Clinical and microbiological findings in prosthetic joint replacement due to aseptic loosening

2014 ◽  
Vol 69 (3) ◽  
pp. 235-243 ◽  
Author(s):  
A. Ribera ◽  
L. Morata ◽  
J. Moranas ◽  
J.L. Agulló ◽  
J.C. Martínez ◽  
...  
Keyword(s):  
Aseptic Loosening ◽  
Joint Replacement ◽  
Prosthetic Joint

Autophagy inhibitors 3-MA and LY294002 repress osteoclastogenesis and titanium particle-stimulated osteolysis

2021 ◽  
Author(s):  
Weishen Chen ◽  
Guoyan Xian ◽  
Minghui Gu ◽  
Baiqi Pan ◽  
Xiaoyu Wu ◽  
...  
Keyword(s):  
Aseptic Loosening ◽  
Joint Replacement ◽  
Revision Surgery ◽  
Wear Particle ◽  
Common Complication ◽  
Titanium Particle ◽  
Inflammation Response

Aseptic loosening caused by peri-implant osteolysis (PIO) is a common complication after joint replacement, and there is still no better treatment than revision surgery. The wear particle-induced inflammation response, especially...

scholarly journals Synovial fluid interleukin-16, interleukin-18, and CRELD2 as novel biomarkers of prosthetic joint infections

2019 ◽  
Vol 8 (4) ◽  
pp. 179-188 ◽  
Author(s):  
M-F. Chen ◽  
C-H. Chang ◽  
L-Y. Yang ◽  
P-H. Hsieh ◽  
H-N. Shih ◽  
...  
Keyword(s):  
Synovial Fluid ◽  
Aseptic Loosening ◽  
Enzyme Linked Immunosorbent Assay ◽  
Interleukin 18 ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Novel Biomarkers ◽  
Baseline Values ◽  
Potential Biomarkers

Objectives Prosthetic joint infection (PJI) diagnosis is a major challenge in orthopaedics, and no reliable parameters have been established for accurate, preoperative predictions in the differential diagnosis of aseptic loosening or PJI. This study surveyed factors in synovial fluid (SF) for improving PJI diagnosis. Methods We enrolled 48 patients (including 39 PJI and nine aseptic loosening cases) who required knee/hip revision surgery between January 2016 and December 2017. The PJI diagnosis was established according to the Musculoskeletal Infection Society (MSIS) criteria. SF was used to survey factors by protein array and enzyme-linked immunosorbent assay to compare protein expression patterns in SF among three groups (aseptic loosening and first- and second-stage surgery). We compared routine clinical test data, such as C-reactive protein level and leucocyte number, with potential biomarker data to assess the diagnostic ability for PJI within the same patient groups. Results Cut-off values of 1473 pg/ml, 359 pg/ml, and 8.45 pg/ml were established for interleukin (IL)-16, IL-18, and cysteine-rich with EGF-like domains 2 (CRELD2), respectively. Receiver operating characteristic curve analysis showed that these factors exhibited an accuracy of 1 as predictors of PJI. These factors represent potential biomarkers for decisions associated with prosthesis reimplantation based on their ability to return to baseline values following the completion of debridement. Conclusion IL-16, IL-18, and CRELD2 were found to be potential biomarkers for PJI diagnosis, with SF tests outperforming blood tests in accuracy. These factors could be useful for assessing successful debridement based on their ability to return to baseline values following the completion of debridement. Cite this article: M-F. Chen, C-H. Chang, L-Y. Yang, P-H. Hsieh, H-N. Shih, S. W. N. Ueng, Y. Chang. Synovial fluid interleukin-16, interleukin-18, and CRELD2 as novel biomarkers of prosthetic joint infections. Bone Joint Res 2019;8:179–188. DOI: 10.1302/2046-3758.84.BJR-2018-0291.R1.

scholarly journals Proximal femoral reconstruction with modular megaprostheses in non-oncological patients

2021 ◽  
Author(s):  
Kevin Döring ◽  
Klemens Vertesich ◽  
Luca Martelanz ◽  
Kevin Staats ◽  
Christoph Böhler ◽  
...  
Keyword(s):  
Bone Loss ◽  
Aseptic Loosening ◽  
Periprosthetic Fracture ◽  
Joint Infection ◽  
Revision Arthroplasty ◽  
Complication Rates ◽  
Non Union ◽  
Prosthetic Joint ◽  
One Year ◽  
Proximal Femoral Reconstruction

Abstract Introduction Multiple revision hip arthroplasties and critical trauma might cause severe bone loss that requires proximal femoral replacement (PFR). The aim of this retrospective study was to analyse complication- and revision-free survivals of patients who received modular megaprostheses in an attempt to reconstruct massive non-neoplastic bone defects of the proximal femur. Questions/purposes (1) What were general complication rates and revision-free survivals following PFR? (2) What is the incidence of complication specific survivals? (3) What were risk factors leading to a diminished PFR survival? Materials and methods Twenty-eight patients with sufficient follow-up after receiving a modular proximal femoral megaprosthesis were identified. The indications for PFR included prosthetic joint infection (PJI), periprosthetic fracture, aseptic loosening, non-union and critical femoral fracture. Complications were grouped according to the ISOLS-classification of segmental endoprosthetic failure by Henderson et al. Results Overall, the complication-free survival was 64.3% at one year, 43.2% at five years and 38.4% at ten years, with 16 patients (57%) suffering at least one complication. Complications were dislocation in eight patients (29%), PJI in 6 patients (21%), periprosthetic fracture in five patients (18%), and aseptic loosening in six patients (21%). Prosthesis stem cementation showed a lower risk for revision in a cox proportional hazard model (95% CI 0.04–0.93, HR 0.2, p = 0.04). Conclusion PFR with modular megaprostheses represents a viable last resort treatment with high complication rates for patients with severe proximal femoral bone loss due to failed arthroplasty or critical fractures. In revision arthroplasty settings, PFR cementation should be advocated in cases of impaired bone quality.

scholarly journals The serum level of D-Dimer is not suitable for distinguishing between prosthetic joint infection and aseptic loosening

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Jincheng Huang ◽  
Yongchao Zhang ◽  
Zhen Wang ◽  
Yonghui Dong ◽  
Yongqiang Zhao ◽  
...  
Keyword(s):  
Aseptic Loosening ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Revision Arthroplasty ◽  
Primary Arthroplasty ◽  
Prosthetic Joint ◽  
Group A ◽  
Group B ◽  
Serum Crp ◽  
D Dimer

Abstract Background To evaluate the meaning of serum CRP, ESR, and D-Dimer in the diagnosis of prosthetic joint infection. Methods In a retrospective study, 101 patients presented with osteoarthritis, PJI, and aseptic loosening were divided into three groups according to the type of operation they received in our department from June 2016 to December 2018: group A, 44 patients treated with primary arthroplasty; group B, 31 PJI patients treated with resection arthroplasty and spacer insertion surgery; group C, 26 aseptic loosening patients treated with revision arthroplasty. Data such as gender, age, preoperative serum CRP, ESR, and D-Dimer level were compared among the three different groups. Results There are no statistically significant differences when comparing general data such as gender and age in patients from the three different groups. However, Serum CRP level in group B (43.49 ± 10.00 mg/L) is significantly higher than in group A (2.97 ± 0.75 mg/L) and C (4.80 ± 1.26 mg/L). Serum ESR level in group B (49.84 ± 5.48 μg/L) is significantly higher than those in group A (15.28 ± 2.63 μg/L) and C (22.50 ± 3.47 μg/L). Serum D-Dimer level in group B (1.58 ± 0.17 μg/L) is significantly higher than that in group A (0.51 ± 0.50 μg/L), but similar with group C (1.22 ± 0.29 μg/L). There are no statistically significant differences when compared with sensitivity and specificity of CRP, ESR, and D-Dimer in the diagnosis of PJI among patients from the three different groups when D-Dimer > 0.85 μg/L was set as the optimal threshold value for the diagnosis of PJI. Conclusion D-Dimer is not a parameter to distinguish between aseptic loosening and PJI.

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