Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Symposium: 2011 Musculoskeletal Infection Society 16 articles


Preoperative Anemia in Total Joint Arthroplasty: Is It Associated with Periprosthetic Joint Infection?

Max Greenky BA, Kishor Gandhi MD, MPH, Luis Pulido MD, Camilo Restrepo MD, Javad Parvizi MD

Anemia is common in patients undergoing total joint arthroplasty (TJA). Numerous studies have associated anemia with increased risk of infection, length of hospital stay, and mortality in surgical populations. However, it is unclear whether and to what degree preoperative anemia in patients undergoing TJA influences postoperative periprosthetic joint infection (PJI) and mortality.

Culture-negative Periprosthetic Joint Infection Does Not Preclude Infection Control

Ronald Huang MD, Chi-Chien Hu MD, Bahar Adeli BS, Javad Mortazavi MD, Javad Parvizi MD

Periprosthetic joint infection (PJI) is a devastating complication after total joint arthroplasty. Lack of confirmation of an infecting organism poses a challenge with regard to the selection of an appropriate antibiotic agent and surgical treatment. It is unclear whether patients with negative cultures presumed to have infections achieve similar rates of infection-free survival as those with positive cultures.

Cis-2-decenoic Acid Inhibits S. aureus Growth and Biofilm In Vitro: A Pilot Study

Jessica Amber Jennings PhD, Harry S. Courtney PhD, Warren O. Haggard PhD

Cis-2 decenoic acid (C2DA) disperses biofilm in many strains of microorganisms. However, whether C2DA inhibits bacterial growth or has potential to boost the actions of antibiotics is unknown.

Low Rate of Infection Control in Enterococcal Periprosthetic Joint Infections

Mohammad R. Rasouli MD, Mohan S. Tripathi BA, Robert Kenyon BS, Nathan Wetters MD, Craig J. Della Valle MD, Javad Parvizi MD

Enterococcal periprosthetic joint infections (PJIs) are rare after joint arthroplasty. These cases are usually reported in series of PJIs caused by other pathogens. Because few studies have focused only on enterococcal PJIs, management and control of infection of these cases have not yet been well defined.

Assessing the Gold Standard: A Review of 253 Two-Stage Revisions for Infected TKA

Tahir Mahmud MBBS, FRCS(Tr&Orth), Matthew C. Lyons MBBS, FRACS, Douglas D. Naudie MD, FRCSC, Steven J. MacDonald MD, FRCSC, Richard W. McCalden MD, FRCSC

Periprosthetic joint infection has been the leading cause of failure following TKA surgery. The gold standard for infection control has been a two-staged revision TKA. There have been few reports on mid- to long-term survivorship, functional outcomes, and fate of patients with a failed two-stage revision TKA.

Mixing Method Affects Elution and Strength of High-dose ALBC: A Pilot Study

Ryan Miller MD, Alex McLaren MD, Christine Leon MS, Ryan McLemore PhD

High-dose antimicrobial-loaded bone cement (ALBC) is used to treat orthopaedic infections. High-dose ALBC is not commercially available and requires surgeon directed formulation, and there are several different methods used to mix high-dose ALBC.

Does a Prefabricated Gentamicin-impregnated, Load-bearing Spacer Control Periprosthetic Hip Infection?

Ryan M. Degen BSc, MD, John R. Davey BSc, J. Roderick Davey MD, FRCSC, James L. Howard MD, FRCSC, Richard W. McCalden MD, FRCSC, Douglas D. R. Naudie MD, FRCSC

Treating deep infection following THA has been a challenge. While the standard treatment has remained a two-stage revision, spacer designs, incorporated antibiotics, and concentrations have varied. Since control of infection may relate to choice and concentration of antibiotics, it is important to report rates of control from various spacers.

Better Function for Fusions Versus Above-the-knee Amputations for Recurrent Periprosthetic Knee Infection

Antonia F. Chen MD, MBA, Nicholas C. Kinback BS, Alma E. Heyl LAS, RTR, CCRC, Edward J. McClain MD, Brian A. Klatt MD

Treatment of chronic periprosthetic joint infections (PJIs) after TKA is limited to fusions, above-the-knee amputations (AKAs), revision TKA, and antibiotic suppression and is often based on the patient’s medical condition. However, when both fusion and AKA are options, it is important to compare these two procedures with regard to function.

Liposomal Formulation Increases Local Delivery of Amphotericin from Bone Cement: A Pilot Study

Brian Cunningham MD, Alex C. McLaren MD, Christine Pauken PhD, Ryan McLemore PhD

Amphotericin is a highly toxic hydrophobic antifungal. Delivery of amphotericin from antifungal-loaded bone cement (ALBC) is much lower than would be expected for an equivalent load of water-soluble antibacterials. Lipid formulations have been developed to decrease amphotericin toxicity. It is unknown how lipid formulations affect amphotericin release and compressive strength of amphotericin ALBC.

What Is the Prevalence of MRSA Colonization in Elective Spine Cases?

Antonia F. Chen MD, MBA, Srinivas Chivukula BS, Lloydine J. Jacobs MD, Matthew W. Tetreault BA, Joon Y. Lee MD

The incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection is increasing. However, the prevalence of MRSA colonization among patients undergoing spine surgery is unclear.

Jeannette Wilkins Award: Can Locally Delivered Gadolinium Be Visualized on MRI? A Pilot Study

Morgan B. Giers BS, Chris S. Estes DO, Alex C. McLaren MD, Michael R. Caplan PhD, Ryan McLemore PhD

Management of orthopaedic infections relies on débridement and local delivery of antimicrobials; however, the distribution and concentration of locally delivered antimicrobials in postdébridement surgical sites is unknown. Gadolinium-DTPA (Gd-DTPA) has been proposed as an imaging surrogate for antimicrobials because it is similar in size and diffusion coefficient to gentamicin.

Does Dual Antibiotic Prophylaxis Better Prevent Surgical Site Infections in Total Joint Arthroplasty?

Amy Sewick MD, Amun Makani MD, Chia Wu MD, Judith O’Donnell MD, Keith D. Baldwin MD, MPH, MSPT, Gwo-Chin Lee MD

It is unclear which antibiotic regimen provides the best prophylaxis against surgical site infection (SSI) in patients undergoing hip and knee surgery.

Operating Room Traffic is a Major Concern During Total Joint Arthroplasty

Pedram Panahi MBBS, Mitchell Stroh BS, David S. Casper BS, Javad Parvizi MD, FRCS, Matthew S. Austin MD

Periprosthetic joint infection (PJI) is a challenging complication associated with total joint arthroplasty (TJA). Traffic in the operating room (OR) increases bacterial counts in the OR, and may lead to increased rates of infection.