New Innovations in the Treatment of PJI and Biofilms—Clinical and Preclinical Topics

Taha, Mariam; Abdelbary, Hesham; Ross, F. Patrick; Carli, Alberto

doi:10.1007/s12178-018-9500-5

Cited by 41 publications

(44 citation statements)

References 88 publications

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“…Another common possibility, though particularly in chronic PJI, of negative cultures is the presence of biofilms, where the need for a different type of culture may require procedures for accurate diagnosis, such as sonication [39] [40].…”

Section: Discussionmentioning

confidence: 99%

PJI with Sepsis, a Complex Emergency Situation with Prodromal Stage

Haustedt¹,

Chapa²,

Hentschke³

2020

OJO

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Introduction: With a considerable morbidity, mortality and a high financial impact, PJI has been considered as one of the most serious complications after arthroplasty. Special awareness must be given to these patients due to a life threatening systemic PJI related complication, sepsis. A prompt detection and adequate medical management of this situation is crucial for avoiding unfavorable outcomes. Methods: Between January 2011 and December 2012, we retrospectively examined adult patients who met PJI-SIRS criteria. Medical history search for patients' anamnesis, surgical times, laboratory-microbiological findings and success rates was performed. Results: Twenty patients were enrolled in this study with a mean age of 71.35 years. Men population was more commonly affected with 55% of the cases. The knee was mainly the affected joint with 52%. A severe systemic disease was present in 80% of the cases. A sickness sensation and pain were the most common prodromal symptoms found 4.9 days before the admission to the hospital. In 85.

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Section: Discussionmentioning

confidence: 99%

PJI with Sepsis, a Complex Emergency Situation with Prodromal Stage

Haustedt¹,

Chapa²,

Hentschke³

2020

OJO

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“…Against S. aureus biofilm, rifampicin is the most common partner drug of effective combinations which were demonstrated in vitro and in vivo [ 34 , 100 ]. New antibiotics, such as oritavancin, have to deal with MRSA and vancomycin-resistant S. aureus , and also with intracellular bacteria—i.e., internalized bacteria in host cells—as rifampicin does, in order to show a better bacterial burden clearance [ 64 , 101 , 102 ]. To enhance these results, new antibiofilm molecules should probably be tested in combination with a classic antibiotic such as rifampicin in order to look for synergistic effects and act against all types of metabolism activities.…”

Section: Emergent Antibiofilm Strategies In Periprosthetic Joint Imentioning

confidence: 99%

“…AMPs are also promising because their activity as antibiofilm molecules can be independent of their activity against planktonic bacteria [ 88 ]. Associated with their low cytotoxicity and their activity against MRSA biofilm in vitro and in vivo, these characteristics arise in AMPs as serious candidates to investigate [ 101 , 105 ]. They also showed efficiency against slow-growing or dormant bacteria [ 106 ].…”

Section: Emergent Antibiofilm Strategies In Periprosthetic Joint Imentioning

confidence: 99%

Antibiotic Tolerance of Staphylococcus aureus Biofilm in Periprosthetic Joint Infections and Antibiofilm Strategies

et al. 2020

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The need for bone and joint prostheses is currently growing due to population aging, leading to an increase in prosthetic joint infection cases. Biofilms represent an adaptive and quite common bacterial response to several stress factors which confer an important protection to bacteria. Biofilm formation starts with bacterial adhesion on a surface, such as an orthopedic prosthesis, further reinforced by matrix synthesis. The biofilm formation and structure depend on the immediate environment of the bacteria. In the case of infection, the periprosthetic joint environment represents a particular interface between bacteria, host cells, and the implant, favoring biofilm initiation and maturation. Treating such an infection represents a huge challenge because of the biofilm-specific high tolerance to antibiotics and its ability to evade the immune system. It is crucial to understand these mechanisms in order to find new and adapted strategies to prevent and eradicate implant-associated infections. Therefore, adapted models mimicking the infectious site are of utmost importance to recreate a relevant environment in order to test potential antibiofilm molecules. In periprosthetic joint infections, Staphylococcus aureus is mainly involved because of its high adaptation to the human physiology. The current review deals with the mechanisms involved in the antibiotic resistance and tolerance of Staphylococcus aureus in the particular periprosthetic joint infection context, and exposes different strategies to manage these infections.

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“…Nonetheless, these implants are nonfunctional and do not articulate within a weight‐bearing joint. A murine model that utilizes a load‐bearing implant to effectively mimic the periprosthetic environment would be an ideal preclinical platform for basic scientists conducting orthopaedic research aimed at improving implant longevity 12‐16,21 . This approach has been attempted previously: Carli et al 14 described a model of PJI in the mouse knee; Jie et al 13 summarized several animal models of PJI in the knee, and; Powers et al 21 described a rat model of cemented total hip replacement.…”

Section: Introductionmentioning

confidence: 99%

Image‐based design and 3D‐metal printing of a rat hip implant for use in a clinically representative model of joint replacement

Paish

Nikolov

Welch

et al. 2020

Journal Orthopaedic Research

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The aim of this study was to obtain micro‐computed tomography derived measurements of the rat proximal femur, to create parameterized rat hip implants that could be surgically installed in a clinically representative small animal model of joint replacement. The proximal femoral anatomy of N = 25 rats (male, Sprague‐Dawley, 390‐605 g) was quantified. Key measurements were used to parameterize computer‐aided design models of monoblock rat femoral implants. Linear regression analysis was used to determine if rat hip dimensions could be predicted from animal weight. A correlation analysis was used to determine how implants could be scaled to create a range of sizes. Additive manufacturing (3D printing) was used to create implants in medical‐grade metal alloys. Linear regressions comparing rat weight to femoral head diameter and neck‐head axis length revealed a significant nonzero slope (P < .05). Pearson's correlation analysis revealed five significant correlations between key measurements in the rat femur (P < .05). Implants were installed into both cadaveric and live animals; iterative design modifications were made to prototypes based on these surgical findings. Animals were able to tolerate the installation of implants and were observed ambulating on their affected limbs postoperatively. Clinical significance: We have developed a preclinical rat hip hemiarthroplasty model using image‐based and iterative design techniques to create 3D‐metal printed implants in medical‐grade metal alloys. Our findings support further development of this model for use as a low‐cost translational test platform for preclinical orthopaedic research into areas such as osseointegration, metal‐on‐cartilage wear, and periprosthetic joint infection.

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New Innovations in the Treatment of PJI and Biofilms—Clinical and Preclinical Topics

Cited by 41 publications

References 88 publications

PJI with Sepsis, a Complex Emergency Situation with Prodromal Stage

PJI with Sepsis, a Complex Emergency Situation with Prodromal Stage

Antibiotic Tolerance of Staphylococcus aureus Biofilm in Periprosthetic Joint Infections and Antibiofilm Strategies

Image‐based design and 3D‐metal printing of a rat hip implant for use in a clinically representative model of joint replacement

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