Single-stage versus two-stage revision for shoulder periprosthetic joint infection: a systematic review and meta-analysis

2020 ◽  
Vol 29 (12) ◽  
pp. 2476-2486
Author(s):  
Elshaday S. Belay ◽  
Richard Danilkowicz ◽  
Garrett Bullock ◽  
Kevin Wall ◽  
Grant E. Garrigues
Keyword(s):  
Systematic Review ◽  
Periprosthetic Joint Infection ◽  
Meta Analysis ◽  
Joint Infection ◽  
Single Stage ◽  
Stage Versus ◽  
Two Stage

scholarly journals Correlation between body mass index and two-stage revision failure of periprosthetic joint infection following total joint arthroplasty: A systematic review and meta-analysis

2021 ◽  
Vol 29 (3) ◽  
pp. 230949902110552
Author(s):  
Junbiao Guo ◽  
Shuxu Wu ◽  
Huimin Wang ◽  
Wenzhi Chen ◽  
Xiaoqiang Deng
Keyword(s):  
Systematic Review ◽  
Body Mass Index ◽  
Publication Bias ◽  
Periprosthetic Joint Infection ◽  
Total Joint Arthroplasty ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Joint Infection ◽  
Joint Arthroplasty ◽  
Two Stage

Background: Although the correlation between body mass index (BMI) and two-stage revision failure of periprosthetic joint infection (PJI) following total joint arthroplasty (TJA) have been frequently reported, the results remain controversial. Therefore, the correlation between them was systematically evaluated and meta-classified in this study. Methods: Literature on the correlation between BMI and two-stage revision failure of PJI following TJA was retrieved in PubMed, Embase and Cochrane Library due May 2020. Stata 13.0 software and Cochrane Collaboration Review Manager software (RevMan version 5.3) were applied to data synthesis, subgroup analysis, analyses of publication bias, and sensitivity. Results: A total of 15 observational studies included 1267 patients, of which 15 studies were included in systematic review and 11 studies in meta-analysis. Eight studies found a correlation between BMI and two-stage revision failure of PJI following TJA, but seven other studies found no correlation. Meta-analysis found that the risk of two-stage revision failure of PJI following TJA significantly boosted by 3.53 times in patients with BMI ≥ 30 kg/m2 (OR = 3.53; 95% CI = 1.63–7.64 for the BMI ≥ 30 kg/m2 vs. BMI < 30 kg/m2) and the risk of two-stage revision failure of PJI following TJA significantly increased by 2.92 times in patients with BMI ≥ 40 kg/m2 ( OR = 2.92; 95% CI = 1.06–8.03 for the BMI ≥ 40 kg/m2 vs. BMI < 30 kg/m2). The subgroup analysis showed that significant association was observed among the studies performed in TKA ( OR = 3.63; 95% CI = 2.27–5.82), but not among those conducted in THA ( OR = 3.06; 95% CI = 0.42–22.19). A significant association remained consistent, as indicated by sensitivity analyses. Because there are too few studies that can be combined in the included studies, Egger’s and Begg’s tests were not performed. Conclusion: Meta-analysis suggests that the risk of two-stage revision failure of PJI following TJA significantly boosted in obese patients. However, because there may be publication bias of this study, combined overall systematically evaluated and meta-analysis results, we cannot yet conclude that BMI is associated with two-stage revision failure of PJI following TJA.

scholarly journals The diagnostic effect of α-defensin, D-dimer, and IL-6 in periprosthetic joint infection: A systematic review and diagnostic meta-analysis

2020 ◽  
Vol 28 (3) ◽  
pp. 230949902097186
Author(s):  
Baozhong Tian ◽  
Liwen Cui ◽  
Weihai Jiang
Keyword(s):  
Systematic Review ◽  
Sensitivity And Specificity ◽  
Periprosthetic Joint Infection ◽  
Meta Analysis ◽  
Joint Infection ◽  
Common Complication ◽  
Online Databases ◽  
Artificial Joint Replacement ◽  
Sensitivity Specificity ◽  
D Dimer

Background: Periprosthetic joint infection (PJI) is the most common complication after artificial joint replacement as previously reported. However, the main problem at present is its difficulty in diagnosis. This systematic review and meta-analysis aimed to compare the diagnostic accuracy of α-defensin, D-dimer, and interleukin-6 (IL-6) in clinical practice. Method: Online databases were systematically searched until June 18th, 2020 with keywords and medical sub-headings terms. Studies mentioned the sensitivity and specificity of biological markers in detecting PJI were included in our study. The sensitivity, specificity, and diagnostic odds ratios (DORs) were obtained after integration. Results: A total of 34 studies with 1036 patients diagnosing as PJI were included for comparing α-defensin, D-dimer, and IL-6. The sensitivity and specificity of α-defensin for PJI were 0.88 and 0.96, and the DOR was 189 (95% CI 72–496), respectively. The sensitivity and specificity of D-dimer (0.82 and 0.72) and IL-6 (0.80 and 0.89) were lower than α-defensin. Conclusion: The detection of α-defensin is a promising biomarker for diagnosing PJI. The optional cut-off needs to be curtained when using other biomarkers.

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

scholarly journals Effectiveness of diluted povidone-iodine lavage for preventing periprosthetic joint infection: an updated systematic review and meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Naomi Kobayashi ◽  
Emi Kamono ◽  
Kento Maeda ◽  
Toshihiro Misumi ◽  
Yohei Yukizawa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Periprosthetic Joint Infection ◽  
Fixed Effects ◽  
Povidone Iodine ◽  
Meta Analysis ◽  
Joint Infection ◽  
Assessment Process ◽  
Cochrane Library ◽  
Saline Control ◽  
Control Group

Abstract Background Of the several methods used to prevent surgical site infection (SSI), diluted povidone-iodine (PI) lavage is used widely. However, the clinical utility of PI for preventing periprosthetic joint infection (PJI) remains controversial. The aim of this study was to perform a systematic review and meta-analysis of the utility of dilute PI lavage for preventing PJI in primary and revision surgery. Methods This study was conducted in accordance with the PRISMA checklist for systematic reviews and meta-analyses. A comprehensive literature search of PubMed, CINAHL, ClinicalTrials.gov, and Cochrane Library databases was performed. The results are summarized qualitatively and as a meta-analysis of pooled odds ratios with 95% confidence intervals (95% CIs). Heterogeneity of treatment effects among studies was classified as low, moderate, or high, corresponding to I2 values of < 25%, 25–50%, and > 50%. A random effects model was applied in cases of high heterogeneity; otherwise, the fixed effects model was applied. Subgroup analyses were conducted to identify potential sources of heterogeneity. Results After the screening and eligibility assessment process, eight studies were finally extracted for analysis. Overall, the results showed that PI had no significant effect on PJI with ununified control group. However, subgroup analysis of studies with a saline control group revealed an odds ratio of 0.33 (95% CI, 0.16–0.71) for the PI group, suggesting a significant effect for preventing PJI. Conclusion The systematic review and meta-analysis of the current literature demonstrates that diluted PI lavage is significantly better than saline solution lavage for preventing PJI. Level of evidence Level I, Systematic review and meta-analysis.

scholarly journals Is Extended Trochanteric Osteotomy Safe for Use in Two-stage Revision of Periprosthetic Hip Infection? A Systematic Review

2020 ◽  
Vol 04 (01) ◽  
pp. 015-022
Author(s):  
Michael-Alexander Malahias ◽  
Roberto De Filippis ◽  
Lazaros Kostretzis ◽  
Alex Gu ◽  
Ivan De Martino ◽  
...  
Keyword(s):  
Systematic Review ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Femoral Stem ◽  
Trochanteric Osteotomy ◽  
Two Stage ◽  
Radiographic Outcomes ◽  
Extended Trochanteric Osteotomy ◽  
Cochrane Database ◽  
The Us

AbstractSeveral clinical trials have retrospectively evaluated the role of extended trochanteric osteotomy in two-stage total hip arthroplasty (THA) revision for the management of periprosthetic joint infection of the hip. However, no systematic review of the literature has been published to date to evaluate the clinical, functional, and radiographic outcomes of extended trochanteric osteotomy (ETOs) performed as part of implant removal during a two-stage revision for the management of periprosthetic joint infection (PJI). The US National Library of Medicine (PubMed/MEDLINE), and the Cochrane Database of Systematic Reviews were queried for publications from January 1980 to April 2019 using the following keywords: “extended” AND “trochanteric” AND “osteotomy.” Six studies included in this systematic review assessed 305 cases (281 patients) of PJI treated surgically with two-stage revision combined with ETO at the first stage. The mean overall union rate of the ETO was 97%, while the overall rate of radiographic femoral stem subsidence >5 mm was 5%. In addition, the overall mean infection-free rate of two-stage revision combined with ETO was 94% (288 out of 305 operated hips), while the overall complication rate requiring reoperation was 8% (26 out of 305 operated hips). Finally, there was some evidence to show that two-stage revision with ETO was associated with improved infection-free rates compared with two-stage revision without ETO. ETO seems safe and effective in patients with well-fixed femoral stems who require two-stage THA revision for the management of chronic PJI. Two-stage revision with ETO might result in improved infection-free rates compared with two-stage revision without ETO.

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