Quantifying the Burden of Revision Total Joint Arthroplasty for Periprosthetic Infection

Kamath, Atul F.; Ong, Kevin; Lau, Edmund; Chan, Vanessa; Vail, Thomas P.; Rubash, Harry E.; Berry, Daniel J.; Bozic, Kevin J.

doi:10.1016/j.arth.2015.03.035

Cited by 249 publications

(144 citation statements)

References 52 publications

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“…However, very few studies have looked at burden of infection in total joint arthroplasty. Kamath et al., using the US National Impatient Sample (NIS) from 2005-2010, demonstrated that PJI was the most common reason for revision TKA (25%) and third most common reason for revision THA (15.4%) [21]. They used the term “burden”, however, as the strain placed on the surgeon, patients, and healthcare system rather than a mathematical formula.…”

Section: Discussionmentioning

confidence: 99%

Infection burden in total hip and knee arthroplasties: an international registry-based perspective

et al. 2017

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BackgroundInfection remains a leading cause of failure of hip and knee replacements. Infection burden is the ratio of implants revised for infection to the total number of arthroplasties in a specific period, measuring the steady state of infection in a registry. We hypothesized infection burden would be similar among arthroplasty registries.MethodsWe evaluated publicly reported data from 6 arthroplasty registries (Australian Orthopaedic Association National Joint Replacement Registry [AOANJRR], New Zealand Joint Registry, Swedish Hip Arthroplasty Register, Swedish Knee Arthroplasty Register, National Joint Registry of England, Wales, Northern Ireland, and the Isle of Man, and the American Joint Replacement Registry) for revisions performed with an infection diagnosis over the last 6 years.ResultsThe 2015 hip infection burden varied between registries from 0.76% (AOANJRR) to 1.24% (Swedish Hip Arthroplasty Register), and the unweighted overall average for hip infection burden was 0.97%. In 2012, 2013, and 2014, average hip infection burden held steady at 0.87%, 0.93%, and 0.94%, respectively, higher than the preceding 2 years. The 2015 knee infection burden varied from 0.88% (AOANJRR) to 1.28% (Swedish Knee Arthroplasty Register), and the unweighted average was 1.03%. In 2012, 2013, and 2014, knee infection burden was 1.04%, 1.11%, and 1.02%, respectively. These numbers were also higher than the preceding 2 years.ConclusionsInfection burden may be one measure of the overall success in registry populations as well as monitoring the steady state of infection worldwide. Despite global efforts to reduce postoperative infection, infection burden has actually increased in the selected registries over time.

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Section: Discussionmentioning

confidence: 99%

Infection burden in total hip and knee arthroplasties: an international registry-based perspective

et al. 2017

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“…Moreover, given the increasing number of hip and knee arthroplasties performed, the prevalence of this complication is rising, with increasing costs for national health systems and increasing biological costs for the patients, such as loss or reduced joint function and deterioration in their physical and psychological health 7.…”

Section: Introductionmentioning

confidence: 99%

Hyaluronic Acid and Its Composites as a Local Antimicrobial/Antiadhesive Barrier

Romanò¹,

Vecchi

Bortolin

et al. 2017

J. Bone Joint Infect.

119

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Living in biofilms is probably the most common condition for bacteria and fungi and biofilm-related infections account for the majority of bacterial infectious diseases worldwide.Among others biofilm-related infections, those associated with implanted biomaterials have an enormous and still largely underestimated impact in orthopaedics and trauma, cardio-surgery and several other surgical disciplines.Given the limited efficacy of existing antibiotics in the prevention and treatment of bacterial biofilms, new strategies are needed to protect implants and host tissues, overcoming the striking ability of the microorganisms to adhere on different surfaces and to immediately protect themselves by forming the biofilm matrix.Adhesion is a necessary first step in microbial colonization and pathogenesis and provides a potential target for new preventive and treatment approach.Among various polymers, tested as antibacterial coatings, hyaluronic acid and some of its composites do offer a well-established long-term safety profile and a proven ability to reduce bacterial adhesion and biofilm formation.Aim of the present review is to summarize the available evidence concerning the antiadhesion/antibiofilm activity of hyaluronic acid and some of its derivatives to reduce/prevent bacterial adhesion and biofilm formation in various experimental and clinical settings.

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“…A retrospective analysis of 450 clinics in the Western part of Germany by using a questionnaire revealed a prevalence of about 5-6% of septic arthroplastic revisions related to the numbers of implant placements [1]. In USA, the Nationwide Inpatient Sample (Q4 2005–2010) was analyzed for more than 200 thousand revisions of total hip arthroplasties (THA) and for more than 300 thousand revisions of total knee arthroplasties (TKA); periprosthetic joint infection was the most common reason for revision of TKA (25%) and the third most common reason for revision of THA (15.4%) [2]. …”

Section: Introductionmentioning

confidence: 99%

“…The treatment of prosthetic joint infections is mostly a two-stage revision by using polymethylmethacrylate (PMMA) bone cement as spacer [1, 2]. This standard procedure for managing of infected TKAs and THAs consists of debridement with hardware removal, local and systemic antibiotic therapy, and delayed reimplantation [7].…”

Section: Introductionmentioning

confidence: 99%

Activity of Fosfomycin- and Daptomycin-Containing Bone Cement on Selected Bacterial Species Being Associated with Orthopedic Infections

Eick

Hofpeter

Sculean

et al. 2017

BioMed Research International

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The purpose of this study was to determine activity of fosfomycin/gentamicin and daptomycin/gentamicin-containing PMMA bone-cement against Staphylococcus aureus (MRSA, MSSA), Staphylococcus epidermidis, Enterococcus faecium (VRE), and E. coli (ESBL; only fosfomycin). Test specimens of the bone cement were formed and bacteria in two concentrations were added one time or repeatedly up to 96 h. All fosfomycin-containing cement killed ultimately all MSSA, Staphylococcus epidermidis, and E. coli within 24 h; growth of MRSA was suppressed up to 48 h. Activity of daptomycin-containing cement depended on the concentration; the highest concentrated bone cement used (1.5 g daptomycin/40 g of powder) was active against all one-time added bacteria. When bacteria were added repeatedly to fosfomycin-containing cement, growth was suppressed up to 96 h and that of MRSA and VRE only up to 24 h. The highest concentration of daptomycin suppressed the growth of repeated added bacteria up to 48 h (VRE) until 96 h (MSSA, MRSA). In conclusion, PMMA bone cement with 1.5 g of daptomycin and 0.5 g of gentamicin may be an alternative in treatment of periprosthetic infections caused by Gram-positive bacteria.

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Quantifying the Burden of Revision Total Joint Arthroplasty for Periprosthetic Infection

Cited by 249 publications

References 52 publications

Infection burden in total hip and knee arthroplasties: an international registry-based perspective

Infection burden in total hip and knee arthroplasties: an international registry-based perspective

Hyaluronic Acid and Its Composites as a Local Antimicrobial/Antiadhesive Barrier

Activity of Fosfomycin- and Daptomycin-Containing Bone Cement on Selected Bacterial Species Being Associated with Orthopedic Infections

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