Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Infection 119 articles


Low Rate of Infection Control in Enterococcal Periprosthetic Joint Infections

Mohammad R. Rasouli MD, Mohan S. Tripathi BA, Robert Kenyon BS, Nathan Wetters MD, Craig J. Della Valle MD, Javad Parvizi MD

Enterococcal periprosthetic joint infections (PJIs) are rare after joint arthroplasty. These cases are usually reported in series of PJIs caused by other pathogens. Because few studies have focused only on enterococcal PJIs, management and control of infection of these cases have not yet been well defined.

Mixing Method Affects Elution and Strength of High-dose ALBC: A Pilot Study

Ryan Miller MD, Alex McLaren MD, Christine Leon MS, Ryan McLemore PhD

High-dose antimicrobial-loaded bone cement (ALBC) is used to treat orthopaedic infections. High-dose ALBC is not commercially available and requires surgeon directed formulation, and there are several different methods used to mix high-dose ALBC.

Does a Prefabricated Gentamicin-impregnated, Load-bearing Spacer Control Periprosthetic Hip Infection?

Ryan M. Degen BSc, MD, John R. Davey BSc, J. Roderick Davey MD, FRCSC, James L. Howard MD, FRCSC, Richard W. McCalden MD, FRCSC, Douglas D. R. Naudie MD, FRCSC

Treating deep infection following THA has been a challenge. While the standard treatment has remained a two-stage revision, spacer designs, incorporated antibiotics, and concentrations have varied. Since control of infection may relate to choice and concentration of antibiotics, it is important to report rates of control from various spacers.

Do Dynamic Cement-on-Cement Knee Spacers Provide Better Function and Activity During Two-stage Exchange?

David J. Jaekel MS, Judd S. Day PhD, Gregg R. Klein MD, Harlan Levine MD, Javad Parvizi MD, Steven M. Kurtz PhD

Implantation of an antibiotic bone cement spacer is used to treat infection of a TKA. Dynamic spacers fashioned with cement-on-cement articulating surfaces potentially facilitate patient mobility and reduce bone loss as compared with their static counterparts, while consisting of a biomaterial not traditionally used for load-bearing articulations. However, their direct impact on patient mobility and wear damage while implanted remains poorly understood.

Better Function for Fusions Versus Above-the-knee Amputations for Recurrent Periprosthetic Knee Infection

Antonia F. Chen MD, MBA, Nicholas C. Kinback BS, Alma E. Heyl LAS, RTR, CCRC, Edward J. McClain MD, Brian A. Klatt MD

Treatment of chronic periprosthetic joint infections (PJIs) after TKA is limited to fusions, above-the-knee amputations (AKAs), revision TKA, and antibiotic suppression and is often based on the patient’s medical condition. However, when both fusion and AKA are options, it is important to compare these two procedures with regard to function.

Liposomal Formulation Increases Local Delivery of Amphotericin from Bone Cement: A Pilot Study

Brian Cunningham MD, Alex C. McLaren MD, Christine Pauken PhD, Ryan McLemore PhD

Amphotericin is a highly toxic hydrophobic antifungal. Delivery of amphotericin from antifungal-loaded bone cement (ALBC) is much lower than would be expected for an equivalent load of water-soluble antibacterials. Lipid formulations have been developed to decrease amphotericin toxicity. It is unknown how lipid formulations affect amphotericin release and compressive strength of amphotericin ALBC.

Jeannette Wilkins Award: Can Locally Delivered Gadolinium Be Visualized on MRI? A Pilot Study

Morgan B. Giers BS, Chris S. Estes DO, Alex C. McLaren MD, Michael R. Caplan PhD, Ryan McLemore PhD

Management of orthopaedic infections relies on débridement and local delivery of antimicrobials; however, the distribution and concentration of locally delivered antimicrobials in postdébridement surgical sites is unknown. Gadolinium-DTPA (Gd-DTPA) has been proposed as an imaging surrogate for antimicrobials because it is similar in size and diffusion coefficient to gentamicin.

Does Dual Antibiotic Prophylaxis Better Prevent Surgical Site Infections in Total Joint Arthroplasty?

Amy Sewick MD, Amun Makani MD, Chia Wu MD, Judith O’Donnell MD, Keith D. Baldwin MD, MPH, MSPT, Gwo-Chin Lee MD

It is unclear which antibiotic regimen provides the best prophylaxis against surgical site infection (SSI) in patients undergoing hip and knee surgery.

Treatment of Early Postoperative Infections after THA: A Decision Analysis

Hany Bedair MD, Nicholas Ting MD, Kevin J. Bozic MD, MBA, Craig J. Della Valle MD, Scott M. Sporer MD

The treatment for an early postoperative periprosthetic infection after cementless THA that results in the highest quality of life after the control of infection is unknown. Although common treatments include irrigation and débridement with component retention, a one-stage exchange, or a two-stage exchange, it is unclear whether any of these provides a higher quality of life after the control of infection.

Are Bone and Serum Cefazolin Concentrations Adequate for Antimicrobial Prophylaxis?

Koji Yamada MD, Kunihiro Matsumoto PhD, Fumiaki Tokimura MD, Hiroshi Okazaki MD, PhD, Sakae Tanaka MD, PhD

Antimicrobial prophylaxis is considered beneficial for preventing surgical-site infections in clean orthopaedic surgery. However, whether tissue concentrations of cefazolin achieve the minimum inhibitory concentration for the targeted contaminants have yet to be clarified.