Peri-Prosthetic Joint Infection: Prevention, Diagnosis and Management

Cassar-Gheiti, Adrian J.; Mulhall, Kevin

doi:10.5772/53247

Cited by 3 publications

(2 citation statements)

References 183 publications

(213 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hair removal immediately prior to surgery should be performed with clippers and not razors. 33,34 Laminar airflow in the operating room remains However, it is still less effective than proper techniques and correction of errors in the operating room. 35,36 The surgeon's operative technique and expertise that ameliorate the duration of surgery, hemostasis, gentle handling of tissue, and the eradication and removal of dead space are believed to lower the risk of infection.…”

Section: Preventionmentioning

confidence: 98%

“…Such a clinical presentation should be considered to be associated with infection until proved otherwise. 29,33 Of note, fever during the first week after arthroplasty is frequent and may only reflect inflammation. Thus, it should be considered as part of the diagnosis of PJI only if other clinical manifestations or biomarkers appear relevant, or in specific cases of patients with comorbidities such as neutropenia.…”

Section: Clinical Presentationmentioning

confidence: 99%

See 1 more Smart Citation

Optimal diagnosis, prevention, and management of periprosthetic joint infection

Tafer

Belaieff²,

Cuérel³

et al. 2015

ORR

View full text Add to dashboard Cite

The pace of the aging population is steadily rising worldwide with a parallel increase in the demand for joint replacement procedures. With the increasing number of patients undergoing arthroplasty, there is also an increased risk for arthroplasty infection that may lead to severe complications, poorer outcome, and substantial extra costs for health care systems. Current rates of prosthetic joint infection are not dramatically different from the 1960s or 1970s, but some general principles are now better defined, and their management has been studied extensively during the past decades, thus resulting in a change in clinical practice. The purpose of this review is to summarize important principles of prosthetic joint infection to guide the clinician and to contribute to the optimal diagnosis, prevention, and management of periprosthetic joint infections.

show abstract

Section: Preventionmentioning

confidence: 98%

Section: Clinical Presentationmentioning

confidence: 99%

Optimal diagnosis, prevention, and management of periprosthetic joint infection

Tafer

Belaieff²,

Cuérel³

et al. 2015

ORR

View full text Add to dashboard Cite

show abstract

Microfluidic processing of synovial fluid for cytological analysis

Krebs

Alapan

Dennstedt

et al. 2017

Biomed Microdevices

View full text Add to dashboard Cite

Cytological analysis of synovial fluid is widely used in the clinic to assess joint health and disease. However, in general practice, only the total number of white blood cells (WBCs) are available for cytologic evaluation of the joint. Moreover, sufficient volume of synovial aspirates is critical to run conventional analyses, despite limited volume of aspiration that can normally be obtained from a joint. Therefore, there is a lack of consistent and standardized synovial fluid cytological tests in the clinic. To address these shortcomings, we developed a microfluidic platform (Synovial Chip), for the first time in the literature, to achieve repeatable, cost- and time-efficient, and standardized synovial fluid cytological analysis based on specific cell surface markers. Microfluidic channels functionalized with antibodies against specific cell surface antigens are connected in series to capture WBC subpopulations, including CD4+, CD8+, and CD66b+ cells, simultaneously from miniscule volumes (100 μL) of synovial fluid aspirates. Cell capture specificity was evaluated by fluorescent labeling of isolated cells in microchannels and was around 90% for all three WBC subpopulations. Furthermore, we investigated the effect of synovial fluid viscosity on capture efficiency in the microfluidic channels and utilized hyaluronidase enzyme treatment to reduce viscosity and to improve cell capture efficiency (>60%) from synovial fluid samples. Synovial Chip allows efficient and standardized point-of-care isolation and analysis of WBC subpopulations in miniscule volumes of patient synovial fluid samples in the clinic.

show abstract

Importance of the Algorithm for Diagnosis of Late Deep Periprosthetic Hip Infection

Куковенко¹,

Елизаров²,

Алексеев³

et al. 2019

Traumatology and Orthopedics of Russia

View full text Add to dashboard Cite

Relevance. Late deep periprosthetic infection (PJI) of the hip joint is a serious complication after arthroplasty which takes the lead among the world reasons for revision. Accurate diagnostics allows to achieve good results and select a proper treatment tactics. Purpose of the study — to evaluate the efficiency of diagnostics algorithm for late deep PJI and impact of the microbial landscape on the risk of infection recurrence. Materials and methods. The authors evaluated two groups of patients who underwent revision in the period from 2002 to 2014 and from 2015 to 2018. The first (retrospective) group included 144 patients who were not diagnosed for late deep PJI. The second (prospective) group included 157 patients who underwent detailed diagnostics for late deep PJI based on the algorithm including the analysis of x-rays, pelvic CT, triple evaluation of ESR and CRP, puncturing of affected joint and microbiology examination. The authors assessed the microbial landscape in 51 patients with late deep hip PJI. Results. In the first group 12 patients (8.3%) underwent sanation and spacer insertion during first stage of treatment, 46 patients (59.7%) after revision demonstrated positive intraoperative cultures confirming septic etiology of implant loosening, 19 patients (24.67%) had no flora growth, and no intraoperative microbiological examination was done for remaining 67 patients (46.52%). In the second group after detailed diagnostics 51 patients (32.4%) underwent removal of prosthesis and spacer insertion in the first stage, other 13 patients (8.2%) featured flora growth after revision, remaining 93 patients (59.2%) had no flora growth after revision. Recurrent PJI was observed in 21 patients (14.5%) in the first group, and in 10 patients (6.3%) in the second group. In the second group recurrent PJI was reported in 40% of patients due to microbial associations, in 30% — due to MRSA, in 20% — due to culture negative bacteria and in 10% — due to S. aureus. Conclusion. Triple examination allows to obtain an accurate diagnosis and isolate the pathogen for deep PJI. Application of such diagnostics algorithm allows to reduce 2.1 times the risk of recurrent deep PJI and to scale down 4 times the detection of type IV infection by Coventry–Tsukayama classification.

show abstract

Peri-Prosthetic Joint Infection: Prevention, Diagnosis and Management

Cited by 3 publications

References 183 publications

Optimal diagnosis, prevention, and management of periprosthetic joint infection

Optimal diagnosis, prevention, and management of periprosthetic joint infection

Microfluidic processing of synovial fluid for cytological analysis

Importance of the Algorithm for Diagnosis of Late Deep Periprosthetic Hip Infection

Contact Info

Product

Resources

About