Sepsis after total hip or knee joint replacement in relation to airborne contamination

1983 ◽  
Vol 302 (1111) ◽  
pp. 583-592 ◽  
Keyword(s):  
Joint Replacement ◽  
Lower Risk ◽  
Bacterial Contamination ◽  
Total Joint Replacement ◽  
Knee Joint Replacement ◽  
Surgical Infection ◽  
Large Numbers ◽  
Airborne Contamination ◽  
Clean Air ◽  
Control Study

The beginning of aseptic surgery was marked by the hypothesis that surgical infection might be caused by particles from the air. The importance of other ways of contaminating the wound soon became apparent, however, and these seemed to predominate. With the development of operations for total joint replacement large numbers of operations began to be done on clean tissue with maximal exposure to the air of the operating room. The incidence of infection was high and the airborne hypothesis was advanced as the reason. Extensive investigations with clean-air systems gave support to this. A recently completed control study has concluded that in conventional ventilated operating rooms over 90% of the bacterial contamination of the wound comes from the air and that cleaner air results in a lower risk of sepsis.

The Cost Implications of Clean Air Systems and Antibiotic Prophylaxis in Operations for Total Joint Replacement

1984 ◽  
Vol 5 (1) ◽  
pp. 36-37 ◽  
Author(s):  
O.M. Lidwell
Keyword(s):  
Antibiotic Prophylaxis ◽  
Joint Replacement ◽  
Total Joint Replacement ◽  
Hospital Costs ◽  
Cost Effective ◽  
Prophylactic Antibiotics ◽  
Airborne Contamination ◽  
Clean Air ◽  
Cost Implications ◽  
The Cost

AbstractThe effect on sepsis of the use of prophylactic antibiotics and measures for reducing the level of airborne contamination in the operating room has been related to the costs of these measures and of dealing with a septic joint. While antibiotic prophylaxis is the most cost effective, the benefits that may be obtained from the introduction of cleaner air also appear to be worthwhile, even when considered solely in terms of hospital costs.

scholarly journals Extended follow-up of patients suspected of having joint sepsis after total joint replacement

1985 ◽  
Vol 95 (3) ◽  
pp. 655-664 ◽  
Author(s):  
O. M. Lidwell ◽  
E. J. L. Lowbury ◽  
W. Whyte ◽  
R. Blowers ◽  
D. Lowe
Keyword(s):  
Knee Joint ◽  
Failure Rate ◽  
Joint Replacement ◽  
Total Joint Replacement ◽  
Joint Infection ◽  
Hospital Records ◽  
Knee Joint Replacement ◽  
Total Hip

SUMMARYDuring an average follow-up time of about 2½ years after total hip or knee-joint replacement in 8052 patients, suspected joint infection was recorded in 85 patients whose joints had not been re-operated during that period. The hospital records of 72 of these patients were examined after a further period, averaging about 5 years. Thirty-five of these had suffered continuing major problems with the joint, 18 of which had been revised, and a further 9 joints needed such treatment. Infection was confirmed in 17 of the 35. These numbers are proportionately about three times greater than those observed among a set of matched controls followed-up for a similar period. The evidence from the extended follow-up suggests that the failure rate, unassociated with infection, reached about 5% by 7 years after operation and that late infections, manifested between about 2½ and 7 years after operation, were about as frequent as those confirmed during the first 2½ years.

Piroxicam spares buprenorphine after total joint replacement

1992 ◽  
Vol 63 (6) ◽  
pp. 658-660
Author(s):  
Michel Boeckstyns ◽  
Marianne Backer ◽  
Else Petersen ◽  
Iben Høj ◽  
Henrik Albrechtsen ◽  
...  
Keyword(s):  
Joint Replacement ◽  
Total Joint Replacement

Postoperative Anesthesia Of Elderly And Senile Patients With Total Joint Replacement Of The Lower Extremities

2020 ◽  
Vol 2 (09) ◽  
pp. 75-81
Author(s):  
Gaziev Z.T. ◽  
Avakov V.E. ◽  
Shorustamov M.T. ◽  
Bektemirova N.T.
Keyword(s):  
Epidural Analgesia ◽  
Postoperative Period ◽  
Joint Replacement ◽  
Total Joint Replacement ◽  
Lower Extremities ◽  
Multimodal Analgesia ◽  
Control Group ◽  
Patient Controlled Analgesia ◽  
Physical Status ◽  
Traumatic Injuries

Objective: To evaluate the efficacy and safety of patient-controlled analgesia through prolonged epidural analgesia after joint replacement of the lower extremities. Material and methods. We analyzed the postoperative period of 213 elderly and senile patients who were operated on for degenerative-dystrophic and traumatic injuries of the joints of the lower extremities. All patients underwent total joint replacement (164 - THA and 49 - TKA). The age of patients is from 65 to 90 years (average age was 78 ± 8 years) with a physical status of ASA 3 and above. All examined patients were divided into 2 groups. 63 patients comprised the main group, which in the postoperative period underwent patient-controlled analgesia (PCA) through prolonged epidural analgesia. The control group consisted of 150 patients, for the anesthesia of which in the postoperative period only standard systemic multimodal analgesia was used Conclusion. Patient-controlled analgesia is an alternative to traditional analgesic regimens. This method should be one of the main methods after surgical anesthesia for joint replacement of the lower limb in elderly and senile patients.

scholarly journals COVID-19 (SARS-CoV-2) lymphocyte responses are associated with inflammatory biomarkers in total joint replacement surgery candidates pre-operatively

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Marco S. Caicedo ◽  
Vianey Flores ◽  
Alicia Padilla ◽  
Samelko Lauryn ◽  
Joshua J. Jacobs ◽  
...  
Keyword(s):  
Joint Replacement ◽  
Total Joint Replacement ◽  
Cross Reactivity ◽  
Inflammatory Biomarkers ◽  
Nucleocapsid Proteins ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
Operative Planning ◽  
Lymphocyte Responses ◽  
Reactive Lymphocytes

Abstract Background Recent studies indicate that, in addition to antibody production, lymphocyte responses to SARS-CoV-2 may play an important role in protective immunity to COVID-19 and a percentage of the general population may exhibit lymphocyte memory due to unknown/asymptomatic exposure to SARS-CoV-2 or cross-reactivity to other more common coronaviruses pre-vaccination. Total joint replacement (TJR) candidates returning to elective surgeries (median age 68 years) may exhibit similar lymphocyte and/or antibody protection to COVID-19 prior to vaccination Methods In this retrospective study, we analyzed antibody titters, lymphocyte memory, and inflammatory biomarkers specific for the Spike and Nucleocapsid proteins of the SARS-CoV-2 virus in a cohort of n=73 returning TJR candidates (knees and/or hips) pre-operatively. Results Peripheral blood serum of TJR candidate patients exhibited a positivity rate of 18.4% and 4% for IgG antibodies specific for SARS-CoV-2 nucleocapsid and spike proteins, respectively. 13.5% of TJR candidates exhibited positive lymphocyte reactivity (SI > 2) to the SARS-CoV-2 nucleocapsid protein and 38% to the spike protein. SARS-CoV-2 reactive lymphocytes exhibited a higher production of inflammatory biomarkers (i.e., IL-1β, IL-6, TNFα, and IL-1RA) compared to non-reactive lymphocytes. Conclusions A percentage of TJR candidates returning for elective surgeries exhibit pre-vaccination positive SARS-CoV-2 antibodies and T cell memory responses with associated pro-inflammatory biomarkers. This is an important parameter for understanding immunity, risk profiles, and may aid pre-operative planning. Trial registration Retrospectively registered.

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