Failed 2-Stage Revision Knee Arthroplasty for Periprosthetic Joint Infection—Patient Characteristics and Outcomes

Shichman, Ittai; Ward, Spencer; Lu, Laura; Garceau, Simon; Piuzzi, Nicolás S.; Seyler, Thorsten M.; Schwarzkopf, Ran

doi:10.1016/j.arth.2023.04.063

Cited by 6 publications

(1 citation statement)

References 31 publications

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“…However, the question of which of the two procedures is more likely to produce the better outcome remains unclear in some studies 8 . Despite these invasive procedures, relapse can be frequent 9 – 11 . Health care costs for treatment of prosthetic joint infections (PJI) in the US alone were approximately $1.6 billion in 2020 12 .…”

Section: Introductionmentioning

confidence: 99%

Intermittent alternating magnetic fields diminish metal-associated biofilm in vivo

Shaikh,

Lapin,

Prasad

et al. 2023

Sci Rep

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Prosthetic joint infection (PJI) is a complication of arthroplasty that results in significant morbidity. The presence of biofilm makes treatment difficult, and removal of the prosthesis is frequently required. We have developed a non-invasive approach for biofilm eradication from metal implants using intermittent alternating magnetic fields (iAMF) to generate targeted heating at the implant surface. The goal of this study was to determine whether iAMF demonstrated efficacy in an in vivo implant biofilm infection model. iAMF combined with antibiotics led to enhanced reduction of biofilm on metallic implants in vivo compared to antibiotics or untreated control. iAMF-antibiotic combinations resulted in a > 1 − log further reduction in biofilm burden compared to antibiotics or iAMF alone. This combination effect was seen in both S. aureus and P. aeruginosa and seen with multiple antibiotics used to treat infections with these pathogens. In addition, efficacy was temperature dependent with increasing temperatures resulting in a greater reduction of biofilm. Tissue damage was limited (< 1 mm from implant-tissue interface). This non-invasive approach to eradicating biofilm could serve as a new paradigm in treating PJI.

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Section: Introductionmentioning

confidence: 99%

Intermittent alternating magnetic fields diminish metal-associated biofilm in vivo

Shaikh,

Lapin,

Prasad

et al. 2023

Sci Rep

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Clinical outcome and survival rate of condylar constrained knee prosthesis in revision total knee arthroplasty: an average nine point six year follow-up

Yu,

Xu,

Weng

et al. 2024

International Orthopaedics (SICOT)

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Diamond-like carbon (DLC) surface treatment decreases biofilm burden by S. aureus on titanium alloy in vitro— a pilot study

Visperas,

Cui,

Alam

et al. 2024

Eur J Orthop Surg Traumatol

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Purpose Periprosthetic joint infection is a complication of total joint arthroplasty with treatment costs over $1.6 billion dollars per year in the US with high failure rates. Therefore, generation of coatings that can prevent infection is paramount. Diamond-like carbon (DLC) is an ideal coating for implants as they are wear-resistant, corrosion-resistant, inert, and have a low friction coefficient. The purpose of this study was to test the efficacy of DLC surface treatment in prevention of biofilm on titanium discs infected with Staphylococcus aureus in vitro. Methods Titanium alloy discs (n = 4 non-coated and n = 4 DLC-coated) were infected with 5 × 105 colony-forming units (CFU) of S. aureus for 2 weeks then analysed via crystal violet and scanning electron microscopy (SEM). Results Crystal violet analysis yielded differences in the appearance of biofilm on implant surface where DLC-coated had a clumpier appearance but no difference in biofilm quantification. Interestingly, this clumpy appearance did lead to differences in SEM biofilm coverage where significantly less biofilm coverage was found on DLC-coated discs (81.78% vs. 54.17%, p < 0.003). Conclusion DLC-coated titanium alloy implants may have preventative properties in S. aureus infection. Observing differences in biofilm coverage does warrant additional testing including CFU titration and biofilm kinetics with eventual use in an animal model of periprosthetic joint infection.

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Failed 2-Stage Revision Knee Arthroplasty for Periprosthetic Joint Infection—Patient Characteristics and Outcomes

Cited by 6 publications

References 31 publications

Intermittent alternating magnetic fields diminish metal-associated biofilm in vivo

Intermittent alternating magnetic fields diminish metal-associated biofilm in vivo

Clinical outcome and survival rate of condylar constrained knee prosthesis in revision total knee arthroplasty: an average nine point six year follow-up

Diamond-like carbon (DLC) surface treatment decreases biofilm burden by S. aureus on titanium alloy in vitro— a pilot study

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