scholarly journals The mildly decreased preoperative bilirubin level is a risk factor for periprosthetic joint infection after total hip and knee arthroplasty

Arthroplasty ◽  
2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Jun Fu ◽  
Xiyue Chen ◽  
Ming Ni ◽  
Xiang Li ◽  
Libo Hao ◽  
...  
Keyword(s):  
Risk Factor ◽  
Bilirubin Level ◽  
Knee Arthroplasty ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Primary Arthroplasty ◽  
Significant Difference ◽  
Serologic Markers ◽  
Hip And Knee Arthroplasty ◽  
Laboratory Biomarkers

Abstract Background Many serologic markers are routinely tested prior to joint arthroplasty, but only few are commonly used to guide surgeons in determining patients most at risk of periprosthetic joint infection (PJI). The objective of this study was to investigate the association between preoperative bilirubin level and PJI after primary hip and knee arthroplasty. Methods A retrospective analysis was performed on patients undergoing revision hip and knee arthroplasty at our hospital from January 2016 to December 2019. Laboratory biomarkers were collected before the primary arthroplasty, as well as general patient information. The association between the above serologic markers and postoperative PJI was analyzed. Results A total of 72 patients (30 hips/42 knees) were analyzed, including 39 patients with PJI and 33 patients without PJI. Except for total bilirubin (TB) and direct bilirubin (DB), there was no significant difference between the remaining laboratory biomarkers. The preoperative TB and DB in the PJI group were 10.84 ± 0.61 μmol/L and 3.07 ± 0.19 μmol/L, respectively, which were lower than those in the non-PJI group (14.68 ± 0.75 μmol/L and 4.70 ± 0.39 μmol/L, P < 0.001). The area under the curve (AUC) of preoperative TB to predict PJI was 0.755 (P < 0.001, cutoff = 11.55 μmol/L, sensitivity = 66.67%, specificity = 75.76%). Meanwhile, the AUC of preoperative DB was 0.760 (P < 0.001, cutoff = 4.00 μmol/L, sensitivity = 84.62%, specificity = 54.45%). Conclusions The serum levels of TB and DB before the primary arthroplasty were lower in PJI patients than in non-PJI patients, and the preoperative values lower than 11.55 μmol/L and 4.00 μmol/L could be considered as a risk factor for postoperative PJI.

scholarly journals Mildly decreased preoperative bilirubin levels are considered as risk factors for periprosthetic joint infection after total hip and knee arthroplasty

2020 ◽  
Author(s):  
Jun Fu ◽  
Xiyue Chen ◽  
Chi Xu ◽  
Ming Ni ◽  
Xiang Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Knee Arthroplasty ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Serum Levels ◽  
Blood Biomarkers ◽  
Primary Arthroplasty ◽  
Significant Difference ◽  
Hip And Knee Arthroplasty ◽  
Laboratory Biomarkers

Abstract Background and Purpose Many blood biomarkers are routinely assessed before joint arthroplasty, but only few are commonly used to guide surgeons in determining patients most at risk of periprosthetic joint infection (PJI). The objective of this study was to investigate the correlation between preoperative bilirubin level and PJI after hip and knee arthroplasty. Methods A retrospective analysis was performed on patients undergoing revision hip and knee arthroplasty at our hospital from January 2016 to December 2019. Laboratory biomarkers were collected before the primary arthroplasty, as well as general patient information. The correlation between the above blood biomarkers and postoperative PJI was analyzed. Results A total of 72 patients (30 hips/42 knees) were analyzed, including 39 patients with PJI and 33 patients without PJI. Except for total bilirubin (TB) and direct bilirubin (DB), there was no significant difference between the remaining laboratory biomarkers. The preoperative TB and DB in the PJI group were 10.84 ± 0.61 µmol/L and 3.07 ± 0.19 µmol/L, respectively, which were lower than those in the non-PJI group (14.68 ± 0.75 µmol/L and 4.70 ± 0.39 µmol/L, p = 0.0001 and 0.0002). The AUC of preoperative TB to predict PJI was 0.7552 (p = 0.0002, cutoff = 11.55 µmol/L, sensitivity = 66.67%, specificity = 75.76%, PPV = 76.47%, NPV = 65.79%). Meanwhile, the AUC of preoperative DB was 0.7603 (p = 0.0001, cutoff = 4.00 µmol/L, sensitivity = 84.62%, specificity = 54.45%, PPV = 68.75%, NPV = 75%). Conclusions The serum levels of TB and DB before the primary arthroplasty of PJI patients were lower than those non-PJI patients, and the preoperative values lower than 11.55 µmol/L and 4.00 µmol/L could be considered as risk factors for postoperative PJI.

Development of antibiotic resistance in periprosthetic joint infection after total knee arthroplasty

2021 ◽  
Vol 103-B (6 Supple A) ◽  
pp. 171-176
Author(s):  
Antonio Klasan ◽  
Arne Schermuksnies ◽  
Florian Gerber ◽  
Matt Bowman ◽  
Susanne Fuchs-Winkelmann ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Antibiotic Resistance ◽  
Knee Arthroplasty ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Revision Arthroplasty ◽  
Bacterial Strains ◽  
Coagulase Negative Staphylococci ◽  
Primary Arthroplasty ◽  
Total Knee

Aims The management of periprosthetic joint infection (PJI) after total knee arthroplasty (TKA) is challenging. The correct antibiotic management remains elusive due to differences in epidemiology and resistance between countries, and reports in the literature. Before the efficacy of surgical treatment is investigated, it is crucial to analyze the bacterial strains causing PJI, especially for patients in whom no organisms are grown. Methods A review of all revision TKAs which were undertaken between 2006 and 2018 in a tertiary referral centre was performed, including all those meeting the consensus criteria for PJI, in which organisms were identified. Using a cluster analysis, three chronological time periods were created. We then evaluated the antibiotic resistance of the identified bacteria between these three clusters and the effectiveness of our antibiotic regime. Results We identified 129 PJIs with 161 culture identified bacteria in 97 patients. Coagulase-negative staphylococci (CNS) were identified in 46.6% cultures, followed by Staphylococcus aureus in 19.8%. The overall resistance to antibiotics did not increase significantly during the study period (p = 0.454). However, CNS resistance to teicoplanin (p < 0.001), fosfomycin (p = 0.016), and tetracycline (p = 0.014) increased significantly. Vancomycin had an 84.4% overall sensitivity and 100% CNS sensitivity and was the most effective agent. Conclusion Although we were unable to show an overall increase in antibiotic resistance in organisms that cause PJI after TKA during the study period, this was not true for CNS. It is concerning that resistance of CNS to new antibiotics, but not vancomycin, has increased in a little more than a decade. Our findings suggest that referral centres should continuously monitor their bacteriological analyses, as these have significant implications for prophylactic treatment in both primary arthroplasty and revision arthroplasty for PJI. Cite this article: Bone Joint J 2021;103-B(6 Supple A):171–176.

scholarly journals Can Topical Vancomycin Prevent Periprosthetic Joint Infection in Hip and Knee Arthroplasty? A Systematic Review

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Murray T. Wong ◽  
Sarup S. Sridharan ◽  
Erin M. Davison ◽  
Richard Ng ◽  
Nicholas M. Desy
Keyword(s):  
Systematic Review ◽  
Knee Arthroplasty ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Hip And Knee Arthroplasty

scholarly journals Active Rheumatoid Arthritis in a Mouse Model is not an Independent Risk Factor for Periprosthetic Joint Infection

2021 ◽  
Author(s):  
Rishi Trikha ◽  
Danielle Greig ◽  
Troy Sekimura ◽  
Nicolas Cevallos ◽  
Benjamin Kelley ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factor ◽  
Periprosthetic Joint Infection ◽  
Ex Vivo ◽  
Joint Infection ◽  
Bacterial Burden ◽  
Crystal Violet Assay ◽  
Significant Difference ◽  
Infectious Burden

Introduction Periprosthetic joint infection (PJI) represents a devastating complication of total joint arthroplasty associated with significant morbidity and mortality. Literature suggests a possible higher incidence of periprosthetic joint infection (PJI) in patients with rheumatoid arthritis (RA). There is, however, no consensus on this relative risk nor a well-defined mechanism of this purported risk. This study investigates how collagen-induced arthritis (CIA), a validated animal model of RA, impacts infectious burden in a well-established model of PJI.   Methods Control mice were compared against CIA mice. Whole blood samples were collected to quantify systemic IgG levels via ELISA. Ex vivo respiratory burst function was measured via dihydrorhodamine assay. Ex vivo Staphylococcus aureus Xen36 burden was measured directly via colony forming unit (CFU) counts and crystal violet assay to assess biofilm formation. In vivo , surgical placement of a titanium implant through the knee joint and inoculation with S. aureus Xen36 was performed. Bacterial burden was then quantified by longitudinal bioluminescent imaging.   Results Mice with CIA demonstrated significantly higher levels of systemic IgG compared with control mice (p = 0.003). Ex vivo, there was no significant difference in respiratory burst function (p=0.89) or S. aureus bacterial burden as measured by CFU counts (p=0.91) and crystal violet assay (p=0.96). In vivo , no significant difference in bacterial bioluminescence between groups was found at all postoperative time points. CFU counts of both the implant and the peri-implant tissue were not significantly different between groups (p=0.82 and 0.80, respectively).   Conclusion This study demonstrated no significant difference in S. aureus infectious burden between mice with CIA and control mice. These results suggest that untreated, active RA may not represent a significant intrinsic risk factor for PJI. Further mechanistic translational and clinical studies are, however, warranted to thoroughly investigate the infectious risk of RA.

scholarly journals Epidemiology of Hip And Knee Arthroplasty and Periprosthetic Joint Infection in Russian Federation

2021 ◽  
Vol 27 (3) ◽  
pp. 84-93
Author(s):  
Andrei P. Sereda ◽  
Andrei A. Kochish ◽  
Alexander A. Cherny ◽  
Alexander P. Antipov ◽  
Alimuad G. Aliev ◽  
...  
Keyword(s):  
Russian Federation ◽  
Knee Arthroplasty ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Federal State ◽  
Orthopaedic Implant ◽  
State Budget ◽  
Private Hospitals ◽  
Arthroplasty Registry ◽  
Hip And Knee Arthroplasty

Background. Since there is no national arthroplasty registry in the Russian Federation, the exact number of arthroplasty operations performed is unknown. Aim of the study to evaluate the epidemiology of primary, revision hip and knee arthroplasty and periprosthetic joint infection in Russian Federation. Materials and Methods. The inquires were made to 85 subjects, 73 federal state budget institutions and 30 private hospitals. Results. Answers were received from 76 subjects of Russian Federation, 41 federal and 18 private hospitals. The studied indicators revealed to be pretty much heterogenic. The decrease of operations number from 20% to 40% in subjects of Russian Federation due to SARS-CoV-2 pandemic forced us to make no analysis for these 2020 indicators in Russian Federation generally. 147 061 primary hip and knee arthroplasties were performed in 2019 in Russian Federaion. 7 770 revison hip and knee arthroplasties were done. 6 606 cases of severe orthopaedic implant-assosiated infection were cured including 4 282 cases post hip and knee arthroplasties that constitutes 2,91 % from primary arthroplasties. Conclusions. The frequency of periprosthetic joint infection in Russian Federation correlates to the world data. High complexity for patients routing with implant-assosiated infection and strong demand for Federal Center of implant-assosiated orthopaedic infection are revealed.

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