Two-Stage Revision for Prosthetic Joint Infection: Outcome and Role of Reimplantation Microbiology in 107 Cases

Puhto, Ari‐Pekka; Puhto, Teija; Niinimäki, Tuukka; Leppilahti, Juhana; Syrjälä, Hannu

doi:10.1016/j.arth.2013.12.027

Cited by 72 publications

(42 citation statements)

References 36 publications

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“…Furthermore, there is considerable variability in the literature with regard to how these studies define the success of periprosthetic joint infection treatment, which could result in an overestimation of the outcome measures. In addition, the study populations often consist of a small cohort 6 . To accurately depict the clinical course of two-stage exchange, an enhanced understanding of the interstage period is needed.…”

mentioning

confidence: 99%

The Fate of Spacers in the Treatment of Periprosthetic Joint Infection

Gómez

Tan

Manrique

et al. 2015

The Journal of Bone and Joint Surgery

185

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mentioning

confidence: 99%

The Fate of Spacers in the Treatment of Periprosthetic Joint Infection

Gómez

Tan

Manrique

et al. 2015

The Journal of Bone and Joint Surgery

185

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“…Age, gender, comorbidities, American Society of Anesthesiologists (ASA) score, time of primary and revision surgery, microbiological culture results, dosage and duration of antimicrobial therapy, and antibiotics added to spacers were recorded. PJI was defined as the growth of the same microorganism in two or more cultures of synovial fluid or periprosthetic tissue, purulent synovial fluid or purulence at the implant site, acute inflammation upon histopathological examination of the periprosthetic tissue, or the presence of a sinus tract communicating with the prosthesis [ 8 , 9 ]. Polymicrobial PJIs could be defined in the same manner only using the plural form for microorganisms.…”

Section: Methodsmentioning

confidence: 99%

Ertapenem Articulating Spacer for the Treatment of Polymicrobial Total Knee Arthroplasty Infection

Radoicic

Milanovic

Marinkovic

2016

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Introduction. Periprosthetic joint infections (PJIs) are the primary cause of early failure of the total knee arthroplasty (TKA). Polymicrobial TKA infections are often associated with a higher risk of treatment failure. The aim of the study was to assess the efficacy of ertapenem loaded spacers in the treatment of polymicrobial PJI. Methods. There were 18 patients enrolled; nine patients with polymicrobial PJI treated with ertapenem loaded articulating spacers were compared to the group of 9 patients treated with vancomycin or ceftazidime loaded spacers. Results. Successful reimplantation with revision implants was possible in 66.67%. Ertapenem spacers were used in 6 cases in primary two-stage procedure and in 3 cases in secondary spacer exchange. Successful infection eradication was achieved in all cases; final reimplantation with revision knee arthroplasty implants was possible in 6 cases. Conclusion. Ertapenem can be successfully used as antimicrobial addition to the cement spacers in two-stage revision treatment of polymicrobial PJIs. However, this type of spacer may also be useful in the treatment of infections caused by monomicrobial extended spectrum beta-lactamases producing gram-negative bacilli. Further clinical studies are required to evaluate the efficacy and safety of ertapenem spacers in the treatment of polymicrobial and monomicrobial PJIs.

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“…Много раз сообщалось, что микробы, выделенные при реимплантации, отличались от микробов, культивируемых при удалении. Возможная причина роста различных организмов на втором этапе связана с загрязнением образца во время первой операции [18,19,20,21]. В нашем исследовании не удалось установить связь между положительным результатом микробиологического исследования на втором этапе и возникновением рецидива, что может быть связано с небольшим количеством наблюдений и требует проведения более масштабных многоцентровых исследований.…”

Section: статистический анализunclassified

Two-Stage Treatment of Periprostetic Infection: Mid-Term Results

Павлов

Петрова

Шералиев

2019

Traumatology and Orthopedics of Russia

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Purpose — to evaluate the efficiency of two-stage revision arthroplasty performed according to a standardized protocol by a multidisciplinary surgical team. Materials and Methods. 87 patients with deep periprosthetic hip and knee joint infection (PJI) were included into the prospective study. The patients were admitted to the clinic in the period from January 2012 until December 2014 and underwent two-stage revision procedure. First stage included removal of infected implant and insertion of a cemented spacer, second stage — re-implantation of a prosthesis. Results. Re-implantation of a prosthesis was performed in 89.7% (95% CI 82.8–95.4) of cases. Infection recurrence rate was 13.8% (95% CI 6.9–20.7) and 12.8% (95% CI 6.4–21.8) after the first and the second stage, respectively. Overall efficiency of two-stage procedure was 80,5% (95% CI 71.3–88.5) with a median of 4.7 year follow up. Conclusion. Rate of re-implantation, recurrent infection and newly occurred infection should be taken into consideration for evaluation of treatment efficiency. Application of single criteria for assessment of successful treatment outcomes will allow to compare various studies. Positive microbiological tests during the second stage of procedure are not a risk factor for recurrent infection but can be caused by contamination of specimens.

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Two-Stage Revision for Prosthetic Joint Infection: Outcome and Role of Reimplantation Microbiology in 107 Cases

Cited by 72 publications

References 36 publications

The Fate of Spacers in the Treatment of Periprosthetic Joint Infection

The Fate of Spacers in the Treatment of Periprosthetic Joint Infection

Ertapenem Articulating Spacer for the Treatment of Polymicrobial Total Knee Arthroplasty Infection

Two-Stage Treatment of Periprostetic Infection: Mid-Term Results

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