scholarly journals Perioperative hyperglycemia and postoperative periprosthetic joint infection (PJI) after total knee and hip arthroplasty

2018 ◽  
pp. 001-006
Author(s):  
Maeda Yuki
Keyword(s):  
Hip Arthroplasty ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Total Knee ◽  
Knee And Hip Arthroplasty

scholarly journals Diagnostic Criteria and Treatment of Acute and Chronic Periprosthetic Joint Infection of Total Ankle Arthroplasty

2019 ◽  
Vol 4 (2) ◽  
pp. 247301141984100
Author(s):  
Kempland C. Walley ◽  
Christopher B. Arena ◽  
Paul J. Juliano ◽  
Michael C. Aynardi
Keyword(s):  
Diagnostic Criteria ◽  
Hip Arthroplasty ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Total Ankle Arthroplasty ◽  
Level Of Evidence ◽  
Ankle Arthroplasty ◽  
Prosthetic Joint ◽  
Ankle Replacement ◽  
Knee And Hip Arthroplasty

Background: Prosthetic joint infection (PJI) after total ankle arthroplasty (TAA) is a serious complication that results in significant consequences to the patient and threatens the survival of the ankle replacement. PJI in TAA may require debridement, placement of antibiotic spacer, revision arthroplasty, conversion to arthrodesis, or potentially below the knee amputation. While the practice of TAA has gained popularity in recent years, there is some minimal data regarding wound complications in acute or chronic PJI of TAA. However, of the limited studies that describe complications of PJI of TAA, even fewer studies describe the criteria used in diagnosing PJI. This review will cover the current available literature regarding total ankle arthroplasty infection and will propose a model for treatment options for acute and chronic PJI in TAA. Methods: A review of the current literature was conducted to identify clinical investigations in which prosthetic joint infections occurred in total ankle arthroplasty with associated clinical findings, radiographic imaging, and functional outcomes. The electronic databases for all peer-reviewed published works available through January 31, 2018, of the Cochrane Library, PubMed MEDLINE, and Google Scholar were explored using the following search terms and Boolean operators: “total ankle replacement” OR “total ankle arthroplasty” AND “periprosthetic joint infection” AND “diagnosis” OR “diagnostic criteria.” An article was considered eligible for inclusion if it concerned diagnostic criteria of acute or chronic periprosthetic joint infection of total ankle arthroplasty regardless of the number of patients treated, type of TAA utilized, conclusion, or level of evidence of study. Results: No studies were found in the review of the literature describing criteria for diagnosing PJI specific to TAA. Conclusions: Literature describing the diagnosis and treatment of PJI in TAA is entirely reliant on the literature surrounding knee and hip arthroplasty. Because of the limited volume of total ankle arthroplasty in comparison to knee and hip arthroplasty, no studies to our knowledge exist describing diagnostic criteria specific to total ankle arthroplasty with associated reliability. Large multicenter trials may be required to obtain the volume necessary to accurately describe diagnostic criteria of PJI specific to TAA. Level of Evidence: Level III, systematic review.

scholarly journals Neutrophil to lymphocyte ratio as a predictor for diagnosis of early Periprosthetic joint infection

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Bao-Zhan Yu ◽  
Jun Fu ◽  
Wei Chai ◽  
Li-Bo Hao ◽  
Ji-Ying Chen
Keyword(s):  
Hip Arthroplasty ◽  
Periprosthetic Joint Infection ◽  
Predictive Value ◽  
Joint Infection ◽  
Early Postoperative Period ◽  
Infected Group ◽  
Neutrophil To Lymphocyte Ratio ◽  
Musculoskeletal Infection ◽  
Lymphocyte Ratio ◽  
Total Knee

Abstract Background Periprosthetic joint infection (PJI) is a catastrophic complication after total knee or hip arthroplasty. The diagnosis of PJI is very difficult, especially in the early postoperative period. The value of the neutrophil to lymphocyte ratio (NLR) is useful for diagnosing infectious diseases. The objective of this study was to investigate the accuracy of the NLR for the diagnosis of early PJI after total knee or hip arthroplasty. Methods We retrospectively evaluated consecutive primary total knee or hip arthroplasty and identified the patients who readmitted within the first 90 days postoperatively between January 2011 and October 2018.There were 20 cases diagnosed early PJI and 101 uninfected cases on the basis of the modified Musculoskeletal Infection Society (MSIS) criteria. The serum parameters including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood-cell (WBC) count, NLR and interleukin-6 (IL-6) were compared between the two groups. Receiver operating characteristic curves were generated to estimate the optimal cutoff values for each parameter. The sensitivity, specificity, positive predictive value and negative predictive value for each parameter were calculated. Results The CRP, ESR, WBC, NLR and IL-6 values were all significally higher in the infected group than the uninfected group. The median of CRP was 66.6 mg/l in the infected group and 8.6 mg/l in the uninfected group (p < 0.001). The median of ESR was 34.8 mm/hr. in the infected group and 17.4 mm/hr. in the uninfected group (p < 0.001). In the infected group and uninfected group, the median of WBC was 8.2X109 /L and 6.1 X109 /L (p = 0.002), respectively; while the median of NLR was 5.2 and 2.1 (p < 0.001). The median of IL-6 was 46 pg/ml and 6.4 pg/ml (p < 0.001),respectively. The best parameter for the diagnosis of early PJI was IL-6 (AUC = 0.814) followed by the NLR (AUC =0.802), CRP (AUC =0.793), ESR (AUC =0.744) and WBC (AUC = 0.632). Conclusions This study is the first to show that NLR values are more accurate than CRP and may be considered as useful parameters for the diagnosis of early PJI because it is a cheap and convenient parameter to be calculated in daily practice without extra costs.

scholarly journals Neutrophil to Lymphocyte Ratio as a predictor for diagnosis of early Periprosthetic Joint Infection

2020 ◽  
Author(s):  
BaoZhan Yu ◽  
Jun Fu ◽  
Wei Chai ◽  
LiBo Hao ◽  
Jiying Chen
Keyword(s):  
Hip Arthroplasty ◽  
Periprosthetic Joint Infection ◽  
Predictive Value ◽  
Joint Infection ◽  
Early Postoperative Period ◽  
Infected Group ◽  
Neutrophil To Lymphocyte Ratio ◽  
Musculoskeletal Infection ◽  
Lymphocyte Ratio ◽  
Total Knee

Abstract Background: Periprosthetic joint infection (PJI) is a catastrophic complication after total knee or hip arthroplasty. The diagnosis of PJI is very difficult, especially in the early postoperative period. The value of the neutrophil to lymphocyte ratio (NLR) is useful for diagnosing infectious diseases. The objective of this study was to investigate the accuracy of the NLR for the diagnosis of early PJI after total knee or hip arthroplasty.Methods: We retrospectively evaluated consecutive primary total knee or hip arthroplasty and identified the patients who readmitted within the first 90 days postoperatively between January 2011 and October 2018.There were 20 cases diagnosed early PJI and 101 uninfected cases on the basis of the modified Musculoskeletal Infection Society (MSIS) criteria. The serum parameters including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood-cell (WBC) count, NLR and interleukin-6 (IL-6) were compared between the two groups. Receiver operating characteristic curves were generated to estimate the optimal cutoff values for each parameter.The sensitivity, specificity, positive predictive value and negative predictive value for each parameter were calculated.Results: The CRP, ESR, WBC, NLR and IL-6 values were all significally higher in the infected group than the uninfected group. The median of CRP was 66.6 mg/l in the infected group and 8.6mg/l in the uninfected group (p<0.001). The median of ESR was 34.8 mm/hr in the infected group and 17.4mm/hr in the uninfected group (p<0.001). In the infected group and uninfected group, the median of WBC was 8.2X109 /L and 6.1 X109 /L (p = 0.002), respectively; while the median of NLR was 5.2 and 2.1 (p<0.001). The median of IL-6 was 46pg/ml and 6.4pg/ml (p<0.001),respectively. The best parameter for the diagnosis of early PJI was IL-6 (AUC=0.814) followed by the NLR (AUC =0.802), CRP (AUC =0.793), ESR (AUC =0.744) and WBC (AUC = 0.632).Conclusions: This study is the first to show that NLR values are more accurate than CRP and may be considered as useful parameters for the diagnosis of early PJI because it is a cheap and convenient parameter to be calculated in daily practice without extra costs.

scholarly journals Neutrophil to Lymphocyte Ratio as a predictor for diagnosis of early Periprosthetic Joint Infection

2020 ◽  
Author(s):  
BaoZhan Yu ◽  
Jun Fu ◽  
Wei Chai ◽  
LiBo Hao ◽  
Jiying Chen
Keyword(s):  
Hip Arthroplasty ◽  
Periprosthetic Joint Infection ◽  
Predictive Value ◽  
Joint Infection ◽  
Neutrophil To Lymphocyte Ratio ◽  
Optimal Cutoff ◽  
Musculoskeletal Infection ◽  
Cutoff Value ◽  
Lymphocyte Ratio ◽  
Total Knee

Abstract Background Periprosthetic joint infection (PJI) is a catastrophic complication after total knee or hip arthroplasty. The diagnosis of PJI is very difficult, especially in the early postoperative period. The value of the neutrophil to lymphocyte ratio (NLR) is useful for diagnosing infectious diseases. The objective of this study was to investigate the accuracy of the NLR for the diagnosis of early PJI after total knee or hip arthroplasty. Methods We retrospectively evaluated consecutive primary total knee or hip arthroplasty and identified the patients who readmitted within the first 90 days postoperatively between January 2011 and October 2018. There were 20 cases diagnosed early PJI and 101 uninfected cases on the basis of the modified Musculoskeletal Infection Society (MSIS) criteria. The serum parameters including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood-cell (WBC) count, NLR, interleukin-6 (IL-6) were compared between the two groups. Receiver operating characteristic curves were generated to estimate the optimal cutoff values for each parameter. The sensitivity, specificity, positive predictive value and negative predictive value for each parameter were calculated. Results The CRP, ESR, WBC, NLR and IL-6 values were all significally higher in the infected group than the uninfected group. The mean CRP (infected = 59.06, uninfected = 10.09), ESR (infected = 35, uninfected = 17), WBC(infected = 7.95 × 109,uninfected = 6.16 × 109), NLR (infected = 4.89, uninfected = 2.18), IL-6 (infected = 40.68, uninfected = 7.46).. The best parameter for the diagnosis of early PJI was IL-6 (AUC = 81.4%; optimal cutoff value 8.07 pg/ml) followed by the NLR (AUC = 80.2%; optimal cutoff value 2.13), CRP (AUC = 79.3%; optimal cutoff value 9.27 mg/l), ESR (AUC = 74.4%; optimal cutoff value 22 mm/h) and WBC (AUC = 63.2%; optimal cutoff value 8.91 × 109). Conclusions This study is the first to show that NLR values are more accurate than CRP and may be considered as useful parameters for the diagnosis of early PJI because it is a cheap and convenient parameter to be calculated in daily practice without extra costs.

What Is the Definition of Acute and Chronic Periprosthetic Joint Infection (PJI) of Total Ankle Arthroplasty (TAA)?

2019 ◽  
Vol 40 (1_suppl) ◽  
pp. 19S-21S ◽  
Author(s):  
Michael C. Aynardi ◽  
Milena M. Plöger ◽  
Kempland C. Walley ◽  
Christopher B. Arena
Keyword(s):  
Hip Arthroplasty ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Total Ankle Arthroplasty ◽  
Level Of Evidence ◽  
Ankle Arthroplasty ◽  
Ankle Replacement ◽  
Definition Of ◽  
Knee And Hip Arthroplasty

Recommendation: There is a paucity of data for defining acute or chronic periprosthetic joint infection (PJI) following total ankle arthroplasty (TAA) in the literature. Any discussion of PJI after ankle replacement is entirely reliant on the literature surrounding knee and hip arthroplasty. Level of Evidence: Consensus. Delegate Vote: Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)

scholarly journals Neutrophil to Lymphocyte Ratio as a predictor for diagnosis of early Periprosthetic Joint Infection

2020 ◽  
Author(s):  
BaoZhan Yu ◽  
Jun Fu ◽  
Wei Chai ◽  
LiBo Hao ◽  
Jiying Chen
Keyword(s):  
Hip Arthroplasty ◽  
Periprosthetic Joint Infection ◽  
Predictive Value ◽  
Joint Infection ◽  
Early Postoperative Period ◽  
Infected Group ◽  
Neutrophil To Lymphocyte Ratio ◽  
Musculoskeletal Infection ◽  
Lymphocyte Ratio ◽  
Total Knee

Abstract Background: Periprosthetic joint infection (PJI) is a catastrophic complication after total knee or hip arthroplasty. The diagnosis of PJI is very difficult, especially in the early postoperative period. The value of the neutrophil to lymphocyte ratio (NLR) is useful for diagnosing infectious diseases. The objective of this study was to investigate the accuracy of the NLR for the diagnosis of early PJI after total knee or hip arthroplasty.Methods: We retrospectively evaluated consecutive primary total knee or hip arthroplasty and identified the patients who readmitted within the first 90 days postoperatively between January 2011 and October 2018.There were 20 cases diagnosed early PJI and 101 uninfected cases on the basis of the modified Musculoskeletal Infection Society (MSIS) criteria. The serum parameters including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood-cell (WBC) count, NLR and interleukin-6 (IL-6) were compared between the two groups. Receiver operating characteristic curves were generated to estimate the optimal cutoff values for each parameter.The sensitivity, specificity, positive predictive value and negative predictive value for each parameter were calculated.Results: The CRP, ESR, WBC, NLR and IL-6 values were all significally higher in the infected group than the uninfected group. The median of CRP was 66.6 mg/l in the infected group and 8.6mg/l in the uninfected group (p<0.001). The median of ESR was 34.8 mm/hr in the infected group and 17.4mm/hr in the uninfected group (p<0.001). In the infected group and uninfected group, the median of WBC was 8.2X109 /L and 6.1 X109 /L (p = 0.002), respectively; while the median of NLR was 5.2 and 2.1 (p<0.001). The median of IL-6 was 46pg/ml and 6.4pg/ml (p<0.001),respectively.The best parameter for the diagnosis of early PJI was IL-6 (AUC=0.814) followed by the NLR (AUC =0.802), CRP (AUC =0.793), ESR (AUC =0.744) and WBC (AUC = 0.632).Conclusions: This study is the first to show that NLR values are more accurate than CRP and may be considered as useful parameters for the diagnosis of early PJI because it is a cheap and convenient parameter to be calculated in daily practice without extra costs.

scholarly journals Neutrophil to Lymphocyte Ratio as a predictor for diagnosis of early Periprosthetic Joint Infection

2020 ◽  
Author(s):  
BaoZhan Yu ◽  
Jun Fu ◽  
Wei Chai ◽  
LiBo Hao ◽  
Jiying Chen
Keyword(s):  
Hip Arthroplasty ◽  
Periprosthetic Joint Infection ◽  
Predictive Value ◽  
Joint Infection ◽  
Early Postoperative Period ◽  
Infected Group ◽  
Neutrophil To Lymphocyte Ratio ◽  
Musculoskeletal Infection ◽  
Lymphocyte Ratio ◽  
Total Knee

Abstract Background: Periprosthetic joint infection (PJI) is a catastrophic complication after total knee or hip arthroplasty. Thediagnosis of PJI is very difficult, especially in the early postoperative period . The value of the neutrophil to lymphocyte ratio (NLR) is useful for diagnosing infectious diseases. The objective of this study was to investigate the accuracy of the NLR for the diagnosis of early PJI after total knee or hip arthroplasty. Methods: We retrospectively evaluated consecutive primary total knee or hip arthroplasty and identified the patients who readmitted within the first 90 days postoperatively between January 2011 and October 2018.There were 20 cases diagnosed early PJI and 101 uninfected cases on the basis of the modified Musculoskeletal Infection Society (MSIS) criteria. The serum parameters including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood-cell (WBC) count, NLR, interleukin-6 (IL-6) were compared between the two groups. Receiver operating characteristic curves were generated to estimate the optimal cutoff values for each parameter.The sensitivity, specificity, positive predictive value and negative predictive value for each parameter were calculated. Results: The CRP, ESR, WBC, NLR and IL-6 values were all significally higher in the infected group than the uninfected group. The median of CRP was 66.6 mg/l in the infected group and 8.6mg/l in the uninfected group (p<0.001). The median of ESR was 34.8 mm/hr in the infected group and 17.4mm/hr in the uninfected group (p<0.001). In the infected group and uninfected group, the median of WBC was 8.2X10 9 /L and 6.1 X10 9 /L (p = 0.002), respectively; while the median of NLR was 5.2 and 2.1 (p<0.001). The median of IL-6 was 46pg/ml and 6.4pg/ml (p<0.001),respectively.The best parameter for the diagnosis of early PJI was IL-6 (AUC=0.814) followed by the NLR (AUC =0.802), CRP (AUC =0.793), ESR (AUC =0.744) and WBC (AUC = 0.632). Conclusions: This study is the first to show that NLR values are more accurate than CRP and may be considered as useful parameters for the diagnosis of early PJI because it is a cheap and convenient parameter to be calculated in daily practice without extra costs.

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