Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Infection 111 articles

Articles

Is There an Association Between Hemoglobin A1C and Deep Postoperative Infection After TKA?

Jourdan M. Cancienne MD, Brian C. Werner MD, James A. Browne MD

Despite substantial research into the use of glycemic markers to stratify infection risk in patients with diabetes mellitus, there is little evidence to support a perioperative hemoglobin A1c (HbA1c) level associated with an increased risk of deep postoperative infection after TKA.

Blended Chitosan Paste for Infection Prevention: Preliminary and Preclinical Evaluations

Joel M. Berretta MS, Jessica A. Jennings PhD, Harry S. Courtney PhD, Karen E. Beenken PhD, Mark S. Smeltzer PhD, Warren O. Haggard PhD

Local drug delivery devices offer a promising method for delivering vancomycin and amikacin for musculoskeletal wounds. However, current local delivery devices such as beads and sponges do not necessarily allow for full coverage of a wound surface with eluted antibiotics and do not address the need for reducing the antibiotic diffusion distance to help prevent contamination by bacteria or other microorganisms. We blended chitosan/polyethylene glycol (PEG) pastes/sponges to increase biocompatibility and improve antibiotic coverage within the wound.

Obesity Epidemic: Is Its Impact on Total Joint Arthroplasty Underestimated? An Analysis of National Trends

Jaiben George MBBS, Alison K. Klika MS, Suparna M. Navale MS, MPH, Jared M. Newman MD, Wael K. Barsoum MD, Carlos A. Higuera MD

Obesity is a well-established risk factor for total joint arthroplasty (TJA) and a number of complications including prosthetic joint infection. The annual changes in the prevalence of obesity among primary, revision, and infected TJA has not been studied at a national level. Given the higher costs of complications of TJA, it is important to understand the association of obesity with the annual trends of revision and infected TJA.

What Orthopaedic Operating Room Surfaces Are Contaminated With Bioburden? A Study Using the ATP Bioluminescence Assay

Raveesh Daniel Richard MD, Thomas R. Bowen MD

Contaminated operating room surfaces can increase the risk of orthopaedic infections, particularly after procedures in which hardware implantation and instrumentation are used. The question arises as to how surgeons can measure surface cleanliness to detect increased levels of bioburden. This study aims to highlight the utility of adenosine triphosphate (ATP) bioluminescence technology as a novel technique in detecting the degree of contamination within the sterile operating room environment.

Phosphatidylcholine Coatings Deliver Local Antimicrobials and Reduce Infection in a Murine Model: A Preliminary Study

Michael A. Harris BSBE, Karen E. Beenken PhD, Mark S. Smeltzer PhD, Warren O. Haggard PhD, J. Amber Jennings PhD

Phosphatidylcholine coatings have been shown to elute antibiotics for several days. A recently developed biofilm inhibitor, cis-2-decenoic acid (C2DA), has been shown to exhibit synergistic activity with several common antibiotics. This study aims to evaluate the effectiveness of C2DA and amikacin dual drug delivery from a phosphatidylcholine coating.

Racial Disparities in Above-knee Amputations After TKA: A National Database Study

Jaiben George MBBS, Suparna M. Navale MS, MPH, Nicholas K. Schiltz PhD, Miguel Siccha MD, Alison K. Klika MS, Carlos A. Higuera MD

Above-knee amputation (AKA) is a rare but devastating complication of TKA. Although racial disparities have been previously reported in the utilization of TKA, it is unclear whether disparities exist in the rates of AKA after TKA.

False-positive Cultures After Native Knee Aspiration: True or False

Jason M. Jennings MD, DPT, Douglas A. Dennis MD, Raymond H. Kim MD, Todd M. Miner MD, Charlie C. Yang MD, David C. McNabb MD

Synovial fluid aspiration is a routine practice used by most orthopaedic surgeons to aid in the diagnosis of joint infection. In patients for whom there is a low pretest probability of infection, a positive culture—particularly if it is a broth-only culture—may be considered a contaminant, especially if the bacterial species are skin pathogens. To our knowledge no study has evaluated the incidence of contamination of aspirations from the native knee.

What is the Intraarticular Concentration of Tobramycin Using Low-dose Tobramycin Bone Cement in TKA: An In Vivo Analysis?

Gregory Vrabec MD, FRCS, Willis Stevenson MD, Sameh Elguizaoui MD, Matthew Kirsch MD, John Pinkowski MD

Antibiotic-impregnated bone cement has increased in popularity as an effort to reduce the risk of infection in high-risk TKAs. However, limited data has been reported regarding antibiotic levels achieved when using tobramycin-impregnated bone cement after implanting total knee components.

The Alpha-defensin Test for Periprosthetic Joint Infections Is Not Affected by Prior Antibiotic Administration

Alisina Shahi MD, Javad Parvizi MD, FRCS, Gregory S. Kazarian AB, Carlos Higuera MD, Salvatore Frangiamore MD, Joshua Bingham MD, Christopher Beauchamp MD, Craig Della Valle MD, Carl Deirmengian MD

Previous studies have demonstrated that the administration of antibiotics to patients before performing diagnostic testing for periprosthetic joint infection (PJI) can interfere with the accuracy of test results. Although a single-institution study has suggested that alpha-defensin maintains its concentration and sensitivity even after antibiotic treatment, this has not yet been demonstrated in a larger multiinstitutional study.

The ACS NSQIP Risk Calculator Is a Fair Predictor of Acute Periprosthetic Joint Infection

Nathaniel C. Wingert MD, James Gotoff BA, Edgardo Parrilla BA, BS, Robert Gotoff MD, Laura Hou MSc, Elie Ghanem MD

Periprosthetic joint infection (PJI) is a severe complication from the patient’s perspective and an expensive one in a value-driven healthcare model. Risk stratification can help identify those patients who may have risk factors for complications that can be mitigated in advance of elective surgery. Although numerous surgical risk calculators have been created, their accuracy in predicting outcomes, specifically PJI, has not been tested.