Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2024
Gram negative periprosthetic hip infection: nearly 25% same pathogen infection persistence at a mean of 2 years.
While gram negative (GN) periprosthetic joint infections (PJI) have previously been described as difficult to treat pathogens with high rates of reinfection, limited investigations have addressed midterm outcomes and risk of infection persistence by the same pathogen. This study analyzed (1) baseline demographics, treatment strategy, and midterm outcomes of GN PJIs, as well as (2) differences in reinfection and relapse rates compared to gram positive (GP) PJIs. ⋯ Therapeutic Level III.
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Arch Orthop Trauma Surg · Dec 2024
Preoperative MRSA screening using a simple questionnaire prior elective total joint replacement.
The purpose of this study was to evaluate the management and results of our standarized protocol for preoperative identification of MRSA colonisation in patients undergoing primary total hip and knee replacement procedures. ⋯ Our results suggest that the simple and standardized questionnaire is a valuable tool for preoperative screening, effectively identifying high-risk patients prone to MRSA colonisation. The risk of periprosthetic joint infection (PJI) and its associated sequelae may be reduced by this approach.
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Arch Orthop Trauma Surg · Dec 2024
ReviewAntibiotic-loaded cement in total joint arthroplasty: a comprehensive review.
This review evaluates the decision-making framework for using antibiotic-loaded cement (ALC) in the management of prosthetic joint infection (PJI). Drawing on available literature, we offer orthopaedic surgeons a guided discussion on several critical considerations. First, we explore the impact of antibiotic-loading on the mechanical properties of polymethylmethacrylate (PMMA) cement, assessing both strength and durability. ⋯ Furthermore, we explore how cement and antibiotic properties affect the overall antibiotic elution characteristics of ALC. Finally, we discuss risks of systemic toxicity, particularly acute kidney injury, when using ALC. The principal goal in this review is to provide a balanced approach based on best available evidence that optimises antibiotic elution from ALC whilst minimising potential harms associated with its use.
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Arch Orthop Trauma Surg · Nov 2024
Meta AnalysisCorrelation of revision rate of unicompartmental knee arthroplasty with total knee arthroplasty: a meta-analysis of clinical studies and worldwide arthroplasty registers.
The purpose of this study was to elucidate differences and similarities in revision rates amongst studies and national registers featuring total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA). Thereby comparability and reproducibility between study and register findings should be created. ⋯ A positive correlation of revision rates of TKA and UKA in studies and registers was found, with overall revision rates of UKA comparted to TKA being 2.29 times higher in clinical studies and 1.96 times higher in registers. Revision rates in registers were 1.56 times higher than presented in clinical studies.