Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Infection 119 articles


Antimicrobial Distribution From Local Delivery Depends on Dose

Alex McLaren MD, Morgan B. Giers PhD, James Fraser MD, MPH, Luke Hosack MD, Michael R. Caplan PhD, Ryan McLemore PhD

Tissue distribution after local delivery has been quantified over a period of 5 hours on 7-T MRI in a rabbit model using gadolinium-labeled diethylenetriamine pentaacetic acid (Gd-DTPA) as an antimicrobial surrogate; however, it is unknown how the Gd-DTPA load in a local depot will affect the duration of high-concentration Gd-DTPA in local tissues after surgical débridement.

Diagnosis of Periprosthetic Joint Infection in Medicare Patients: Multicriteria Decision Analysis

Claudio Diaz-Ledezma MD, Paul M. Lichstein MD, MS, James G. Dolan MD, Javad Parvizi MD, FRCS

In the setting of finite healthcare resources, developing cost-efficient strategies for periprosthetic joint infection (PJI) diagnosis is paramount. The current levels of knowledge allow for PJI diagnostic recommendations based on scientific evidence but do not consider the benefits, opportunities, costs, and risks of the different diagnostic alternatives.

Industrially Prefabricated Cement Spacers: Do Vancomycin- and Gentamicin-impregnated Spacers Offer Any Advantage?

Pablo S. Corona MD, Victor Barro MD, Marye Mendez MD, Enric Cáceres PhD, Xavier Flores MD

Industrially preformed antibiotic-loaded cement spacers are useful to facilitate the second stage of two-stage exchange arthroplasty for infected THAs and TKAs. However, whether gentamicin alone or a combination of antibiotics (such as vancomycin and gentamicin) is more effective is not known.

Prosthesis Failure Within 2 Years of Implantation Is Highly Predictive of Infection

María Eugenia Portillo MD, PhD, Margarita Salvadó MD, PhD, Albert Alier MD, Lluisa Sorli MD, Santos Martínez MD, Juan Pablo Horcajada MD, PhD, Lluis Puig MD, PhD

The outcome of revision surgery depends on accurate determination of the cause of prosthesis failure because treatment differs profoundly among aseptic loosening, mechanical failure, and prosthetic joint infections (PJI).

Are Cementless Stems More Durable Than Cemented Stems in Two-stage Revisions of Infected Total Knee Arthroplasties?

Paul K. Edwards MD, Thomas K. Fehring MD, William G. Hamilton MD, Brett Perricelli MD, Walter B. Beaver MD, Susan M. Odum PhD

The routine use of stems in revision TKA improves survival rates by enhancing the stability of the prosthesis. The ideal method of stem fixation (cemented or uncemented) in two-stage reimplantation remains controversial.

Diagnosis of Periprosthetic Joint Infection: The Threshold for Serological Markers

Pouya Alijanipour MD, Hooman Bakhshi MD, Javad Parvizi MD, FRCS

Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) have recently been suggested as diagnostic criteria for periprosthetic joint infection (PJI) diagnosis. Thresholds for these markers should be reexamined since they have been determined arbitrarily.

Tuberculosis of the Pubic Symphysis: Four Unusual Cases and Literature Review

Hitesh Lal MS, Vijay Kumar Jain MS, Sudhir Kannan MS

The incidence of extrapulmonary tuberculosis (TB) has increased in the chemotherapeutic era owing to the increasing presence of immunodeficiency disorders. Pubic symphysis TB, although uncommon, is again important as these infections once were in the prechemotherapeutic era.

What Is the Success of Treatment of Hip and Knee Candidal Periprosthetic Joint Infection?

Steve W. N. Ueng MD, Ching-Yu Lee MD, Chih-chien Hu MD, Pang-Hsin Hsieh MD, Yuhan Chang MD, PhD

Fungal infection at an arthroplasty site is rare and poses a therapeutic challenge. To the best of our knowledge, no reports have been published thus far on the success rate of prosthesis reimplantation after fungal prosthetic joint infections.

Novel Biomarkers to Detect Infection in Revision Hip and Knee Arthroplasties

Mathias Glehr MD, Joerg Friesenbichler MD, Günter Hofmann MD, Gerwin Alexander Bernhardt MD, Maximilian Zacherl MD, Alexander Avian PhD, Reinhard Windhager MD, Andreas Leithner MD

A periprosthetic joint infection is one of the most challenging complications associated with THA and TKA. In the diagnostic process for detecting a periprosthetic joint infection, one of the most important steps is analysis of laboratory infection biomarkers.

Chitosan Sponges for Local Synergistic Infection Therapy: A Pilot Study

J. Keaton Smith MS, Abteen R. Moshref BS, Jessica A. Jennings PhD, Harry S. Courtney PhD, Warren O. Haggard PhD

Although bacterial antibiotic resistance is increasing, fewer new antibiotics are being developed to compensate. Localized delivery of synergistic antiseptics and antibiotics with a chitosan sponge device may offer an alternative infection treatment.