Hip and Knee Section, Diagnosis, Definitions: Proceedings of International Consensus on Orthopedic Infections

Amanatullah, Derek F.; Dennis, Douglas A.; Oltra, Ester Garcia; Gomes, Luiz Humberto; Goodman, Stuart B.; Hamlin, Brian R.; Hansen, Erik N.; Hashemi-Nejad, Aresh; Holst, David C.; Komnos, Georgios; Koutalos, Antonios; Malizos, Konstantinos N.; Pastor, Juan C. Martínez; McPherson, Ed; Meermans, Geert; Mooney, Jake A.; Mortazavi, Seyed Mohammad Javad; Parsa, Ali; Pécora, José Ricardo; Pereira, Gilberto A.; Sabater-Martos, Marta; Shohat, Noam; Shope, Alexander J.; Zullo, Sergio S.

doi:10.1016/j.arth.2018.09.044

Cited by 72 publications

(110 citation statements)

References 92 publications

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“…A retrospective study was carried out using data collected prospectively for all acute infections of total knee and hip arthroplasty from our institution over the period from 2011 to 2015. We included all cases of acute infection (up to 3 weeks after the index surgery) that meet the revised criteria of PJI by the International Consensus on Orthopedic Infection [13] (table A) and had identi cation of the infecting organism in cultures from the initial diagnostic aspiration or intraoperative samples.…”

Section: Methodsmentioning

confidence: 99%

Bacteria drug resistance profile affects knee and hip periprosthetic joint infection outcome with debridement, antibiotics and implant retention

Rudelli

Giglio

Carvalho

et al. 2020

Preprint

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BACKGROUND: debridement, antibiotics and implant retention (DAIR) with the exchange of modular components is the most widely used option for the treatment of acute periprosthetic joint infections. The objective of this study is to evaluate the effect of bacteria drug resistance profile on the success rates of DAIR. METHODS: All early acute periprosthetic infections in hip and knee arthroplasties treated with DAIR at our institution over the period from 2011 to 2015 were retrospectively analyzed. The success rate was evaluated according to the type of organism identified in culture: multidrug-sensitive (MSB), methicillin-resistant Staphylococcus aureus (MRSA), multidrug-resistant Gram-negative bacteria (MRB) and according to other risk factors for treatment failure. The data were analyzed using univariate and multivariate statistics.RESULTS: Fifty-seven patients were analyzed; there were 37 in the multidrug-sensitive bacteria (MSB) group, 11 in the methicillin-resistant Staphylococcus aureus (MRSA) group and 9 in the other multidrug-resistant Gram-negative bacteria (MRB) group. There was a statistically significant difference (p<0.05) in the treatment failure rate among the three groups: 8.3% for the MSB group, 18.2% for the MRSA group and 55.6% for the MRB group (p=0.005). Among the other risk factors for treatment failure, the presence of inflammatory arthritis presented a failure rate of 45.1 (p<0.05).CONCLUSION: DAIR showed a good success rate in cases of early acute infection by multidrug-sensitive bacteria. In the presence of infection by multidrug-resistant bacteria or association with rheumatic diseases the treatment failure rate was higher and other surgical options should be considered in this specific population. The MRSA group showed intermediate results between MSB and MRB and should be carefully evaluated.

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Section: Methodsmentioning

confidence: 99%

Bacteria drug resistance profile affects knee and hip periprosthetic joint infection outcome with debridement, antibiotics and implant retention

Rudelli

Giglio

Carvalho

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…A painful joint is the most sensitive but least specific clinical finding in PJI. 11 Signs of deep tissue involvement (ie, sinus tract, purulence, abscess, and extensive necrosis) are the most specific signs and, when present, justify the condition of major criteria for the diagnosis of PJI. 11,12 Clinical findings differ based on the type of joint involved (hip or knee) as well as on the timing and presentation of PJI (ie, early postoperative, acute hematogenous, and chronic).…”

Section: Diagnosis Of Periprosthetic Joint Infectionmentioning

confidence: 99%

“…11 Signs of deep tissue involvement (ie, sinus tract, purulence, abscess, and extensive necrosis) are the most specific signs and, when present, justify the condition of major criteria for the diagnosis of PJI. 11,12 Clinical findings differ based on the type of joint involved (hip or knee) as well as on the timing and presentation of PJI (ie, early postoperative, acute hematogenous, and chronic). 11 Preoperative synovial fluid culture and serum and synovial fluid analysis for infection markers may be helpful to rule in or rule out PJI (see Table 1).…”

Section: Diagnosis Of Periprosthetic Joint Infectionmentioning

confidence: 99%

“…11,12 Clinical findings differ based on the type of joint involved (hip or knee) as well as on the timing and presentation of PJI (ie, early postoperative, acute hematogenous, and chronic). 11 Preoperative synovial fluid culture and serum and synovial fluid analysis for infection markers may be helpful to rule in or rule out PJI (see Table 1). An important limitation, however, is the considerable percentage of dry taps, that is, cases in which no fluid can be aspirated despite appropriate anatomic location within the prosthetic hip or knee joint capsule.…”

Section: Diagnosis Of Periprosthetic Joint Infectionmentioning

confidence: 99%

“…9,10 Their formation is intrinsic to the pathogenesis of chronic PJI and is beneficial to bacterial survival and antibiotic resistance. [9][10][11]…”

Section: Introductionmentioning

confidence: 99%

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