Greater Prevalence of Mental Health Conditions in Septic Revision Total Knee Arthroplasty: A Call to Action

2020 ◽  
Author(s):  
Hiba K. Anis ◽  
Jared A. Warren ◽  
Alison K. Klika ◽  
Suparna M. Navale ◽  
Guangjin Zhou ◽  
...  
Keyword(s):  
Mental Health ◽  
Total Knee Arthroplasty ◽  
Drug Abuse ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Health Conditions ◽  
Mental Health Conditions ◽  
Aseptic Revision ◽  
Total Knee ◽  
Septic Revision

AbstractThe purpose of this study was to compare the prevalence of mental health conditions among patients undergoing (1) primary total knee arthroplasty (pTKA), (2) septic revision total knee arthroplasty (rTKA), and (3) aseptic revision total knee arthroplasty (TKA). The State Inpatient Databases were queried for all TKAs from 2005 to 2014 yielding 563,144 patients. Patients were separated into the following cohorts: primary, septic revision, and aseptic revision. Diagnoses of any mental health condition and the following specific conditions were compared between the three cohorts: schizophrenia/delusion, bipolar disorder, depression/mood disorder, personality disorder, anxiety/somatic/dissociative disorder, eating disorders, attention deficit hyperactivity disorder /conduct/impulse control, alcohol abuse, and drug abuse. Throughout the study period, an increase in the prevalence of mental health conditions was observed in septic and aseptic revision patients. Overall, there was a significantly higher prevalence of mental health conditions in the septic revision cohort (22.7%) compared with the primary (17.8%, p < 0.001) and aseptic revision (20.0%, p < 0.001) cohorts. Specifically, septic revision TKA patients had a higher prevalence of depression (p < 0.001), alcohol abuse (p < 0.001), drug abuse (p < 0.001), schizophrenia (p = 0.0007), and bipolar disorder (p < 0.001), compared with primary TKA patients. Additionally, there was a significantly higher prevalence of depression (p < 0.001), alcohol abuse (p < 0.001), and drug abuse (p < 0.001) among septic revision patients compared with aseptic revision patients. Mental health conditions were significantly higher among septic revision patients. Alcohol and drug abuse were approximately twice as prevalent in septic revision patients compared with primary and aseptic revision patients. These findings should serve as a call to action for mental health support for patients suffering from PJI.

Cost of Aseptic Revision Total Knee Arthroplasty at a Tertiary Medical Center

2020 ◽  
Author(s):  
John R. Steele ◽  
Sean P. Ryan ◽  
William A. Jiranek ◽  
Samuel S. Wellman ◽  
Michael P. Bolognesi ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Medical Center ◽  
Revision Total Knee Arthroplasty ◽  
Aseptic Revision ◽  
Total Knee

Clinical Survivorship of Aseptic Revision Total Knee Arthroplasty Using Hinged Knees and Tantalum Cones at Minimum 10-Year Follow-Up

2019 ◽  
Vol 34 (12) ◽  
pp. 3018-3022 ◽  
Author(s):  
Hussein Abdelaziz ◽  
Rodrigo Jaramillo ◽  
Thorsten Gehrke ◽  
Malte Ohlmeier ◽  
Mustafa Citak
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Aseptic Revision ◽  
Total Knee

Patient satisfaction and outcome after septic versus aseptic revision total knee arthroplasty

2000 ◽  
Vol 15 (8) ◽  
pp. 990-993 ◽  
Author(s):  
Robert L. Barrack ◽  
Gerard Engh ◽  
Cecil Rorabeck ◽  
Jaswin Sawhney ◽  
Michael Woolfrey
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Aseptic Revision ◽  
Total Knee

Intraoperative Fracture During Aseptic Revision Total Knee Arthroplasty

2014 ◽  
Vol 29 (11) ◽  
pp. 2187-2191 ◽  
Author(s):  
Adam A. Sassoon ◽  
Cody C. Wyles ◽  
German A. Norambuena Morales ◽  
Matthew T. Houdek ◽  
Robert T. Trousdale
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Aseptic Revision ◽  
Total Knee

Tibial tubercle osteotomy in septic revision total knee arthroplasty

2014 ◽  
Vol 134 (9) ◽  
pp. 1311-1315 ◽  
Author(s):  
Josep M. Segur ◽  
Felix Vilchez-Cavazos ◽  
Juan Carlos Martinez-Pastor ◽  
Francisco Macule ◽  
Santiago Suso ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Tibial Tubercle ◽  
Tibial Tubercle Osteotomy ◽  
Total Knee ◽  
Septic Revision

scholarly journals Variation of synovial fluid leucocyte cell count and polymorphonuclear percentage in patients with aseptic revision total knee arthroplasty

2021 ◽  
Vol 2 (8) ◽  
pp. 566-572
Author(s):  
Michael Fuchs ◽  
Felix Kirchhoff ◽  
Heiko Reichel ◽  
Carsten Perka ◽  
Martin Faschingbauer ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Synovial Fluid ◽  
Cell Count ◽  
Knee Arthroplasty ◽  
Revision Surgery ◽  
Joint Infection ◽  
Revision Total Knee Arthroplasty ◽  
Time Points ◽  
Aseptic Revision ◽  
Total Knee

Aims Current guidelines consider analyses of joint aspirates, including leucocyte cell count (LC) and polymorphonuclear percentage (PMN%) as a diagnostic mainstay of periprosthetic joint infection (PJI). It is unclear if these parameters are subject to a certain degree of variability over time. Therefore, the aim of this study was to evaluate the variation of LC and PMN% in patients with aseptic revision total knee arthroplasty (TKA). Methods We conducted a prospective, double-centre study of 40 patients with 40 knee joints. Patients underwent joint aspiration at two different time points with a maximum period of 120 days in between these interventions and without any events such as other joint aspirations or surgeries. The main indications for TKA revision surgery were aseptic implant loosening (n = 24) and joint instability (n = 11). Results Overall, 80 synovial fluid samples of 40 patients were analyzed. The average time period between the joint aspirations was 50 days (SD 32). There was a significantly higher percentage change in LC when compared to PMN% (44.1% (SD 28.6%) vs 27.3% (SD 23.7%); p = 0.003). When applying standard definition criteria, LC counts were found to skip back and forth between the two time points with exceeding the thresholds in up to 20% of cases, which was significantly more compared to PMN% for the European Bone and Joint Infection Society (EBJIS) criteria (p = 0.001), as well as for Musculoskeletal Infection Society (MSIS) (p = 0.029). Conclusion LC and PMN% are subject to considerable variation. According to its higher interindividual variance, LC evaluation might contribute to false-positive or false-negative results in PJI assessment. Single LC testing prior to TKA revision surgery seems to be insufficient to exclude PJI. On the basis of the obtained results, PMN% analyses overrule LC measurements with regard to a conclusive diagnostic algorithm. Cite this article: Bone Jt Open 2021;2(8):566–572.

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