scholarly journals Forced-air warming discontinued: periprosthetic joint infection rates drop

2017 ◽  
Vol 9 (2) ◽  
Author(s):  
Scott D. Augustine
Keyword(s):  
Periprosthetic Joint Infection ◽  
Waste Heat ◽  
Joint Infection ◽  
Infection Rates ◽  
Airborne Bacterium ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
Joint Implant ◽  
Forced Air Warming ◽  
Forced Air

Several studies have shown that the waste heat from forced-air warming (FAW) escapes near the floor and warms the contaminated air resident near the floor. The waste heat then forms into convection currents that rise up and contaminate the sterile field above the surgical table. It has been shown that a single airborne bacterium can cause a periprosthetic joint infection (PJI) following joint replacement surgery. We retrospectively compared PJI rates during a period of FAW to a period of air-free conductive fabric electric warming (CFW) at three hospitals. Surgical and antibiotic protocols were held constant. The pooled multicenter data showed a decreased PJI rate of 78% following the discontinuation of FAW and a switch to air-free CFW (n=2034; P=0.002). The 78% reduction in joint implant infections observed when FAW was discontinued suggests that there is a link between the waste FAW heat and PJIs.

scholarly journals Progress in Prevention, Diagnosis, and Treatment of Periprosthetic Joint Infection

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Kai Wang ◽  
Wei Li ◽  
Huayu Liu ◽  
Yang Yang ◽  
Lingyun Lv
Keyword(s):  
Joint Replacement ◽  
Periprosthetic Joint Infection ◽  
Total Joint Replacement ◽  
Joint Infection ◽  
Diagnostic Methods ◽  
Diagnosis And Treatment ◽  
High Morbidity ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
Increased Risk

Periprosthetic joint infection (PJI) after joint replacement surgery is a severe complication associated with high morbidity and increased treatment costs. More than 25% of joint implant failures are attributed to PJI. PJI diagnosis and treatment methods have substantially improved in recent years. However, the prevalence of PJI remains high, primarily due to the increased prevalences of obesity, diabetes, and other underlying conditions. Moreover, increasing elderly prefers to total joint replacement surgery. However, due to frailty and comorbidities, most are at increased risk of infectious arthritis and artificial joint infection (PJI). Therefore, PJI management for the elderly requires multilevel and multiangle intervention. In this review, we summarize the risk factors and diagnostic methods currently available for PJI and discuss the current PJI prevention and treatment interventions, especially the management in older adults.

scholarly journals Meta-analysis in periprosthetic joint infection: a global bibliometric analysis

2020 ◽  
Author(s):  
Cheng Li ◽  
Cristina Ojeda Thies ◽  
Chi Xu ◽  
Andrej Trampuz
Keyword(s):  
Risk Factors ◽  
Bibliometric Analysis ◽  
Periprosthetic Joint Infection ◽  
Clinical Medicine ◽  
Meta Analysis ◽  
Joint Infection ◽  
Relevant Literature ◽  
The United States ◽  
Steroid Injections ◽  
Joint Replacement Surgery

Abstract Background: Periprosthetic joint infection (PJI) is the most serious complication of joint replacement surgery. Further comorbidities include bedsore, deep vein thrombosis, reinfection, or even death. An increasing number of researchers are focusing on this challenging complication. The aim of the present study was to estimate global PJI research based on bibliometrics from meta-analysis studies. Methods: A database search was performed in PubMed, Scopus, and Web of Science. Relevant studies were assessed using the bibliometric analysis. Results: A total of 117 articles were included. The most relevant literature on PJI was found on Scopus. China made the highest contributions to global research, followed by the United States and the United Kingdom. The institution with the most contributions from the University of Bristol. The journal with the highest number of publications was The Journal of Arthroplasty, whereas the Journal of Clinical Medicine had the shortest acceptance time. The day of the week with the greatest number of received and accepted manuscripts was Wednesday. Furthermore, the top three frequently used databases were Embase, MEDLINE, and Cochrane. The most frequent number of authors in meta-analysis studies was four. Most studies focused on the periprosthetic hip and knee. The alpha-defensin diagnostic test, preventive measures on antibiotics use, and risk factors of intra-articular steroid injections were the most popular topic in recent years. Conclusion: Based on the results of the present study, we found that there was no single database covered all relevant articles, the optimal method for bibliometric analysis is a combination of databases. The most popular research topics on PJI focused on alpha-defensin, antibiotic use, risk factors of intra-articular steroid injections, and the location of prosthetic hip and knee infection. Alpha-defensin appears to be a reliable tool for the diagnosis of PJI.

scholarly journals DOES TOPICAL USE OF GENTAMICIN REDUCE THE INFECTION RATE IN PRIMARY TOTAL HIP ARTHROPLASTY?

2019 ◽  
Vol 27 (4) ◽  
pp. 197-201 ◽  
Author(s):  
Caio Luiz de Toledo Oliveira ◽  
Felipe Abrahão Elias ◽  
André dos Santos Ribacionka ◽  
Celso Hermínio Ferraz Picado ◽  
Flávio Luís Garcia
Keyword(s):  
Total Hip Arthroplasty ◽  
Antibiotic Prophylaxis ◽  
Hip Arthroplasty ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
University Hospital ◽  
Fisher Exact Test ◽  
Infection Rates ◽  
Total Hip ◽  
Primary Total Hip Arthroplasty

ABSTRACT Objective: To determine whether the topical use of gentamicin reduces periprosthetic joint infection rates in primary total hip arthroplasty (THA). Methods: We retrospectively evaluated two cohorts of patients who underwent primary THA in a university hospital, with a minimum of 1-year postoperative follow-up and full clinical, laboratory, and radiological documentation. Patients who underwent operation in the first 59 months of the study period (263 hips) received only intravenous cefazolin as antibiotic prophylaxis (Cef group), and those who underwent operation in the following 43 months (170 hips) received intravenous cefazolin plus topical gentamicin directly applied on the wound as antibiotic prophylaxis (Cef + Gen group). For the diagnosis of periprosthetic joint infection, we used the criteria of the Centers for Disease Control and Prevention. Data were analyzed using the Fisher exact test, and p values of <0.05 were considered significant. Results: Thirteen hips (4.9%) in the Cef group and eight hips (4.7%) in the Cef + Gen group presented periprosthetic joint infection. Statistical analysis revealed no difference between the infection rates (p = 1.0). Conclusion: Topical gentamicin as used in this study did not reduce periprosthetic joint infection rates in primary THA. Level of Evidence III, Retrospective comparative study.

scholarly journals Salvage Procedures for Management of Prosthetic Joint Infection After Hip and Knee Replacements

2016 ◽  
Vol 10 (1) ◽  
pp. 600-614 ◽  
Author(s):  
Samer S.S. Mahmoud ◽  
Mohamed Sukeik ◽  
Sulaiman Alazzawi ◽  
Mohammed Shaath ◽  
Omar Sabri
Keyword(s):  
Antibiotic Therapy ◽  
Health Care Systems ◽  
Joint Infection ◽  
Resection Arthroplasty ◽  
Surgical Interventions ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
Prosthetic Joint ◽  
Care Systems ◽  
Suppressive Antibiotic Therapy

Background:The increasing load placed by joint replacement surgery on health care systems makes infection, even with the lowest rates, a serious concern that needs to be thoroughly studied and addressed using all possible measures.Methods:A comprehensive review of the current literature on salvage procedures for recurrent PJIs using PubMed, EMBASE and CINAHL has been conducted.Results:Prolonged suppressive antibiotic therapy (PSAT), resection arthroplasty and arthrodesis were the most common procedures performed. Suppressive antibiotic therapy is based on the use of well tolerated long term antibiotics in controlling sensitive organisms. Resection arthroplasty which should be reserved as a last resort provided more predictable outcomes in the hip whereas arthrodesis was associated with better outcomes in the knee. Various methods for arthrodesis including internal and external fixation have been described.Conclusion:Despite good union and infection control rates, all methods were associated with complications occasionally requiring further surgical interventions.

Assessment of synovial joint fluid

2016 ◽  
Author(s):  
Engy Abdelattif ◽  
Anthony J. Freemont ◽  
DC Mangham
Keyword(s):  
Synovial Fluid ◽  
Joint Infection ◽  
Microscopic Analysis ◽  
Joint Fluid ◽  
Joint Diseases ◽  
Synovial Joint ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
Invasive Test ◽  
Key Steps

Assessment of synovial joint fluid is a simple, cheap, and relatively non-invasive test that can be applied to the whole spectrum of joint diseases, provided there is sufficient fluid within the joint to aspirate. The chapter outlines the key steps in undertaking microscopic analysis of synovial fluid in order to maximize the diagnostic and prognostic return, while placing the features seen within the context of some of the most important joint diseases. The chapter also examines the changing face of microbiological examination of synovial fluid to diagnose joint infection as a primary event and also the increasingly important problem of infection secondary to joint replacement surgery.

scholarly journals Clinical Characteristics, Etiology, and Initial Management Strategy of Newly Diagnosed Periprosthetic Joint Infection: A Multicenter, Prospective Observational Cohort Study of 783 Patients

2020 ◽  
Vol 7 (5) ◽  
Author(s):  
Laurens Manning ◽  
Sarah Metcalf ◽  
Benjamin Clark ◽  
James Owen Robinson ◽  
Paul Huggan ◽  
...  
Keyword(s):  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Acute Infection ◽  
Bloodstream Infections ◽  
Management Approach ◽  
Newly Diagnosed ◽  
Initial Management ◽  
Joint Replacement Surgery ◽  
Mode Of Presentation ◽  
Large Joint

Abstract Background Periprosthetic joint infection (PJI) is a devastating complication of joint replacement surgery. Most observational studies of PJI are retrospective or single-center, and reported management approaches and outcomes vary widely. We hypothesized that there would be substantial heterogeneity in PJI management and that most PJIs would present as late acute infections occurring as a consequence of bloodstream infections. Methods The Prosthetic joint Infection in Australia and New Zealand, Observational (PIANO) study is a prospective study at 27 hospitals. From July 2014 through December 2017, we enrolled all adults with a newly diagnosed PJI of a large joint. We collected data on demographics, microbiology, and surgical and antibiotic management over the first 3 months postpresentation. Results We enrolled 783 patients (427 knee, 323 hip, 25 shoulder, 6 elbow, and 2 ankle). The mode of presentation was late acute (&gt;30 days postimplantation and &lt;7 days of symptoms; 351, 45%), followed by early (≤30 days postimplantation; 196, 25%) and chronic (&gt;30 days postimplantation with ≥30 days of symptoms; 148, 19%). Debridement, antibiotics, irrigation, and implant retention constituted the commonest initial management approach (565, 72%), but debridement was moderate or less in 142 (25%) and the polyethylene liner was not exchanged in 104 (23%). Conclusions In contrast to most studies, late acute infection was the most common mode of presentation, likely reflecting hematogenous seeding. Management was heterogeneous, reflecting the poor evidence base and the need for randomized controlled trials.

scholarly journals Periprosthetic Joint Infections as a Consequence of Bacteremia

2019 ◽  
Vol 6 (6) ◽  
Author(s):  
Meeri Honkanen ◽  
Esa Jämsen ◽  
Matti Karppelin ◽  
Reetta Huttunen ◽  
Antti Eskelinen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Joint Replacement ◽  
Joint Infection ◽  
Tertiary Care ◽  
Care Hospital ◽  
Hip Joint Replacement ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
Staphylococcus Aureus Bacteremia

Abstract Background The risk for developing a periprosthetic joint infection (PJI) during bacteremia is unclear, except for Staphylococcus aureus bacteremia. The aim of this study was to examine the risk for developing a PJI during bacteremia and to identify possible risk factors leading to it. Methods Patients with a primary knee or hip joint replacement performed in a tertiary care hospital between September 2002 and December 2013 were identified (n = 14 378) and followed up until December 2014. Positive blood culture results during the study period and PJIs were recorded. PJIs associated with an episode of bacteremia were identified and confirmed from patient records. Potential risk factors for PJI among those with bacteremia were examined using univariate logistic regression. Results A total of 542 (3.8%) patients had at least 1 episode of bacteremia. Seven percent (47/643) of the bacteremias resulted in a PJI. Development of a PJI was most common for Staphylococcus aureus (21% of bacteremias led to a PJI) and beta-hemolytic streptococci (21%), whereas it was rare for gram-negative bacteria (1.3%). Having ≥2 bacteremias during the study period increased the risk for developing a PJI (odds ratio, 2.29; 95% confidence interval, 1.17–4.50). The risk for developing a PJI was highest for bacteremias occurring within a year of previous surgery. Chronic comorbidities did not affect the risk for PJI during bacteremia. Conclusions The development of a PJI during bacteremia depends on the pathogen causing the bacteremia and the timing of bacteremia with respect to previous joint replacement surgery. However, significant patient-related risk factors for PJI during bacteremia could not be found.

scholarly journals Influence of Antibiotic-Loaded Acrylic Bone Cement Composition on Drug Release Behavior and Mechanism

Polymers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 2240
Author(s):  
I-Cheng Chen ◽  
Chen-Ying Su ◽  
Wei-Han Nien ◽  
Tzu-Tien Huang ◽  
Chang-Hung Huang ◽  
...  
Keyword(s):  
Infection Control ◽  
Bone Cement ◽  
Joint Replacement ◽  
Total Joint Replacement ◽  
Joint Infection ◽  
Acrylic Bone Cement ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
Antibiotic Release

Periprosthetic joint infection (PJI) is a devastating complication after total joint replacement with considerable morbidity and large economic burdens. Antibiotic-Loaded Bone Cement (ALBC) has been developed as a valuable tool for local administration and is becoming one of the most effective methods for the prevention and treatment of orthopedic infections. Controlling antibiotic release from ALBC is critical to achieve effective infection control, however, the antibiotic elution rates are generally low, and the mechanisms are poorly understood. Thus, the present study aims to investigate the effects of the basic acrylic bone cement components, including liquid/powder (monomer-to-polymer) ratios, radiopacifier, initiator, and doses of antibiotics on the porosity, antibiotic elution rates and mechanical properties of polymethylmethacrylate (PMMA) based ALBC. The obtained results from the in vitro studies suggested that a reduction in the liquid/powder ratio and an increase in the radiopacifier ratio and gentamicin doses led to increased porosity and release of antibiotic, while the initiator ratio exerted no effect on elution rates. In conclusion, we hope that by varying the composition of ALBC, we could considerably enhance the antibiotic elution rates by increasing porosity, while maintaining an adequate mechanical strength of the bone cements. This finding might provide insights into controlling antibiotic release from ALBC to achieve effective infection control after total joint replacement surgery.

Sign in / Sign up

Export Citation Format

Share Document