Der Orthopäde
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Case Reports
[Risk factors for failed cleansing following periprosthetic delayed hip prosthesis infection].
Despite extensive cleansing concepts recurrent infections are relatively common especially for infections of hip prostheses. The aim of this retrospective study was to identify factors which hinder cleansing and facilitate recurrence. ⋯ A poorer general physical condition and resistant infectious pathogens are the main risk factors for recurrent infections following prosthesis reimplantation. Therefore, a different treatment concept should be used for polymorbid patients with resistant pathogen infections.
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Review
[Antiplatelet therapy after coronary stenting and its importance in total joint arthroplasty].
Coronary stenting is an effective treatment for reopening atherosclerotic occlusions of coronary arteries. Depending on the manifestation of coronary artery disease (stable CAD or acute coronary syndrome) and on the type of implanted stent, dual antiplatelet therapy is recommended for a period of 4 weeks to 12 months. In this period total joint replacement is associated with high blood loss and high perioperative morbidity. ⋯ The surgery should be scheduled after the dual antiplatelet therapy is replaced by lifelong aspirin therapy. On the other hand, if surgery cannot be postponed perioperative bridging of dual antiplatelet therapy can be conducted to minimize bleeding complications with the best possible stent protection. Lifelong therapy with aspirin should not be discontinued in any case.