Risk factors and a prognostic model of hip periprosthetic infection recurrence after surgical treatment using articulating and non-articulating spacers

Tikhilov, Rashid M.; Божкова, С. А.; Денисов, А. О.; Labutin, Dmitry; Shubnyakov, I. I.; Разоренов, В Л; Artyukh, Vasiliy A.; Клиценко, О. А.

doi:10.1007/s00264-015-3072-4

Cited by 20 publications

(20 citation statements)

References 27 publications

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“…Tikhilov et al used total risk score to calculate the risk of infection recurrence after two-stage procedure. They found BMI was identified as one of main factors related to infection recurrence [13]. Our study agreed with Tikhilov et al We used multivariate analysis and found BMI≥30 kg/m 2 was associated with an increased risk for treatment failure following two-stage reimplantation.…”

Section: Discussionsupporting

confidence: 88%

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The risk factors of failed reimplantation arthroplasty for periprosthetic hip infection

Jhan

Lee

et al. 2017

BMC Musculoskelet Disord

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BackgroundTwo-stage reimplantation arthroplasty is one of the standard treatments for chronic periprosthetic joint infection (PJI). Scanty data exist regarding the risk factors for failure after two-stage reimplantation for periprosthetic hip infection. The purpose of this study was to investigate and identify the risk factors associated with failure after two-stage reimplantation hip arthroplasty.MethodsSixty-two patients with hip PJI treated with a two-stage reimplantation protocol at our institution from 2005 to 2012 were reviewed. Patients requiring medical treatment or reoperation for recurrent infection were defined as treatment failure. A multivariate Cox proportional hazards model was used to analyze the risk factors associated with treatment failure.ResultsOf the 62 patients, 11 (17.7%) patients had developed reinfection after the two-stage reimplantation with a mean follow-up of 5.7 years. The implant survival was 82.2% (95% confidence interval [CI] 75.19−92.55) at 10 years. Multivariate analysis revealed BMI ≥30 kg/m2 (hazard ratio [HR] 9.16; 95% CI 1.51−55.3; p = 0.0158), liver cirrhosis (HR 6.39; 95% CI 1.09−37.4; p = 0.0398), gram-negative organism (HR 5.68; 95% CI 1.18−27.4; p = 0.0303), and presence of sinus tract (HR 18.2; 95% CI 2.15−153; p = 0.0077) as the independent risk factors for treatment failure.ConclusionsWe found obesity, liver cirrhosis, gram-negative organism, and the presence of sinus tract were significantly related to the risks of failure after reimplantation arthroplasties.

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Section: Discussionsupporting

confidence: 88%

“…However, few studies have been done to analyze the risk factors of failed reimplantation protocol [6, 13]. The purpose of this study was to investigate the patient-related risk factors associated with treatment failure following the reimplantation protocol in hip PJI.…”

Section: Introductionmentioning

confidence: 99%

The risk factors of failed reimplantation arthroplasty for periprosthetic hip infection

Jhan

Lee

et al. 2017

BMC Musculoskelet Disord

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“…Despite all sterilization conditions and antibiotic prophylaxis, PIJ is seen, even though rarely, and it continues to be the most fearful nightmare of orthopedic surgeons (Zmistowski et al ., ; Tikhilov et al ., ; Yoon et al ., ). Debridement and breaking are performed if PJI occurs in the early period; however, if it is seen late, all the implants are removed and concurrent or two‐stage revision surgery is performed (Tikhilov et al ., ; Yoon et al ., ). However, despite all these treatments, reinfection rates may become 25% after revision surgeries.…”

Section: Discussionmentioning

confidence: 99%

“…The most common gram‐negative bacteria are Pseudomonas aeruginosa and Acinetobacter . PJI recurrences caused by these bacteria are higher than those caused by gram‐positive bacteria (Tikhilov et al ., ). The reason for this is that the active microorganism is unknown and the biofilm layer, which is a formed cause the bacteria to become resistant to treatment.…”

Section: Introductionmentioning

confidence: 97%

N‐acetylcysteine eradicates Pseudomonas aeruginosa biofilms in bone cement

et al. 2016

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Biofilm is an example of bacterial group behavior. We investigated the effect of N-acetylcysteine (NAC) alone and in combination with ciprofloxacin on Pseudomonas aeruginosa biofilm formation. Four groups (each contains six molds) of standardized bone cement molds were infected. NAC, ciprofloxacin each alone, and NAC/ciprofloxacin combination were evaluated in point of inhibiting and eradicating biofilm capacity using microbiological and electron microscopical evaluation techniques. Microbial counts and electron microscopical observations showed that the effect of NAC and ciprofloxacin combination on biofilm formation in bone cement is valuable. NAC enhances the beneficial effect of ciprofloxacin when used in combination with it in bone cement. SCANNING 38:766-770, 2016. © 2016 Wiley Periodicals, Inc.

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“…[3]. Особое место в структуре осложнений занимают инфекционные осложнения [4,5]. doi: 10.21823/2311-2905-2019-25-4-141-149 Early Deep Periprosthetic Hip Infection of Odontogenic Origin (Case Report) T.u Deep periprosthetic joint infection (PJI) is a severe complication after primary and revision hip joint arthroplasty resulting in multiple interventions on the joint.…”

Section: Introductionmentioning

confidence: 99%

Early Deep Periprosthetic Hip Infection of Odontogenic Origin (Case Report)

Шералиев

Павлов

Кретьен

et al. 2019

Traumatology and Orthopedics of Russia

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Deep periprosthetic joint infection (PJI) is a severe complication after primary and revision hip joint arthroplasty resulting in multiple interventions on the joint. The present paper describes a rare case of early deep hip PJI of odontogenic etiology. The patient suffered from early PJI after a planned procedure of left hip joint arthroplasty. Antibacterial therapy without surgical debridement was performed in an outpatient unit which resulted in a late, on day 12th after surgery, admittance of the patient to hospital with continued administration of antibiotics. Treatment tactics was selected upon patient’s admission basing on patient complaints, medical history of the disease, clinical signs and findings of roentgenological, laboratory and bacteriological examinations. Two-stage treatment consisting of revision, removal of implant, debridement, biopsy and wound drainage by a swab was performed and followed by empiric antibacterial therapy (for 5 days). Targeted antibacterial therapy was prescribed basing on bacteriological test findings. Together with dentists the authors examined oral cavity of the patient, identified a site of chronic infection and undertook the focused treatment by dental extraction and sanitation of the oral cavity. Postoperative period after the first stage was uncomplicated. Second stage of revision (re-arthroplasty of left hip joint) was performed on week 36 of the surgical time-out with a good clinical outcome: 80 points on Harris hip score in 40 weeks after the second stage. Presented clinical case illustrates the existence of hematogenous mechanism of postoperative microorganism dissemination from the chronic infection nidus with subsequent progression of inflammation at the surgical site, including PJI. In the present case the Actinomyces odontolyticus was isolated from periprosthetic tissues and parodontal recesses which allowed the authors to suggest a highly probable cause for early PJI by Actinomyces odontolyticus translocation into periprosthetic tissues of the hip joint. However, strain sequencing is required for the complete verification. The described case confirms the need for debridement of chronic infection nidus prior to joint arthroplasty aiming at prevention of hematogenous periprosthetic infection.

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Risk factors and a prognostic model of hip periprosthetic infection recurrence after surgical treatment using articulating and non-articulating spacers

Cited by 20 publications

References 27 publications

The risk factors of failed reimplantation arthroplasty for periprosthetic hip infection

The risk factors of failed reimplantation arthroplasty for periprosthetic hip infection

N‐acetylcysteine eradicates Pseudomonas aeruginosa biofilms in bone cement

Early Deep Periprosthetic Hip Infection of Odontogenic Origin (Case Report)

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