Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Infection 114 articles


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.

Staphylococcus aureus Colonization among Arthroplasty Patients Previously Treated by a Decolonization Protocol: A Pilot Study

Demetri M. Economedes DO, Gregory K. Deirmengian MD, Carl A. Deirmengian MD

Although testing and treatment forcolonization before total joint arthroplasty (TJA) are well described and understood, the durability of decolonization has not been studied extensively.

Cyanoacrylate Microbial Sealant May Reduce the Prevalence of Positive Cultures in Revision Shoulder Arthroplasty

Adam J. Lorenzetti MD, Montri D. Wongworawat MD, Christopher M. Jobe MD, Wesley P. Phipatanakul MD

Cyanoacrylate-based, microbial sealant is an adhesive skin barrier designed to prevent bacterial contamination in surgical wounds. This type of adhesive barrier could have use in decreasing the incidence of positive cultures and subsequent infection in shoulder arthroplasty.

Distribution of Locally Delivered Antimicrobials Is Limited by Cortical Bone: A Pilot Study

Ryan Odgers MD, Keith Jarbo MD, Alex McLaren MD, Ryan McLemore PhD

Local delivery is required to achieve the high antimicrobial concentrations needed to treat biofilm-forming infections. The delivery site is commonly either in the intramedullary canal or at the periosteal surface. It is unknown whether locally delivered antimicrobials are transported transcortically between the endosteal and periosteal surfaces when the infection involves the opposite surface.

Treatment Solutions Are Unclear for Perimegaprosthetic Infections

Lisa B. Ercolano MD, Tyson Christensen BS, Richard McGough MD, Kurt Weiss MD

Infection about a megaprosthesis is a dreaded complication. Treatment options vary from débridement alone to staged revisions, arthrodesis, and amputation. Indications for how to treat this complication are unclear.

Impact of Preoperative MRSA Screening and Decolonization on Hospital-acquired MRSA Burden

Sapna Mehta MD, Scott Hadley MD, Lorraine Hutzler BA, James Slover MD, MS, Michael Phillips MD, Joseph A. Bosco MD

Hospital-acquired infections caused by methicillin-resistant(MRSA) are a source of morbidity and the most common pathogen in prosthetic joint infections and the incidence of MRSA is increasing.