scholarly journals Prosthetic joint infection in patients of rheumatoid arthritis undergoing total knee replacement

2011 ◽  
Vol 6 (1) ◽  
pp. 36-39
Author(s):  
Vijay Kumar ◽  
Rajesh Malhotra
Keyword(s):  
Rheumatoid Arthritis ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Prosthetic Joint ◽  
Total Knee

scholarly journals Fungal Prosthetic Joint Infection Following Total Knee Arthroplasty: A Case Report

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Baraa W Mafrachi ◽  
Ashraf H Al Debei ◽  
Farah M Al Muhtaseb ◽  
Jihad M Al Ajlouni ◽  
Yazan S Hammad
Keyword(s):  
Total Knee Arthroplasty ◽  
Case Report ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Knee Arthroplasty ◽  
Prosthetic Joint Infection ◽  
Rare Complication ◽  
Joint Infection ◽  
Prosthetic Joint ◽  
Total Knee

Introduction: Prosthetic joint infection (PJI) is a rare complication of total knee replacement (TKR), yet it is a serious and debilitating condition. Bacterial infection accounts for the majority of cases and fungal infection is estimated to cause 1% of all prosthesis infection. Case Report: This case presents a 60years female, who presented to our outpatient orthopedic clinic complaining of right knee pain, swelling, and hotness. The physical examination revealed redness, hotness, restricted range of movement, and tibial loosening, 9 months following TKR revision. Culture of the joint aspirate showed growth of “Candida parapsilosis” and second aspirate confirmed the diagnosis. The patient then underwent two stages revision surgery with placement of amphotericin B loaded cement, to maintain high local antifungal concentration in addition to decrease the side effects of amphotericinB infusion such as thrombophlebitis and the more serious systemic effect as nephrotoxicity. The post-operative course was uneventful, with gradual improvement and restoration of normal movement range. Conclusion: Fungal PJI is a rare complication of TKR, yet it results in severe debilitating symptoms and impairment of the patient functional capacity. Careful evaluation of the patient followed by a detailed workup is necessary for the identification of the underlying causative micro-organism. Two-stage revision surgery with antifungal loaded cement spacer and antifungal therapy currently is the standard of management. To the best of our knowledge, this is the first fungal PJI following total knee arthroplasty reported in Jordan. Keywords: Fungal prosthetic joint infection, fungal infection, total knee replacement, total knee replacement complication.

scholarly journals Incidence and risk factors of prosthetic joint infection after total hip or knee replacement in patients with rheumatoid arthritis

2008 ◽  
Vol 59 (12) ◽  
pp. 1713-1720 ◽  
Author(s):  
Tim Bongartz ◽  
Christine S. Halligan ◽  
Douglas R. Osmon ◽  
Megan S. Reinalda ◽  
William R. Bamlet ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Knee Replacement ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Total Hip ◽  
Prosthetic Joint

Predictors of revision, prosthetic joint infection and mortality following total hip or total knee arthroplasty in patients with rheumatoid arthritis: a nationwide cohort study using Danish healthcare registers

2017 ◽  
Vol 77 (2) ◽  
pp. 281-288 ◽  
Author(s):  
Rene Lindholm Cordtz ◽  
Kristian Zobbe ◽  
Pil Højgaard ◽  
Lars Erik Kristensen ◽  
Søren Overgaard ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Total Knee Arthroplasty ◽  
Cohort Study ◽  
Knee Arthroplasty ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Risk Of Death ◽  
Prosthetic Joint ◽  
Increased Risk ◽  
Total Knee

ObjectivesTo investigate predictors of 10-year risk of revision and 1-year risk of prosthetic joint infection (PJI) and death following total hip/total knee arthroplasty (THA/TKA) in (1) patients with rheumatoid arthritis (RA) compared with patients with osteoarthritis (OA); and (2) patients with RA treated with biological disease-modifying antirheumatic drugs (bDMARD) within 90 days preceding surgery compared with non-treated.MethodsRegister-based cohort study using the Danish National Patient Register, the DANBIO rheumatology register (RA-specific confounders and treatment episodes) and the Danish Hip and Knee Arthroplasty Registers. Survival analyses were used to calculate confounder-adjusted sub-HRs (SHR) and HRs.ResultsIn total, 3913 patients with RA with THA/TKA were compared with 120 499 patients with OA. Patients with RA had decreased risk of revision (SHR 0.71 (0.57–0.89)), but increased risk of PJI (SHR=1.46 (1.13–1.88)) and death (HR=1.25 (1.01–1.55)). In DANBIO, 345 of 1946 patients with RA with THA/TKA had received bDMARD treatment within 90 days preceding surgery. bDMARD-treated patients did not have a statistically significant increased risk of revision (SHR=1.49 (0.65–3.40)), PJI (SHR=1.61 (0.70–3.69)) nor death (HR=0.75 (0.24–2.33)) compared with non-treated. Glucocorticoid exposure (HR=2.87 (1.12–7.34)) and increasing DAS28 (HR=1.49 (1.01–2.20)) were risk factors for mortality.ConclusionPatients with RA had a decreased 10-year risk of revision while the risk of death and PJI was increased compared with patients with OA following THA/TKA. bDMARD exposure was not associated with statistically significant increased risk of neither PJI nor death in this study. Glucocorticoid exposure and increased disease activity were associated with an increased risk of death.

scholarly journals Influence of Fixation Methods on Prosthetic Joint Infection Following Primary Total Knee Replacement: Meta-Analysis of Observational Cohort and Randomised Intervention Studies

2019 ◽  
Vol 8 (6) ◽  
pp. 828 ◽  
Author(s):  
Setor K. Kunutsor ◽  
Vikki Wylde ◽  
Michael R. Whitehouse ◽  
Andrew D. Beswick ◽  
Erik Lenguerrand ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Prosthetic Joint Infection ◽  
Observational Studies ◽  
Meta Analysis ◽  
Joint Infection ◽  
Prosthetic Joint ◽  
Observational Cohort ◽  
Total Knee ◽  
Uncemented Fixation ◽  
Primary Total Knee

The type of fixation used in primary total knee replacement (TKR) may influence the risk of prosthetic joint infection (PJI). We conducted a systematic review and meta-analysis to assess published evidence linking type of fixation (cemented, uncemented, or hybrid) with the risk of PJI following primary TKR. Randomised controlled trials (RCTs) and observational cohort studies comparing fixation methods and reporting PJI incidence following primary TKR were identified in MEDLINE, Embase, Web of Science, and Cochrane Library up until November 2018. Summary measures were relative risks (RR) with 95% confidence intervals (CIs). We identified 32 eligible articles (24 observational studies and 8 RCTs) involving 1,161,292 TKRs. In pooled analysis of observational studies, uncemented fixation was associated with a decreased overall PJI risk when compared with cemented fixation at 0.76 (0.64–0.89). Comparing antibiotic-loaded cemented fixation with plain cement, there was no significant difference in overall PJI risk at 0.95 (0.69–1.31), but PJI risk was increased in the first 6-month postoperative period to 1.65 (1.12–2.43). Limited data from RCTs showed no differences in PJI risk among the fixation types. Observational evidence suggests uncemented fixation may be associated with lower PJI risk in primary TKR when compared with cemented fixation. In the early postoperative period, antibiotic-loaded cemented fixation may be associated with increased PJI risk when compared with plain cement. This may either reflect appropriate selection of higher risk patients for the development of PJI to cemented and antibiotic-loaded cement or may reflect a lower PJI risk in uncemented TKR due to factors such as shorter operative time.

scholarly journals Is adding intra-articular steroid in total knee arthroplasty cocktail obligatory?

2019 ◽  
Vol 5 (2) ◽  
pp. 260
Author(s):  
Sundar Suriyakumar ◽  
Ganesan G. Ram ◽  
Faraz Ahmed
Keyword(s):  
Total Knee Arthroplasty ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Knee Arthroplasty ◽  
Joint Infection ◽  
Knee Replacement Surgery ◽  
Replacement Surgery ◽  
Total Knee Replacement Surgery ◽  
Group I ◽  
Total Knee

<p class="abstract"><strong>Background:</strong> The patients can undergo total knee replacement surgery either under general anaesthesia, combined spinal and epidural anaesthesia, nerve root block, spinal combined with intra-articular knee cocktail. There is an ongoing debate amongst Arthroplasty surgeons whether to include steroid in the cocktail or not. The aim of this study is to assess whether there is an added benefit of including steroid in the intraarticular mixture.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted at Sri Ramachandra Institute of Higher education, Chennai between December 2017 to December 2018. The study was conducted in the Arthroplasty unit, Department of Orthopaedics. SRIHER ethics committee clearance was obtained prior to the start of the study. The inclusion criteria were patients who underwent total knee replacement surgery under combined spinal and intra-articular knee cocktail. Patients were divided into two groups based on the use of steroid in the intra-articular mixture. Patients were evaluated using Visual analogue scale, opioids usage as primary endpoint while any joint infection within six months of the surgery and knee society score at 1 month and 6 months as the secondary endpoint.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean visual analogue score for the 0 pod for the group I and group II were 2.3 and 2.4 respectively. There was no case of infection in both groups.</p><p class="abstract"><strong>Conclusions:</strong> There is no fringe benefit of adding steroid to the knee cocktail. So it is not obligatory to add steroid in intra-articular total knee arthroplasty cocktail.</p>

Long-term outcome of total knee replacement in patients with rheumatoid arthritis

2008 ◽  
Vol 75 (2) ◽  
pp. 163-166 ◽  
Author(s):  
Klemmens Trieb ◽  
Maximillian Schmid ◽  
Thomas Stulnig ◽  
Wolfgang Huber ◽  
Axel Wanivenhaus
Keyword(s):  
Rheumatoid Arthritis ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Total Knee
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