Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Infection 117 articles

Articles

Periprosthetic Joint Infection Is the Main Cause of Failure for Modern Knee Arthroplasty: An Analysis of 11,134 Knees

Chuan Kong Koh MBChB, Irene Zeng PhD, Saiprassad Ravi MBChB, Mark Zhu MBChB, Kelly G. Vince MD, Simon W. Young FRACS

Although large series from national joint registries may accurately reflect indications for revision TKAs, they may lack the granularity to detect the true incidence and relative importance of such indications, especially periprosthetic joint infections (PJI).

Single-stage Acetabular Revision During Two-stage THA Revision for Infection is Effective in Selected Patients

Bernd Fink MD, Michael Schlumberger MD, Damian Oremek MD

The treatment of periprosthetic infections of hip arthroplasties typically involves use of either a single- or two-stage (with implantation of a temporary spacer) revision surgery. In patients with severe acetabular bone deficiencies, either already present or after component removal, spacers cannot be safely implanted. In such hips where it is impossible to use spacers and yet a two-stage revision of the prosthetic stem is recommended, we have combined a two-stage revision of the stem with a single revision of the cup. To our knowledge, this approach has not been reported before.

What is the Long-term Economic Societal Effect of Periprosthetic Infections After THA? A Markov Analysis

Thomas J. Parisi MD, Joseph F. Konopka MD, Hany S. Bedair MD

Current estimates for the direct costs of a single episode of care for periprosthetic joint infection (PJI) after THA are approximately USD 100,000. These estimates do not account for the costs of failed treatments and do not include indirect costs such as lost wages.

Sonication of Arthroplasty Implants Improves Accuracy of Periprosthetic Joint Infection Cultures

Adam C. Rothenberg MD, Alan E. Wilson BS, John P. Hayes, Michael J. O’Malley MD, Brian A. Klatt MD

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.

Vancomycin Prophylaxis for Total Joint Arthroplasty: Incorrectly Dosed and Has a Higher Rate of Periprosthetic Infection Than Cefazolin

Michael M. Kheir MD, Timothy L. Tan MD, Ibrahim Azboy MD, Dean D. Tan BS, Javad Parvizi MD, FRCS

In total joint arthroplasty (TJA), vancomycin is used as perioperative antibiotic prophylaxis in patients with penicillin allergy or in patients colonized with methicillin-resistant(MRSA). Although vancomycin dosing should be weight-based (15 mg/kg), not all surgeons are aware of this; a fixed 1-g dose is instead frequently administered.

Increased Mortality After Prosthetic Joint Infection in Primary THA

Per Hviid Gundtoft MD, PhD, Alma Becic Pedersen MD, PhD, DMSc, Claus Varnum MD, PhD, Søren Overgaard MD, DMSc

Revision for prosthetic joint infection (PJI) has a major effect on patients’ health but it remains unclear if early PJI after primary THA is associated with a high mortality.

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.