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Periprosthetic AND Infection

Ruben Scholten, Wout Füssenich, Matthijs P Somford, Job L C van Susante
INTRODUCTION: Hardware removal preceding total hip arthroplasty may increase the risk of prosthetic joint infection (PJI). Whether hardware removal and total hip arthroplasty (THA) should be performed in a single- or two-stage procedure remains controversial. In this comparative retrospective study, the incidence of PJI following either single- or two-stage THA with hardware removal was assessed in a consecutive series. PATIENTS AND METHODS: All patients that underwent THA preceded by hardware removal from January 2006 until March 2018 were retrospectively reviewed and checked for the occurrence of early PJI...
February 18, 2019: Archives of Orthopaedic and Trauma Surgery
Giuseppe Solarino, Luigi Zagra, Andrea Piazzolla, Arcangelo Morizio, Giovanni Vicenti, Biagio Moretti
BACKGROUND: Ceramic-on-ceramic (CoC) bearings due to their mechanical properties can be used in primary total hip arthroplasty (THA) especially in young patients requiring a long-lasting implant. The goal of this study is to analyze the results of a series of 200 consecutive CoC THAs in patients aged 50 years or less at the time of surgery. METHODS: A retrospective study was conducted on the first 200 consecutive CoC arthroplasties performed using the direct lateral approach on 105 females and 81 males (14 bilateral cases) with an average age of 44...
January 31, 2019: Journal of Arthroplasty
Piotr Terlecki, Tomasz Zubilewicz, Andrzej Wojtak, Eliza Pleban, Stanisław Przywara, Marek Iłżecki, Marcin Feldo, Marek Chrapko, Jan Jakub Kęsik, Karol Terlecki, Tomasz Pedowski, Beata Chrapko, Piotr Szopiński
The infection of a vascular prosthesis is potentially fatal, and its effective treatment still remains the greatest challenge for vascular surgeons. We present our initial experience using bovine pericardial vascular prostheses to replace infected aortoiliac vascular grafts. Six consecutive patients with infection of the graft were prospectively included in this study. Infection of the vascular graft was confirmed by clinical symptoms, laboratory tests and the results of computed tomography and positron emission tomography/computed tomography...
February 15, 2019: Xenotransplantation
Qiaojie Wang, Karan Goswami, Noam Shohat, Arash Aalirezaie, Jorge Manrique, Javad Parvizi
BACKGROUND: Whether prolonged operative time is an independent risk factor for subsequent surgical site infection (SSI) and periprosthetic joint infection (PJI) following total joint arthroplasty (TJA) remains a clinically significant and underexplored issue. The aim of this study is to investigate the association between operative time and the risk of subsequent SSI and PJI in patients undergoing primary TJA. METHODS: We retrospectively reviewed 17,342 primary unilateral total knee arthroplasty and total hip arthroplasty performed at a single institution between 2005 and 2016, with a minimum follow-up of 1 year...
January 18, 2019: Journal of Arthroplasty
Bernd Fink, Konstantinos Anagnostakos, Heinz Winkler
No abstract text is available yet for this article.
2019: BioMed Research International
Giuseppe Solarino, Andrea Piazzolla, Lorenzo Moretti, Giovanni Vicenti, Biagio Moretti
BACKGROUND: Ceramic-on-ceramic (CoC) is currently a viable bearing combination in primary total hip arthroplasty (THA) and, due to its mechanical properties, it can be used in young patients requiring a long-lasting implant. The aim of this study is to report the results of a series of CoC THAs at a minimum 20 years follow-up. METHODS: A retrospective study was conducted on the 1st 100 consecutive alumina-on-alumina arthroplasties performed by a single surgeon on 51 females and 40 males with an average age of 60...
November 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Federico De Meo, Giorgio Cacciola, Vittorio Bellotti, Antongiolio Bruschetta, Pietro Cavaliere
INTRODUCTION: Severe acetabular bone loss during revision hip arthroplasty can be restored with different surgical techniques. Best results have been observed using porous tantalum cementless cups. Trabecular Titanium (TT) cups were designed to reproduce the structure, mechanical and biological characteristics of trabecular bone. Few clinical studies have been published with these cups. The aim of this study is to evaluate the clinical and radiological outcome of patients with large acetabular defects (Paprosky IIb or higher) revised using TT cups...
November 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Scott R Nodzo, K Keely Boyle, Nicholas B Frisch
BACKGROUND: Many periprosthetic joint infections (PJIs) are caused by organisms not susceptible to first-generation cephalosporins. We sought to evaluate the national susceptibility patterns of organisms to cefazolin and, or oxacillin, clindamycin, and vancomycin using antibiogram data. METHODS: Publically available regional and state antibiograms were evaluated for antibiotic susceptibility patterns to commonly infecting gram-positive organisms. The number of isolates tested in each antibiogram and percent of strains susceptible to oxacillin, clindamycin, and vancomycin were recorded...
January 17, 2019: Journal of Arthroplasty
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
Dmitry Gil, Scott Grindy, Orhun Muratoglu, Hany Bedair, Ebru Oral
Despite being a relatively safe surgery, total joint replacement is often associated with two major complications - severe post-operative pain and periprosthetic joint infection. Local sustained delivery of therapeutics to the surgical site has a potential to address these complications more effectively than current clinical approaches. Given that several analgesics were shown to possess antibacterial activity, we propose here to use analgesic-loaded ultra-high molecular weight polyethylene (UHMWPE) as a delivery vehicle to provide antimicrobial effect after an arthroplasty...
February 9, 2019: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
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
Susan M Goodman, Allina A Nocon, Nicolas A Selemon, Bo Shopsin, Yi Fulmer, Mary E Decker, Sarah E Grond, Laura T Donlin, Mark P Figgie, Thomas P Sculco, Linda A Russell, Michael E Henry, Anne R Bass, Andy O Miller, Peter K Sculco
BACKGROUND: Rheumatoid arthritis patients are at increased risk for periprosthetic joint infection after arthroplasty. The reason is multifactorial. Nasal colonization with Staphylococcus aureus is a modifiable risk factor; carriage rates in RA patients are unknown. The goal of this study is to determine the S aureus nasal carriage rates of RA patients on biologics, RA patients on traditional disease-modifying anti-rheumatic drugs (DMARDs), and osteoarthritis. METHODS: Consecutive patients with RA on biologics (±DMARDs), RA on non-biologic DMARDs, or OA were prospectively enrolled from April 2017 to May 2018...
January 17, 2019: Journal of Arthroplasty
M Friedrich, D Cucchi, S Walter, S Gravius, D C Wirtz, J Schmolders
OBJECTIVE: Reconstruction of proximal humeral bone defects in the setting of shoulder revision arthroplasty by implantation of a modular humeral component. INDICATIONS: Severe segmental humeral bone defects in revision total shoulder arthroplasty, after tumor resection, trauma, pathological fractures, post-infectious or after failed osteosynthesis. CONTRAINDICATIONS: Acute or chronic local infections, large diaphyseal bone defects preventing adequate anchorage of the prosthesis, very short life expectancy (<3 months)...
February 6, 2019: Operative Orthopädie und Traumatologie
Khaled M Yaghmour, Emanuele Chisari, Wasim S Khan
Periprosthetic joint infection in total knee arthroplasty is a significant complication that is a common reason for revision surgery. The current standard of care is two-stage revision surgery. There is however increasing evidence to support the use of single-stage revision surgery. We conducted a PRISMA systematic review of the current evidence on the use of single-stage revision for infected total knee arthroplasty. Four databases (PubMed, Embase, Science Direct, and Cochrane Library) were systematically screened for eligible studies...
February 2, 2019: Journal of Clinical Medicine
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
Thomas Falstie-Jensen, Henrik Daugaard, Kjeld Søballe, Janne Ovesen, Anne Kirstine Arveschoug, Jeppe Lange
BACKGROUND: Shoulder periprosthetic joint infections (PJI) caused by low-virulent bacteria pose a diagnostic challenge. Combined labeled leukocyte (WBC) and technetium 99m sulfur colloid bone marrow imaging (WBC/BM) is considered the radionuclide imaging gold standard for diagnosing lower limb PJI. However, it is laborious and expensive to perform, and documentation on shoulder arthroplasties is lacking. This study investigated WBC/BM single-photon emission computed tomography-computed tomography diagnostic performance in shoulder PJI...
January 31, 2019: Journal of Shoulder and Elbow Surgery
Doruk Akgün, Justus Bürger, Matthias Pumberger, Michael Putzier
PURPOSE: C-reactive protein (CRP) has been shown to be a powerful parameter for detecting acute postoperative spinal implant infections (PSII) with a high sensitivity and specificity. However, little data are available on the performance of CRP in the diagnosis of delayed PSII. The aim of the current study was therefore to establish cutoff values for diagnosing delayed infection based on serum CRP. METHODS: All patients who underwent a revision surgery after instrumented spinal fusion from January 2013 through January 2016 were included...
February 2, 2019: European Spine Journal
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
Nathan H Varady, Pierre-Emmanuel Schwab, Todd Jones, Jamie E Collins, Wolfgang Fitz, Antonia F Chen
BACKGROUND: Postoperative glucose levels after total joint arthroplasty are important to monitor as hyperglycemia has been linked to complications such as periprosthetic joint infection. The purposes of this study were to identify how postoperative glucose values vary during the perioperative period and determine the optimal time to check glucose levels to best evaluate for hyperglycemia. METHODS: A retrospective study was conducted from September 2017 to September 2018 on 314 patients who underwent knee and hip arthroplasties...
January 9, 2019: Journal of Arthroplasty
Hussein Abdelaziz, Götz von Förster, Klaus-Dieter Kühn, Thorsten Gehrke, Mustafa Citak
PURPOSE: Due to numerous advantages of the combination of clindamycin and gentamicin in polymethylmethacrylate (PMMA) cement, promising preliminary results have been reported. However, there are no data that analyse mid-term outcomes. METHODOLOGY: This pilot study included patients who experienced 5 years of follow-up and who were treated with gentamicin- and clindamycin-loaded (G+C) PMMA cement. They were divided into two groups: (1) the periprosthetic joint infection (PJI) comprising patients who underwent a one-stage exchange, and (2) aseptic group comprising patients who underwent aseptic revision or primary arthroplasty procedures, but were considered to be high-risk patients for infection...
January 31, 2019: Journal of Medical Microbiology
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