Antibiotic Spacers for Prosthetic Joint Infections Following Total Knee Arthroplasty

2022 ◽  
pp. 685-700
Author(s):  
Samik Banerjee ◽  
Scot Brown ◽  
P. Maxwell Courtney
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Total Knee

Extended Oral Antibiotics and Infection Prophylaxis after a Primary or Revision Total Knee Arthroplasty

2019 ◽  
Vol 33 (02) ◽  
pp. 111-118 ◽  
Author(s):  
Cierra S. Hong ◽  
Collin S. Black ◽  
Sean P. Ryan ◽  
Thorsten M. Seyler
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Primary Total Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Infection Prophylaxis ◽  
Oral Antibiotics ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Total Knee

AbstractOne of the most common reasons for failure of primary total knee arthroplasty and need for revision surgery is periprosthetic infection. Antibiotics are one of the mainstays of treatment to address prosthetic joint infections, but the route of administration and timing of delivery to optimize patient outcomes are debated. This article reviews the use and attributes of commonly used oral antibiotics, especially extended or long-term utilization, as prophylaxis and treatment for prosthetic joint infections in a primary or revision total knee arthroplasty, which include debridement, antibiotics, and implant retention, one-stage and two-stage exchange arthroplasty.

scholarly journals A Case of a Late and Atypical Knee Prosthetic Infection by No-Biofilm Producer Pasteurella multocida Strain Identified by Pyrosequencing

2013 ◽  
Vol 62 (4) ◽  
pp. 435-438 ◽  
Author(s):  
CARLO L. Romanò ◽  
ELENA DE VECCHI ◽  
CHRISTIAN VASSENA ◽  
GIOVANNI MANZI ◽  
LORENZO DRAGO
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Inflammatory Markers ◽  
Pasteurella Multocida ◽  
Prosthetic Infection ◽  
Laboratory Findings ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Total Knee

Prosthetic joint infections due to Pasteurella multocida are rarely but increasingly reported but no data on production of biofilm are available. We report the case of a woman with a late, haematogenous peri-prosthetic infection of cemented total knee arthroplasty caused by a strain of P. multocida identified by pyrosequencing and unable to produce biofilm. Comparison of clinical and laboratory findings with those reported in other patients evidenced differences mainly in the period of symptoms' onset and in the behaviour of some inflammatory markers.

scholarly journals Prosthetic Joint Infection Due to Histoplasma capsulatum Complicating a Total Knee Arthroplasty

2017 ◽  
Vol 4 (3) ◽  
Author(s):  
Cima Nowbakht ◽  
Katherine Garrity ◽  
Nicholas Webber ◽  
Jairo Eraso ◽  
Luis Ostrosky-Zeichner
Keyword(s):  
Total Knee Arthroplasty ◽  
Prosthetic Joint Infection ◽  
Histoplasma Capsulatum ◽  
Joint Infection ◽  
Stage Management ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Oral Itraconazole ◽  
Total Knee

Abstract Histoplasmosis is a common pathogen but rarely reported in prosthetic joint infections. We present a case of Histoplasmosis capsulatum prosthetic joint infection along with a literature review revealing no guidelines or consensus on surgical and antifungal management. We chose the 2-stage management with an antifungal spacer and systemic oral itraconazole.

A Modern Approach to Preventing Prosthetic Joint Infections

2018 ◽  
Vol 31 (07) ◽  
pp. 610-617 ◽  
Author(s):  
Dominick Congiusta ◽  
Giles Scuderi ◽  
Fred Cushner ◽  
Paraskevi Papas
Keyword(s):  
Risk Factors ◽  
Total Knee Arthroplasty ◽  
High Risk ◽  
Postoperative Infection ◽  
Modern Approach ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Total Knee ◽  
Preoperative Counseling

AbstractTotal knee arthroplasty (TKA) is recognized as one of the most successful surgical procedures performed today. One of the most common and dreaded complications of TKA is postoperative infection. To prevent infections, it is critical to identify patients at high risk through analyzing their risk factors, and help in addressing them prior to surgery. The effort to prevent infection must be carried through every step of the surgical process, from preoperative counseling to intraoperative measures and postoperative protocols. Hair removal, the application of antiseptics, the utilization of antibiotics, barbed sutures, smart dressings, and antibacterial washes are some of the avenues surgeons may explore to help prevent infection.

scholarly journals Intraoperative Bacterial Contamination and Activity of Different Antimicrobial Prophylaxis Regimens in Primary Knee and Hip Replacement

Antibiotics ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 18
Author(s):  
Alba Rivera ◽  
Alba Sánchez ◽  
Sonia Luque ◽  
Isabel Mur ◽  
Lluís Puig ◽  
...  
Keyword(s):  
Hip Replacement ◽  
Bacterial Contamination ◽  
Antimicrobial Prophylaxis ◽  
Coagulase Negative Staphylococci ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Total Knee ◽  
Surgical Antimicrobial Prophylaxis ◽  
Almost All

Surgical antimicrobial prophylaxis (SAP) is important for the prevention of prosthetic joint infections (PJIs) and must be effective against the microorganisms most likely to contaminate the surgical site. Our aim was to compare different SAP regimens (cefazolin, cefuroxime, or vancomycin, alone or combined with gentamicin) in patients undergoing total knee (TKA) and hip (THA) arthroplasty. In this preclinical exploratory analysis, we analyzed the results of intraoperative sample cultures, the ratio of plasma antibiotic levels to the minimum inhibitory concentrations (MICs) for bacteria isolated at the surgical wound and ATCC strains, and serum bactericidal titers (SBT) against the same microorganisms. A total of 132 surgical procedures (68 TKA, 64 THA) in 128 patients were included. Cultures were positive in 57 (43.2%) procedures (mostly for coagulase-negative staphylococci and Cutibacterium spp.); the rate was lower in the group of patients receiving combination SAP (adjusted OR 0.475, CI95% 0.229–0.987). The SAP regimens evaluated achieved plasma levels above the MICs in almost all of intraoperative isolates (93/94, 98.9%) and showed bactericidal activity against all of them (SBT range 1:8–1:1024), although SBTs were higher in patients receiving cefazolin and gentamicin-containing regimens. The potential clinical relevance of these findings in the prevention of PJIs remains to be determined.

Outcomes of single- and two-stage revision total knee arthroplasty for chronic periprosthetic joint infection

2021 ◽  
Vol 103-B (8) ◽  
pp. 1373-1379
Author(s):  
Hosam E. Matar ◽  
Benjamin V. Bloch ◽  
Susan E. Snape ◽  
Peter J. James
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Joint Infection ◽  
Recurrent Infection ◽  
Primary Outcome Measure ◽  
Revision Total Knee Arthroplasty ◽  
Single Stage ◽  
Two Stage ◽  
Joint Infections ◽  
Total Knee

Aims Single-stage revision total knee arthroplasty (rTKA) is gaining popularity in treating chronic periprosthetic joint infections (PJIs). We have introduced this approach to our clinical practice and sought to evaluate rates of reinfection and re-revision, along with predictors of failure of both single- and two-stage rTKA for chronic PJI. Methods A retrospective comparative cohort study of all rTKAs for chronic PJI between 1 April 2003 and 31 December 2018 was undertaken using prospective databases. Patients with acute infections were excluded; rTKAs were classified as single-stage, stage 1, or stage 2 of two-stage revision. The primary outcome measure was failure to eradicate or recurrent infection. Variables evaluated for failure by regression analysis included age, BMI, American Society of Anesthesiologists grade, infecting organisms, and the presence of a sinus. Patient survivorship was also compared between the groups. Results A total of 292 consecutive first-time rTKAs for chronic PJI were included: 82 single-stage (28.1%); and 210 two-stage (71.9%) revisions. The mean age was 71 years (27 to 90), with 165 females (57.4%), and a mean BMI of 30.9 kg/m2 (20 to 53). Significantly more patients with a known infecting organism were in the single-stage group (93.9% vs 80.47%; p = 0.004). The infecting organism was identified preoperatively in 246 cases (84.2%). At a mean follow-up of 6.3 years (2.0 to 17.6), the failure rate was 6.1% in the single-stage, and 12% in the two-stage groups. All failures occurred within four years of treatment. The presence of a sinus was an independent risk factor for failure (odds ratio (OR) 4.97; 95% confidence interval (CI) 1.593 to 15.505; p = 0.006), as well as age > 80 years (OR 5.962; 95% CI 1.156 to 30.73; p = 0.033). The ten-year patient survivorship rate was 72% in the single-stage group compared with 70.5% in the two-stage group. This difference was not significant (p = 0.517). Conclusion Single-stage rTKA is an effective strategy with a high success rate comparable to two-stage approach in appropriately selected patients. Cite this article: Bone Joint J 2021;103-B(8):1373–1379.

Lyme Prosthetic Joint Infection in Total Knee Arthroplasty

2021 ◽  
Vol 11 (3) ◽  
Author(s):  
Muzaffar Ali ◽  
Anthony O. Kamson ◽  
Nadia Hussain ◽  
Scott G. King
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Prosthetic Joint ◽  
Total Knee
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