Das infizierte Implantat

Geipel, Udo; Herrmann, M.

doi:10.1007/s00132-004-0741-1

Cited by 59 publications

(20 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Without pathogen detection, targeted antimicrobial therapy is impossible and the chances of eradication are diminished. Miscalculated antibiotic treatment can involve the potential induction of "small colony variants" or the development of resistances [13]. The strategy of a one-step exchange therefore remains under controversial discussion.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of an interdisciplinary therapy algorithm in patients with prosthetic joint infections

Wimmer

Randau

Petersdorf

et al. 2013

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

Purpose Current concepts in the treatment of prosthetic joint infections include prosthetic retention and exchange strategies according to published recommendations. A useful algorithm should fit for each type of prosthetic joint infection, even the most complicated situations. We present the outcome of 147 patients with prosthetic joint infections of the hip or the knee joint in an unselected population in clinical routine. Methods Between November 2006 and November 2009, 147 consecutive patients with prosthetic joint infections of the hip or knee were treated according to an algorithm based on the concept published by Zimmerli et al. in 2004. Causative organism, duration of infection, patient comorbidities, surgical treatment, antibiotic treatment, and outcome of treatment were analysed retrospectively. According to the criteria duration of infection, stability of prosthesis, local and systemic risk factors, and susceptibility of the causative pathogen, patients were treated either with debridement and retention or a longinterval two-stage procedure. Results A pathogen could be detected in 82.8 % of the patients, gram-positive cocci being most common. Twentyseven patients were treated with debridement and retention and 120 were treated with a two-stage procedure. In 68 cases difficult-to-treat pathogens could be detected, a polymicrobial infection was found in 51 patients. Definitely free of infection were 71.6 % after a two-stage procedure, and 70.4 % after debridement and retention. Conclusions Our data indicates that the applied algorithm is suitable to be applied as a day-to-day routine, and we confirmed that published results from the literature can be reproduced in an inhomogeneous patient cohort.

show abstract

Section: Introductionmentioning

confidence: 99%

Evaluation of an interdisciplinary therapy algorithm in patients with prosthetic joint infections

Wimmer

Randau

Petersdorf

et al. 2013

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

“…The majority of these implants reside within these tissues infectionfree; a small percentage, however, become infected. The incidence of infection (Periprosthetic Joint Infection, PJI) following total joint arthroplasty, ranges from 1 % to 4 % for primary total knee arthroplasty and 1 % to 2 % for primary total hip arthroplasty (Cierny et al, 2002;McPherson et al, 2002;Geipel and Herrmann, 2004). These infections are thought to be due to the formation of a biofilm on the surface of the implant.…”

Section: The Need For Implant Tethered Antibioticsmentioning

confidence: 99%

Molecular engineering of an orthopaedic implant: from bench to bedside

Shapiro

Hickok²,

Parvızı³

et al. 2012

eCM

View full text Add to dashboard Cite

The use of metallic implants has revolutionised the practice of orthopaedic surgery. While the safety and biocompatibility of these devices are excellent, a small percentage becomes infected. These infections are due to the formation of a biofilm that harbours bacteria encased in a complex extracellular matrix. The matrix serves as a barrier to immune surveillance as well as limiting the biocidal effects of systemic and local antibiotics. The objective of the review is to describe a novel approach to controlling implant infection using an antibiotic that is linked to titanium through a self-assembled monolayer of siloxy amines. We show that the hybrid-engineered surface is stable, biocompatible and resists colonisation by bacterial species most commonly associated with implant-related infections. Studies with rodent bone infection models suggest that the engineered titanium surface prevents bone infection. Results of a very recent investigation utilising a sheep model of infection indicate that the titanium-tethered antibiotic controls infection without compromising bone formation and remodelling. From all of these perspectives, the tethered antibiotic holds promise of providing a novel and practical approach to reducing implant-associated infections.

show abstract

“…Diese Tatsache ist die Erklärungsgrundlage dafür, dass schon eine sehr geringe Anzahl von Bakterien in der Lage ist, die Infektion auszulösen und zu unterhalten [12,15,36,37]. Die Bakterien können in Anwesenheit [16] hat diesen Mechanismus mit dem Ausdruck 7 "race for the surface" gekennzeichnet.…”

Section: Theoretische Grundlagenunclassified

Management des Protheseninfektes

Friesecke

Wodtke

2008

Chirurg

View full text Add to dashboard Cite

Periprosthetic infection is a permanent risk and severe complication in joint arthroplasty. Systematic diagnostics under optimal conditions are necessary for a successful therapy. Patient history, clinical examination and an elevated CRP-level is the basis for suspicion of infection. The diagnosis is confirmed by identification of the pathogen from a sample collected through joint aspiration under sterile conditions. The microbiological examination is done in a laboratory specialized in the diagnosis of foreign body infections. The pattern of resistance of the identified pathogen determines the topical and systemic course of antibiotics. Surgical treatment is characterized by exchange of the prosthesis and radical debridement. The exchange can be carried out in one or two stages. The one-stage exchange offers several advantages compared to two or more stage procedures for all those involved - patient, surgeon and health care system - while providing the same chance of successful elimination of infection, with even better functional results.

show abstract

Das infizierte Implantat

Cited by 59 publications

References 26 publications

Evaluation of an interdisciplinary therapy algorithm in patients with prosthetic joint infections

Evaluation of an interdisciplinary therapy algorithm in patients with prosthetic joint infections

Molecular engineering of an orthopaedic implant: from bench to bedside

Management des Protheseninfektes

Contact Info

Product

Resources

About