Periprosthetic Infection Following Total Knee Arthroplasty

Abstract

Additional information is available at the end of the chapter http://dx.doi.org/10.5772/53250 . IntroductionOne of the most devastating complications of prosthetic knee arthroplasty is a periprosthetic infection. This complication occurs in -% of knee arthroplasties [ , ] and can exceed % in immunocompromized individuals [ ] and % after revision surgery [ ]. Prosthetic infection leads to loosening of the implant, [ , ]. In this circumstances revision surgery is required. Because of the diversity of the clinical presentation, i.e. early, intermediate or late infection [ ], different surgical methods to treat infected knee prostheses were developed [ , ]. Several treatment methods became well accepted but others are still controversial. In the present review we intend to describe mainly the diagnostic tools for detection of infection and commonly used treatment methods in failed total knee arthroplasty due to infection, with special emphasis on the surgical techniques. Additionally we will describe some trends for the future improvement of the treatment modalities. . Pathology and microbiologyThe main infecting pathogens, around %, of knee prostheses, are the different strains of Staphylococci, e.g. coagulase negative Staphylococci cause around % of knee prostheses infections and Staphylococcus aureus is responsible for % of infections, according to pooled data from nine different studies [ ]. Most of the clinically significant infections are caused by biofilm producing microorganisms. The role of biofilms in pathogenesis of periprosthetic infection is the masking of the pathogens from bodily immune response and antibiotic access. Biofilm is a biological

A resorbable antibiotic eluting bone void filler for periprosthetic joint infection prevention

“…8 Consequently, high concentrations of antibiotics, which produce myriad side effects attributable to toxicity, are required to treat PJI. 9 Finally, ALBC lacks osteoconductivity, serves as a foreign body for bacterial adhesion, 10 and can elute antibiotic for long durations at subtherapeutic levels-often resulting in the development of antibiotic resistant pathogens. 4,5 The multiple shortcomings of the current approaches have led to exploration of other treatment options for PJI.…”

Microbial biofilm formation: a need to act

“…Description of the non-canonical c-di-GAMP as a eukaryotic second messenger produced after sensing of microbial DNA by cyclic GMP-AMP synthase cGAS [44,142] [143], in part b and c reproduced from [144], in part f reproduced from [145]. Image in part d reproduced from (http://portal.pedagogy-inc.com/Demo/Content/111/2/38.aspx) with permission, in part e reproduced from [146] with permission of Macmillan Publishers Ltd, all rights reserved, in part g reproduced from [147] with permission of Elsevier B.V., all rights reserved,; in part h reproduced from [148] with permission of Future Medicine Ltd.…”

Knee joint arthrodesis in non-specific purulent osteoarthritis using external fixation device

“…Время наступления анкилоза у пациентов при остеосинтезе различными методами при АКС составляет 5,1-9 мес. [4,[12][13][14][15]25] (табл. 2).…”

“…В настоящее время травматологи и ортопеды широко применяют аппараты внешней фиксации (АВФ) не только с целью репозиции и иммобилизации фрагментов после переломов, исправ-ления деформаций, но и при артродезировании суставов конечностей [3,[9][10][11][12]. Различают три вида артродеза: внутрисуставной, внесуставной и комбинированный (рис.…”

“…Различают три вида артродеза: внутрисуставной, внесуставной и комбинированный (рис. 1) [3,9,10,[12][13][14][15].…”