scholarly journals Results and Patient Reported Outcome Measures (PROMs) after One-Stage Revision for Periprosthetic Joint Infection of the Hip: A Single-centre Retrospective Study

2018 ◽  
Vol 3 (3) ◽  
pp. 143-149 ◽  
Author(s):  
Jesse W.P. Kuiper ◽  
Christine M.E. Rustenburg ◽  
Jore H. Willems ◽  
Steven J. Verberne ◽  
Edgar J.G. Peters ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Revision Surgery ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Patient Reported Outcome Measures ◽  
Coagulase Negative Staphylococcus ◽  
One Stage ◽  
Prosthetic Joint ◽  
Patient Reported ◽  
Joint Revision

Abstract. Background: Little is known about functional outcome and quality of life (QoL) after one-stage revision for periprosthetic joint infection (PJI) of the hip.Methods: a cohort of 30 subjects treated with one-stage revision between 2011 and 2015 was identified, and questionnaires on functional outcome and QoL were distributed.Results: 28 subjects were successfully treated (93%). Most subjects were referred from other hospitals. Coagulase-negative Staphylococcus was found in 50% of the cases, and 40% of all cultured bacteria were multidrug-resistant. 25% had subsequent revision surgery, unrelated to PJI. Functional outcome was good and QoL scores were high, comparable to prosthetic joint revision surgery in general.Conclusion: Although the cohort was small and statistical analysis was not performed, this study showed that excellent results can be obtained with one-stage revision for hip PJI. Functional outcome and QoL was comparable to prosthetic joint revision surgery in general.

scholarly journals Prosthetic Joint Infection: Report on the One versus Two-stage Exchange EBJIS Survey

2016 ◽  
Vol 1 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Pedro Santos Leite ◽  
Sérgio Figueiredo ◽  
Ricardo Sousa
Keyword(s):  
Prosthetic Joint Infection ◽  
Revision Surgery ◽  
Joint Infection ◽  
Clinical Aspects ◽  
Online Questionnaire ◽  
Two Stage ◽  
Significant Group ◽  
One Stage ◽  
Prosthetic Joint ◽  
Multicentre Research

Abstract. Background: Prosthetic Joint Infection (PJI) is one of the most challenging problems in orthopaedic surgery and musculoskeletal infections specifically. Some very important controversies remain and strong evidence-based recommendations are still lacking in many clinical aspects. Therefore, an undisputed methodology of treatment does not exist yet and there are many different valid approaches.Purposes: To draw a picture of the different practice patterns around Europe and understand the motivations of the European Bone & Joint Infection Society (EBJIS) members in choosing between one- or two-stage revision surgery in treating chronic PJI.Methods: The participants of the 34th EBJIS Annual Meeting were surveyed through an online questionnaire. The survey assessed the main philosophy in the treatment of chronic PJI, personal and institutional information as well as the importance of different factors in choosing two-stage or one-stage procedures.Results: One hundred and forty-three participants responded to the survey, including a significant group of skilful orthopaedic surgeons with large experience in treating musculoskeletal infections. Primarily two-stage was the most common philosophy regrading treatment of chronic PJI (60.1%), followed by two-stage or one-stage accordingly (34,8%) and primarily one-stage (5,1%). Significant soft tissue compromise, failure of previous revision surgery attempts, highly resistant or unclear infective microorganism(s) preoperatively and patient presenting with sepsis or immunosuppression, were considered the more relevant factors in choosing two-stage instead one-stage procedures.Interpretation: Treatment of chronic PJI is challenging and demanding. An open dialogue to share the different experiences and a collective effort to plan a major multicentre research in order to establish standardized protocols are essential.

scholarly journals Local application of vancomycin in one-stage revision of PJI caused by MRSA in a rat model

2021 ◽  
Author(s):  
Jian Wei ◽  
Yinxian Wen ◽  
Kai Tong ◽  
Hui Wang ◽  
Liaobin Chen
Keyword(s):  
Rat Model ◽  
Revision Surgery ◽  
Eradication Rate ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Joint Infection ◽  
Revision Arthroplasty ◽  
Serum Markers ◽  
Acid Glycoprotein ◽  
One Stage ◽  
Better Than

The eradication rate of periprosthetic joint infection (PJI) caused by methicillin-resistant staphylococcus aureus (MRSA) is still not satisfactory by systemic vancomycin administration in one-stage revision arthroplasty. This study aimed to explore the effectiveness and safety of intra-articular injection of vancomycin in the control of MRSA-PJI after one-stage revision surgery in a rat model. Two weeks of intra-peritoneal (IP) and/or intra-articular (IA) injection of vancomycin were applied to control the infection after one-stage revision surgery. The MRSA-PJI rats treated with IA injection of vancomycin showed a better outcome in skin temperature, bacterial counts, biofilm on the prosthesis, serum alpha-1-acid glycoprotein (α1-AGP), residual bone volume and inflammatory reaction in the joint tissues than those with IP vancomycin, while rats with IP & IA administration showed the best outcomes. However, only the IP & IA administration of vancomycin could eradicate MRSA. Minimal changes of renal pathology were observed in IP and IP & IA groups, rather than IA group, while no obvious changes were observed in the liver, as well as serum markers including creatinine (Cr), alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Therefore, IA use of vancomycin is effective and safe in the MRSA-PJI rat model, better than systematic administration, while IA & systemic vancomycin could eradicate the infection in a two-week treatment course.

scholarly journals Is Gram staining still useful in prosthetic joint infections?

2019 ◽  
Vol 4 (2) ◽  
pp. 56-59 ◽  
Author(s):  
Marjan Wouthuyzen-Bakker ◽  
Noam Shohat ◽  
Marine Sebillotte ◽  
Cédric Arvieux ◽  
Javad Parvizi ◽  
...  
Keyword(s):  
Revision Surgery ◽  
Joint Infection ◽  
Individual Case ◽  
Gram Stain ◽  
Reactive Protein ◽  
Joint Infections ◽  
Gram Staining ◽  
Causative Microorganism ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections

Abstract. Introduction: Staphylococcus aureus is an independent risk factor for DAIR failure in patients with a late acute prosthetic joint infection (PJI). Therefore, identifying the causative microorganism in an acute setting may help to decide if revision surgery should be chosen as a first surgical approach in patients with additional risk factors for DAIR failure. The aim of our study was to determine the sensitivity of Gram staining in late acute S. aureus PJI.Material and methods: We retrospectively evaluated all consecutive patients between 2005-2015 who were diagnosed with late acute PJI due to S. aureus. Late acute PJI was defined as the development of acute symptoms and signs of PJI, at least three months after the index surgery. Symptoms existing for more than three weeks were excluded from the analysis. Gram staining was evaluated solely for synovial fluid.Results: A total of 52 cases were included in the analysis. Gram staining was positive with Gram positive cocci in clusters in 31 cases (59.6%). Patients with a C-reactive protein (CRP) > 150 mg/L at clinical presentation had a significantly higher rate of a positive Gram stain (30/39, 77%) compared to patients with a CRP ≤ 150 mg/L (4/10, 40%) (p=0.02). A positive Gram stain was not related to a higher failure rate (60.6% versus 57.9%, p 0.85).Conclusion: Gram staining may be a useful diagnostic tool in late acute PJI to identify S. aureus PJI. Whether a positive Gram stain should lead to revision surgery instead of DAIR should be determined per individual case.

scholarly journals One-Stage Exchange Arthroplasty for Fistulizing Periprosthetic Joint Infection of the Hip: An Effective Strategy

2020 ◽  
Vol 7 ◽  
Author(s):  
Simon Marmor ◽  
Younes Kerroumi ◽  
Vanina Meyssonnier ◽  
Luc Lhotellier ◽  
Antoine Mouton ◽  
...  
Keyword(s):  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Effective Strategy ◽  
One Stage ◽  
Exchange Arthroplasty

Ten-Year Results Following One-Stage Septic Hip Exchange in the Management of Periprosthetic Joint Infection

2019 ◽  
Vol 34 (6) ◽  
pp. 1221-1226 ◽  
Author(s):  
Akos Zahar ◽  
Ianiv Klaber ◽  
Anne-Marie Gerken ◽  
Thorsten Gehrke ◽  
Matthias Gebauer ◽  
...  
Keyword(s):  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
One Stage

scholarly journals Diagnostic Criteria and Treatment of Acute and Chronic Periprosthetic Joint Infection of Total Ankle Arthroplasty

2019 ◽  
Vol 4 (2) ◽  
pp. 247301141984100
Author(s):  
Kempland C. Walley ◽  
Christopher B. Arena ◽  
Paul J. Juliano ◽  
Michael C. Aynardi
Keyword(s):  
Diagnostic Criteria ◽  
Hip Arthroplasty ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Total Ankle Arthroplasty ◽  
Level Of Evidence ◽  
Ankle Arthroplasty ◽  
Prosthetic Joint ◽  
Ankle Replacement ◽  
Knee And Hip Arthroplasty

Background: Prosthetic joint infection (PJI) after total ankle arthroplasty (TAA) is a serious complication that results in significant consequences to the patient and threatens the survival of the ankle replacement. PJI in TAA may require debridement, placement of antibiotic spacer, revision arthroplasty, conversion to arthrodesis, or potentially below the knee amputation. While the practice of TAA has gained popularity in recent years, there is some minimal data regarding wound complications in acute or chronic PJI of TAA. However, of the limited studies that describe complications of PJI of TAA, even fewer studies describe the criteria used in diagnosing PJI. This review will cover the current available literature regarding total ankle arthroplasty infection and will propose a model for treatment options for acute and chronic PJI in TAA. Methods: A review of the current literature was conducted to identify clinical investigations in which prosthetic joint infections occurred in total ankle arthroplasty with associated clinical findings, radiographic imaging, and functional outcomes. The electronic databases for all peer-reviewed published works available through January 31, 2018, of the Cochrane Library, PubMed MEDLINE, and Google Scholar were explored using the following search terms and Boolean operators: “total ankle replacement” OR “total ankle arthroplasty” AND “periprosthetic joint infection” AND “diagnosis” OR “diagnostic criteria.” An article was considered eligible for inclusion if it concerned diagnostic criteria of acute or chronic periprosthetic joint infection of total ankle arthroplasty regardless of the number of patients treated, type of TAA utilized, conclusion, or level of evidence of study. Results: No studies were found in the review of the literature describing criteria for diagnosing PJI specific to TAA. Conclusions: Literature describing the diagnosis and treatment of PJI in TAA is entirely reliant on the literature surrounding knee and hip arthroplasty. Because of the limited volume of total ankle arthroplasty in comparison to knee and hip arthroplasty, no studies to our knowledge exist describing diagnostic criteria specific to total ankle arthroplasty with associated reliability. Large multicenter trials may be required to obtain the volume necessary to accurately describe diagnostic criteria of PJI specific to TAA. Level of Evidence: Level III, systematic review.

scholarly journals Salmonella Sp. as the Cause of Periprosthetic Joint Infection of the Hip: Report of a Rare Case and Literature Review

2020 ◽  
Vol 8 (5_suppl5) ◽  
pp. 2325967120S0004
Author(s):  
Asep Santoso ◽  
Iwan Budiwan Anwar ◽  
Tangkas Sibarani ◽  
Bintang Soetjahjo ◽  
Ismail Mariyanto
Keyword(s):  
Total Hip Arthroplasty ◽  
Literature Review ◽  
Antibiotic Treatment ◽  
Hip Arthroplasty ◽  
Revision Surgery ◽  
Periprosthetic Joint Infection ◽  
Rare Case ◽  
Joint Infection ◽  
Immunosuppressed Patient ◽  
Cement Spacer

Periprosthetic joint infection of the hip due to Salmonella sp. is rare. It is sometimes difficult to treat and needed a prolonged antibiotic treatment. We reported a case of periprosthetic joint infection of the hip in a 67 years old female who received prior left total hip arthroplasty. Two-stage revision surgery with antibiotic-loaded cement spacer has been performed to the patient and successfully control the infection. Review of the literatures also has been done. Salmonella Sp. has to be considered as one of differential etiology in the case of infected arthroplasty especially in an immunosuppressed patient. It showed still there has been no consensus in the treatment of choice for this particular case.

The treatment of periprosthetic joint infection: safety and efficacy of two stage versus one stage exchange arthroplasty

2020 ◽  
Vol 17 (3) ◽  
pp. 245-252 ◽  
Author(s):  
Joseph R. Palmer ◽  
Tejbir S. Pannu ◽  
Jesus M. Villa ◽  
Jorge Manrique ◽  
Aldo M. Riesgo ◽  
...  
Keyword(s):  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Stage Versus ◽  
Two Stage ◽  
Safety And Efficacy ◽  
One Stage ◽  
Exchange Arthroplasty
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