scholarly journals A Modeling Framework for Decision Support in Periprosthetic Joint Infection Treatment

2021 ◽  
Author(s):  
Vasiliy N. Leonenko ◽  
Yulia E. Kaliberda ◽  
Vasiliy A. Artyuk

In this paper, we present a framework, which aims at facilitating the choice of the best strategy related to the treatment of periprosthetic joint infection (PJI). The framework includes two models: a detailed non-Markovian model based on the decision tree approach, and a general Markov model, which captures the most essential states of a patient under treatment. The application of the framework is demonstrated on the dataset provided by Russian Scientific Research Institute of Traumatology and Orthopedics “R.R. Vreden”, which contains records of patients with PJI occurred after total hip arthroplasty. The methods of cost-effectiveness analysis of treatment strategies and forecasting of individual treatment outcomes depending on the selected strategy are discussed.

Author(s):  
Janna van den Kieboom ◽  
Venkatsaiakhil Tirumala ◽  
Hayden Box ◽  
Ruben Oganesyan ◽  
Christian Klemt ◽  
...  

Aims Removal of infected components and culture-directed antibiotics are important for the successful treatment of chronic periprosthetic joint infection (PJI). However, as many as 27% of chronic PJI patients yield negative culture results. Although culture negativity has been thought of as a contraindication to one-stage revision, data supporting this assertion are limited. The aim of our study was to report on the clinical outcomes for one-stage and two-stage exchange arthroplasty performed in patients with chronic culture-negative PJI. Methods A total of 105 consecutive patients who underwent revision arthroplasty for chronic culture-negative PJI were retrospectively evaluated. One-stage revision arthroplasty was performed in 30 patients, while 75 patients underwent two-stage exchange, with a minimum of one year's follow-up. Reinfection, re-revision for septic and aseptic reasons, amputation, readmission, mortality, and length of stay were compared between the two treatment strategies. Results The patient demographic characteristics did not differ significantly between the groups. At a mean follow-up of 4.2 years, the treatment failure for reinfection for one-stage and two-stage revision was five (16.7%) and 15 patients (20.0%) (p = 0.691), and for septic re-revision was four (13.3%) and 11 patients (14.7%) (p = 0.863), respectively. No significant differences were observed between one-stage and two-stage revision for 30- 60- and 90-day readmissions (10.0% vs 8.0%; p = 0.714; 16.7% vs 9.3%; p = 0.325; and 26.7% vs 10.7%; p = 0.074), one-year mortality (3.3% vs 4.0%; p > 0.999), and amputation (3.3% vs 1.3%; p = 0.496). Conclusion In this non-randomized study, one-stage revision arthroplasty demonstrated similar outcomes including reinfection, re-revision, and readmission rates for the treatment of chronic culture-negative PJI after TKA and THA compared to two-stage revision. This suggests culture negativity may not be a contraindication to one-stage revision arthroplasty for chronic culture-negative PJI in selected patients.


2016 ◽  
Vol 26 (1) ◽  
pp. 20-33 ◽  
Author(s):  
Roland Becker ◽  
Martin Clauss ◽  
Niccolo Rotigliano ◽  
Michael Tobias Hirschmann

2018 ◽  
Vol 12 (2) ◽  
pp. 46-52 ◽  
Author(s):  
A.I. Varlamova

The purpose of the research: study of the influence of increased doses of fenbendazole supramolecular complex (FSMC) on sheep’s organism. Materials and methods. The experiment was carried out at the Podolsk Department of All-Russian Scientific Research Institute of Fundamental and Applied Parasitology of Animals and Plants named after K. I. Skryabin on 20 manorial invasion-free sheep aged 2-3 years old. Animals were divided according to the principle of analogues into 4 groups, 5 heads in each group. Animals of the 1, 2 and 3 group were orally administered with FSMC given as a single dose of 2, 6, 10 mg/kg, respectively, according to the active substance, i.e in therapeutic and in a dose increased by 3 and 5 times. Sheep of the fourth group didn’t receive the drug and they were as control. Study of clinical, hematological and biochemical parameters of animals from all groups was conducted 1 day before and in 1, 3, 5 days after administration of the drug by means of standard methods. Results and discussion. FSMC in therapeutic dose as well as in a dose increased by 3 and 5 times doesn’t have negative influence on clinical, hematological and biochemical parameters of the sheep. State of the sheep, which received the drug in doses of 20, 60, 100 mg/kg, was within the physiologically normal state and didn’t differ from the state before administration of the drug and from the animals of the control group. Drug security index exceeds 5. Red blood cell count, white blood cell count, hemoglobin count, leukogram parameters as well as biochemical parameters of blood: activity of alkaline phosphatase and amylase, bilirubin, creatinine, urea and glucose counts were within normal limits and didn’t differ from the parameters of the control animals.


2019 ◽  
Vol 2019 ◽  
pp. 1-2
Author(s):  
Bernd Fink ◽  
Konstantinos Anagnostakos ◽  
Heinz Winkler

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