Periprosthetic joint infections of the shoulder: A 10-year retrospective analysis outlining the heterogeneity among these patients

2021 ◽  
pp. 175857322110190
Author(s):  
Taylor Paziuk ◽  
Ryan M Cox ◽  
Michael J Gutman ◽  
Alexander J Rondon ◽  
Thema Nicholson ◽  
...  
Keyword(s):  
Periprosthetic Joint Infection ◽  
Shoulder Arthroplasty ◽  
Joint Infection ◽  
Sinus Tract ◽  
Difficult Problem ◽  
Consensus Meeting ◽  
International Consensus ◽  
Joint Infections ◽  
Revision Shoulder Arthroplasty ◽  
Culture Negative

Background Diagnosis and treatment of shoulder periprosthetic joint infection is a difficult problem. The purpose of this study was to utilize the 2018 International Consensus Meeting definition of shoulder periprosthetic joint infection to categorize revision shoulder arthroplasty cases and determine variations in clinical presentation by presumed infection classification. Methods Retrospective review of patients undergoing revision shoulder arthroplasty at a single institution. Likelihood of periprosthetic joint infection was determined based on International Consensus Meeting scoring. All patients classified as definitive or probable periprosthetic joint infection were classified as periprosthetic joint infection. All patients classified as possible or unlikely periprosthetic joint infection were classified as aseptic. The periprosthetic joint infection cohort was subsequently divided into culture-negative, non-virulent microorganism, and virulent microorganism cohorts based on culture results. Results Four hundred and sixty cases of revision shoulder arthroplasty were reviewed. Eighty (17.4%) patients were diagnosed as definite or probable periprosthetic joint infection, of which 29 (36.3%), 39 (48.8%), and 12 (15.0%) were classified as virulent, non-virulent, or culture-negative periprosthetic joint infection, respectively. There were significant differences among periprosthetic joint infection subgroups with regard to preoperative C-reactive protein (p = 0.020), erythrocyte sedimentation rate (p = 0.051), sinus tract presence (p = 0.008), and intraoperative purulence (p < 0.001). The total International Consensus Meeting criteria scores were also significantly different between the periprosthetic joint infection cohorts (p < 0.001). Discussion While the diagnosis of shoulder periprosthetic joint infection has improved with the advent of International Consensus Meeting criteria, there remain distinct differences between periprosthetic joint infection classifications that warrant further investigation to determine the accurate diagnosis and optimal treatment.

Should all patients with a culture-negative periprosthetic joint infection be treated with antibiotics?

2022 ◽  
Vol 104-B (1) ◽  
pp. 183-188
Author(s):  
Maxime van Sloten ◽  
Joan Gómez-Junyent ◽  
Tristan Ferry ◽  
Nicolò Rossi ◽  
Sabine Petersdorf ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Joint Infection ◽  
Recurrent Infection ◽  
Molecular Techniques ◽  
Secondary Outcome ◽  
International Consensus ◽  
Joint Infections ◽  
Causative Microorganism ◽  
Culture Negative

Aims The aim of this study was to analyze the prevalence of culture-negative periprosthetic joint infections (PJIs) when adequate methods of culture are used, and to evaluate the outcome in patients who were treated with antibiotics for a culture-negative PJI compared with those in whom antibiotics were withheld. Methods A multicentre observational study was undertaken: 1,553 acute and 1,556 chronic PJIs, diagnosed between 2013 and 2018, were retrospectively analyzed. Culture-negative PJIs were diagnosed according to the Muskuloskeletal Infection Society (MSIS), International Consensus Meeting (ICM), and European Bone and Joint Society (EBJIS) definitions. The primary outcome was recurrent infection, and the secondary outcome was removal of the prosthetic components for any indication, both during a follow-up period of two years. Results None of the acute PJIs and 70 of the chronic PJIs (4.7%) were culture-negative; a total of 36 culture-negative PJIs (51%) were treated with antibiotics, particularly those with histological signs of infection. After two years of follow-up, no recurrent infections occurred in patients in whom antibiotics were withheld. The requirement for removal of the components for any indication during follow-up was not significantly different in those who received antibiotics compared with those in whom antibiotics were withheld (7.1% vs 2.9%; p = 0.431). Conclusion When adequate methods of culture are used, the incidence of culture-negative PJIs is low. In patients with culture-negative PJI, antibiotic treatment can probably be withheld if there are no histological signs of infection. In all other patients, diagnostic efforts should be made to identify the causative microorganism by means of serology or molecular techniques. Cite this article: Bone Joint J 2022;104-B(1):183–188.

The 2018 International Consensus Meeting Minor Criteria for Chronic Hip and Knee Periprosthetic Joint Infection: Validation From a Single Center

2020 ◽  
Vol 35 (8) ◽  
pp. 2200-2203 ◽  
Author(s):  
Hussein Abdelaziz ◽  
Kristof Rademacher ◽  
Eduardo M. Suero ◽  
Thorsten Gehrke ◽  
Christian Lausmann ◽  
...  
Keyword(s):  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Consensus Meeting ◽  
Single Center ◽  
International Consensus ◽  
Minor Criteria

scholarly journals Chronic prosthetic joint infections with a draining sinus. Who should receive suppressive antibiotic treatment?

2020 ◽  
Vol 6 (2) ◽  
pp. 43-45
Author(s):  
Karel-Jan Lensen ◽  
Rosa Escudero-Sanchez ◽  
Javier Cobo ◽  
Alex Soriano ◽  
Marjan Wouthuyzen-Bakker
Keyword(s):  
Antibiotic Treatment ◽  
Patient Group ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Sinus Tract ◽  
Advantages And Disadvantages ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections

Abstract. The benefit of suppressive antibiotic treatment in inoperable patients with a chronic periprosthetic joint infection and a sinus tract is unknown. Some physicians prefer to just let the sinus drain, while others prefer antibiotic treatment. In this viewpoint article we discuss the advantages and disadvantages of suppressive antibiotic treatment in this particular patient group.

scholarly journals Sonication of retrieved implants improves sensitivity in the diagnosis of periprosthetic joint infection

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Petri Bellova ◽  
Veronika Knop-Hammad ◽  
Matthias Königshausen ◽  
Eileen Mempel ◽  
Sven Frieler ◽  
...  
Keyword(s):  
Tissue Sample ◽  
Joint Infection ◽  
Diagnostic Tools ◽  
Coagulase Negative Staphylococci ◽  
International Consensus ◽  
Paired Samples ◽  
Joint Infections ◽  
Difficult Challenge ◽  
Culture Negative ◽  
Fluid Culture

Abstract Background Sonication is a valuable tool in the diagnosis of periprosthetic joint infections (PJI). However, conditions and definition criteria for PJI vary among studies. The aim of this study was to determine the diagnostic performance (i.e., specificity, sensitivity) of sonicate fluid culture (SFC) against periprosthetic tissue culture (PTC), when using European Bone and Joint Infection Society (EBJIS) criteria. Methods From March 2017 to April 2018, 257 implants were submitted for sonication. PJI was defined according to the EBJIS criteria as well as according to the International Consensus Meeting criteria of 2018 (ICM 2018). Only cases with at least one corresponding tissue sample were included. Samples were cultured using traditional microbiological plating techniques. Sensitivity and specificity were determined using two-by-two contingency tables. McNemar’s test was used to compare proportions among paired samples. Subgroup analysis was performed dividing the cohort according to the site of PJI, previous antibiotic treatment, and time of manifestation. Prevalence of pathogens was determined for all patients as well as for specific subgroups. Results Among the 257 cases, 145 and 112 were defined as PJI and aseptic failure, respectively. When using the EBJIS criteria, the sensitivity of SFC and PTC was 69.0 and 62.8%, respectively (p = .04). Meanwhile, the specificity was 90.2 and 92.9%, respectively (p = .65). When adopting ICM 2018 criteria, the sensitivity of SFC and PTC was 87.5 and 84.4% (p = .63) respectively, while the specificity was 85.1 and 92.5% (p = .05), respectively. The most commonly identified pathogens were coagulase-negative staphylococci (26% overall), while 31% of PJI were culture-negative and 9% polymicrobial. Conclusions SFC exhibited significantly greater sensitivity versus PTC when using the EBJIS criteria. Nevertheless, the diagnosis of PJI remains a difficult challenge and different diagnostic tools are necessary to optimize the outcome.

scholarly journals Philadelphia 2013: International Consensus Meeting on Periprosthetic Joint Infection

2014 ◽  
Vol 24 (1) ◽  
pp. 3-4 ◽  
Author(s):  
Bishoy Youssef ◽  
George Pavlou ◽  
Eleftherios Tsiridis
Keyword(s):  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Consensus Meeting ◽  
International Consensus

scholarly journals The 1st International Consensus Meeting on Periprosthetic Joint Infection

2014 ◽  
Vol 32 (S1) ◽  
pp. S1-S1 ◽  
Author(s):  
Edward M. Schwarz ◽  
Volker Alt ◽  
Stephen L. Kates
Keyword(s):  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Consensus Meeting ◽  
International Consensus
Sign in / Sign up

Export Citation Format

Share Document