Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Infection 119 articles


Swab Cultures Are Not As Effective As Tissue Cultures for Diagnosis of Periprosthetic Joint Infection

Vinay K. Aggarwal BS, Carlos Higuera MD, Gregory Deirmengian MD, Javad Parvizi MD, FRCS, Matthew S. Austin MD

While it is accepted accurate identification of infecting organisms is crucial in guiding treatment of periprosthetic joint infection (PJI), there remains no consensus regarding the best method for obtaining cultures.

Has the Rate of In-hospital Infections After Total Joint Arthroplasty Decreased?

Mohammad R. Rasouli MD, Mitchell Gil Maltenfort PhD, James J. Purtill MD, William J. Hozack MD, Javad Parvizi MD

Although infections are a major cause of morbidity and mortality after total joint arthroplasty (TJA), little is known about nationwide epidemiology and trends of infections after TJA.

Negative Pressure Wound Therapy Is Associated With Resolution of Incisional Drainage in Most Wounds After Hip Arthroplasty

Erik Hansen MD, Joel B. Durinka MD, James A. Costanzo MD, Matthew S. Austin MD, Gregory K. Deirmengian MD

Persistent wound drainage after hip arthroplasty is a risk factor for periprosthetic infection. Negative pressure wound therapy (NPWT) has been used in other fields for wound management although it is unclear whether the technique is appropriate for total hip arthroplasty.

Medical Comorbidities Are Independent Preoperative Risk Factors for Surgical Infection After Total Joint Arthroplasty

Joshua S. Everhart BS, Eric Altneu MS, Jason H. Calhoun MD

Surgical site infection (SSI) after total joint arthroplasty (TJA) is a major cause of morbidity. Multiple patient comorbidities have been identified as SSI risk factors including obesity, tobacco use, diabetes, immunosuppression, malnutrition, and coagulopathy. However, the independent effect of multiple individual patient factors on risk of subsequent periprosthetic infection is unclear.

No Infection Reduction Using Chlorhexidine Wipes in Total Joint Arthroplasty

Nicholas J. Farber BS, Antonia F. Chen MD, MBA, Sarah M. Bartsch MPH, Jody L. Feigel MSN, RN, Brian A. Klatt MD

Surgical site infection (SSI) after total joint arthroplasty (TJA) is a rare but devastating complication. Various skin antiseptic applications are used preoperatively to prevent SSI. Recent literature suggests 2% chlorhexidine gluconate (CHG) wipes reduce microbial content at surgical sites, but it is unclear whether they reduce rates of SSI.

The Routine Use of Atypical Cultures in Presumed Aseptic Revisions Is Unnecessary

Anthony T. Tokarski BS, Joseph O’Neil MD, Carl A. Deirmengian MD, Joseph Ferguson BS, Gregory K. Deirmengian MD

In presumed aseptic hip and knee revisions, it is common practice to send intraoperative cultures to screen for occult infection. Currently no guidelines exist for the routine use of acid-fast bacillus (AFB) and fungal cultures in this setting.

Clostridium difficile Colitis in Patients Undergoing Lower-extremity Arthroplasty: Rare Infection With Major Impact

Mitchell Gil Maltenfort PhD, Mohammad R. Rasouli MD, Todd A. Morrison BS, Javad Parvizi MD, FRCS

The prevalence ofcolitis is reportedly increasing in surgical patients and can negatively impact their outcome. However, as yet there are no clear estimates of theinfection colitis rate and its consequences among patients undergoing total joint arthroplasty (TJA).

Staphylococcus aureus Screening and Decolonization in Orthopaedic Surgery and Reduction of Surgical Site Infections

Antonia F. Chen MD, MBA, Charles B. Wessel MLS, Nalini Rao MD

Staphylococcus aureus is the most common organism responsible for orthopaedic surgical site infections (SSIs). Patients who are carriers for methicillin-sensitive S. aureus or methicillin-resistant S. aureus (MRSA) have a higher likelihood of having invasive S. aureus infections. Although some have advocated screening for S. aureus and decolonizing it is unclear whether these efforts reduce SSIs.

Success After Treatment of Periprosthetic Joint Infection: A Delphi-based International Multidisciplinary Consensus

Claudio Diaz-Ledezma MD, Carlos A. Higuera MD, Javad Parvizi MD, FRCS

The lack of agreement regarding what constitutes successful treatment for periprosthetic joint infections (PJI) makes it difficult to compare the different strategies of management that are used in clinical practice and in research studies.

Voriconazole Is Cytotoxic at Locally Delivered Concentrations: A Pilot Study

Kenneth Schmidt MD, Alex McLaren MD, Christine Pauken PhD, Ryan McLemore PhD

Fungal infections are rare but major problems when they involve orthopaedic implants. Preferred treatment in North America is two-staged: resection and then delayed reconstruction, with local delivery of an antifungal between stages. The effect of voriconazole, a hydrophobic antifungal, on local tissues and wound healing is unclear.