retrospective study evaluated the clinical results after distal humeral resection and megaprosthetic reconstruction in 12 patients with an average age of 46 years. All patient files were reviewed for clinical information, and postoperative function and patients' contentment were assessed using the Musculoskeletal Tumor Society score...
February 1, 2019: Journal of Shoulder and Elbow Surgery
Mohamad Khalife, Mira Merashli, Souha S Kanj
BACKGROUND: Septic arthritis is a common rheumatologic condition with myriad microbiological causative agents. Moraxella is one of the very rare causes of septic arthritis. We hereby present the third case of Moraxella nonliquefaciens septic arthritis and the first case in a hematopoietic stem cell transplant patient (HSCT) along with a brief review of the literature. METHODS: We used PubMed with google search engine to search the literature for reported cases of moraxella septic arthritis...
January 30, 2019: Journal of Infection and Public Health
Dustin L Williams, Richard T Epperson, Nicholas N Ashton, Nicholas B Taylor, Brooke Kawaguchi, Raymond E Olsen, Travis J Haussener, Paul R Sebahar, Gina Allyn, Ryan E Looper
Prosthetic joint infection (PJI) is a well-known and persisting problem. Active release coatings have promise to provide early protection to an implant by eradicating small colony biofilm contaminants or planktonic bacteria that can form biofilm. Traditional antibiotics can be limited as active release agents in that they have limited effect against biofilms and develop resistance at sub-lethal concentrations. A unique first-in-class compound (CZ-01127) was assessed as the active release agent in a silicone (Si)-based coating to prevent PJI in a sheep model of joint space infection...
January 30, 2019: Acta Biomaterialia
Bradley W Wills, Jeffrey Pearson, Alan Hsu, Peng Li, Ashish Shah, Sameer Naranje
Background: Total hip arthroplasty (THA) is a very successful surgery in restoring a patient's quality of life. Infection is a devastating complication of THA. Many risks factors for infection in THA have been identified but little is known of the effect by preoperative hematocrit. Purpose: We aimed to evaluate the effect of preoperative hematocrit on early superficial site infections, deep infections, and deep organ space infections. Methods: Our study cohort included patients undergoing a THA in the ACS National Surgical Quality Improvement Program database from 2006 to 2015...
January 2019: Journal of Clinical Orthopaedics and Trauma
Klemens Vertesich, Stephan E Puchner, Kevin Staats, Markus Schreiner, Christian Hipfl, Bernd Kubista, Johannes Holinka, Reinhard Windhager
BACKGROUND: Substantial bone loss following failed total knee arthroplasty (TKA) represents a major challenge in revision arthroplasty, that can require distal femoral reconstruction (DFR). In this study, we aimed to assess the clinical outcome and the complication frequencies of individuals who underwent DFR with modular megaprostheses. Additionally, we aimed to compare functional outcome measures after DFR in these sophisticated cases to an age-matched control group of total knee prostheses to quantify the potential loss of function...
January 31, 2019: BMC Musculoskeletal Disorders
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