Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Infection 119 articles


What is the Role of Serological Testing Between Stages of Two-stage Reconstruction of the Infected Prosthetic Knee?

Sharat K. Kusuma MD, MBA, Joseph Ward BA, Marc Jacofsky PhD, Scott M. Sporer MD, Craig J. Della Valle MD

Two-stage exchange arthroplasty is the gold standard for treatment of infected TKA. The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and synovial fluid white blood cell (WBC) count with differential are often used to determine treatment response; however, it is unclear whether these tests can answer the critical question of whether joint sepsis has been controlled between stages and if reimplantation is indicated.

Diagnosing Periprosthetic Infection: False-positive Intraoperative Gram Stains

Margret Oethinger MD, PhD, Debra K. Warner MT(ASCP), Susan A. Schindler MT(ASCP), Hideo Kobayashi MD, PhD, Thomas W. Bauer MD, PhD

Intraoperative Gram stains have a reported low sensitivity but high specificity when used to help diagnose periprosthetic infections. In early 2008, we recognized an unexpectedly high frequency of apparent false-positive Gram stains from revision arthroplasties.

Durable Infection Control and Function With the PROSTALAC Spacer in Two-stage Revision for Infected Knee Arthroplasty

Christopher R. Gooding BSc, MD, FRCS (Tr & Orth), Bassam A. Masri MD, FRCSC, Clive P. Duncan MD, MSc, FRCSC, Nelson V. Greidanus MD, MPH, FRCSC, Donald S. Garbuz MD, MHSc, FRCSC

A two-stage revision total knee arthroplasty is recognized as the gold standard in the treatment of infection. However, traditional spacers limit function in the interval between the two stages and may cause instability, scarring, and bone erosion. The PROSTALAC knee spacer is an antibiotic-loaded cement articulating spacer that allows some movement of the knee between stages. Whether motion enhances long-term function is unknown.

Functional Ability After Above-the-knee Amputation for Infected Total Knee Arthroplasty

Catherine J. Fedorka MD, Antonia F. Chen MD, William M. McGarry BS, Javad Parvizi MD, FRCS, Brian A. Klatt MD

Prosthetic joint infection is an uncommon but serious complication of total knee arthroplasty (TKA). Control of infection after TKA is not always possible, and the resolution of infection may require an above-knee amputation (AKA).

Acinetobacter baumannii is not Associated with Osteomyelitis in a Rat Model: A Pilot Study

Stefan Collinet-Adler MD, Carlos A. Castro MD, Charles Gerald T. Ledonio MD, Joan E. Bechtold PhD, Dean T. Tsukayama MD

Multidrug resistant Acinetobacter baumannii (MDR AB) with and without Staphylococcus aureus (SA) is a commonly isolated organism in infected segmental bone defects in combat-related trauma in Iraq and Afghanistan. Although MDR AB in visceral infections is a therapeutic challenge, control of infection appears more common for combat-related osteomyelitis.

Articulating Spacers Used in Two-stage Revision of Infected Hip and Knee Prostheses Abrade with Time

Bernd Fink MD, Annett Rechtenbach PhD, Hubert Büchner PhD, Sebastian Vogt PhD, Michael Hahn PhD

Articulating spacers used in two-stage revision surgery of infected prostheses have the potential to abrade and subsequently induce third-body wear of the new prosthesis.

Osseointegrated Titanium Implants for Limb Prostheses Attachments: Infectious Complications

Jonatan Tillander MD, Kerstin Hagberg RPT, PhD, Lars Hagberg MD, PhD, Rickard Brånemark MD, PhD

The concept of osseointegration involves direct contact between titanium implant and bone. This transcutaneous prosthetic system for amputees is intended to assure stable long-term fixation. Most metal transcutaneous implants have failed, primarily owing to infection.

Laboratory Indicators for Early Detection and Surgical Treatment of Vibrio Necrotizing Fasciitis

Yao-Hung Tsai MD, Robert Wen-Wei Hsu MD, Kuo-Chin Huang MD, Tsung-Jen Huang MD

Vibrio necrotizing fasciitis is a rare and life-threatening soft tissue infection, with fulminant clinical courses and high mortality rates. However, the lack of specific disease characteristics and diagnostic tools during the initial examination may delay diagnosis.

Blood Culture Flasks for Culturing Synovial Fluid in Prosthetic Joint Infections

Lluís Font-Vizcarra MD, Sebastián García MD, PhD, Juan C. Martínez-Pastor MD, Josep M. Sierra MD, Alex Soriano MD, PhD

Identifying the etiologic microorganism is essential to guide antimicrobial therapy in prosthetic joint infection.