检索结果-南通市图书馆

Combination of C-reactive protein and fibrinogen is useful for diagnosing periprosthetic joint infection in patients with inflammatory diseases

引用

Chinese Medical Journal 2022年第16期135卷 1986-1992页

作者： Hong Xu Jinwei Xie Xufeng Wan Li Liu Duan Wang Zongke Zhou Department of Orthopedic Surgery Orthopedic Research InstituteWest China HospitalSichuan UniversityChengduSichuan 610041China Department of Orthopedic Surgery West China School of NursingWest China HospitalSichuan UniversityChengduSichuan 610041China

Background:The screening of periprosthetic joint infection(PJI)in patients with inflammatory diseases before revision arthroplasty remains uncertain.Serum C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),plasma fbrinogen(FIB),monocyte/lymphocyte ratio,and neutrophil/lymphocyte ratio(NLR)can help screening PJI,but their values in patients with infammatory diseases have not been determined.Methods:Patients with inflammatory diseases who underwent revision hip or knee arthroplasty at West China Hospital,Sichuan University,from January 2008 to September 2020 were divided into infected and non-infected groups based on the 2013 International Consensus Meeting criteria.Sensitivity and specificity of the tested biomarkers for diagnosing infection were determined based on receiver operating characteristic(ROC)curves,and optimal cutoffs were determined based on the Y ouden index.The diagnostic ability of these biomarkers was re-assessed after combining them with each other.Results:A total of 62 patients with inflammatory diseases were studied;of them 30 were infected.The area under the ROC curve was 0.813 for CRP,0.638 for ESR,0.795 for FIB,and 0.656 for NLR.The optimal predictive cutoff of CRP was 14.04 mg/L with a sensitivity of 86.2%and a specificity of 68.7%,while FIB had a sensitivity of 72.4%and a specificity of 81.2%with the optimal predictive cutoff of 4.04 g/L.The combinations of CRP with FIB produced a sensitivity of 86.2%and specificity of 78.1%.Conclusion:CRP with a slightly higher predictive cutoff and FIB are useful for screening PJI in patients with inflammatory diseases,and the combination of CRP and FIB may further improve the diagnostic values.

关键词： periprosthetic joint infection C-reactive protein Fibrinogen Diagnosis Revision arthroplasty

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Analysis of the clinical efficacy of two-stage revision surgery in the treatment of periprosthetic joint infection in the knee:A retrospective study

引用

World Journal of Clinical Cases 2022年第36期10卷 13239-13249页

作者： Yong-Jie Qiao Feng Li Lv-Dan Zhang Xin-Yuan Yu Hao-Qiang Zhang Wen-Bin Yang Xiao-Yang Song Rui-Ling Xu Sheng-Hu Zhou Department of joint Surgery The 940th Hospital of Joint Logistic Support Force of Chinese People’s Liberation ArmyLanzhou 730050Gansu ProvinceChina Department of Orthopedics The 943rd Hospital of Joint Logistic Support Force of Chinese People’s Liberation ArmyWuwei 733000Gansu ProvinceChina Department of Respiratory Medicine The 940^(th) Hospital of Joint Logistic Support Force of Chinese People’s Liberation ArmyLanzhou 730050Gansu ProvinceChina

BACKGROUND periprosthetic joint infection(PJI)is a catastrophic complication that can occur following total knee arthroplasty(TKA).Currently,the treatment for PJI mainly includes the use of antibiotics alone,prosthetic debridement lavage,primary revision,secondary revision,joint fusion,amputation,etc.AIM To explore the clinical effect of two-stage revision surgery for the treatment of PJI after TKA.METHODS The clinical data of 27 patients(3 males and 24 females;age range,47–80 years;mean age,66.7±8.0 years;27 knees)with PJI treated with two-stage revision surgery in our hospital between January 1,2010 and December 31,2020 were analyzed retrospectively.The following outcomes were compared for changes between preoperative and last follow-up results:Erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),visual analogue scale(VAS)scores,Hospital for Special Surgery(HSS)scores,knee range of motion(ROM),and infection cure rates.RESULTS All 27 patients were followed up(range,13–112 mo).The ESR(14.5±6.3 mm/h)and CRP(0.6±0.4 mg/dL)of the patients at the last follow-up were significantly lower than those at admission;the difference was statistically significant(Pinfection,whereas 1 case had an infection recurrence;the infection control rate was 96.3%.CONCLUSION Two-stage revision surgery can effectively relieve pain,control infection,and retain good joint function in the treatment of PJI after TKA.

关键词： Total knee arthroplasty periprosthetic joint infection Two-stage Revision Antibiotic therapy

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Comprehensive meta-analysis of antibiotic-impregnated bone cement versus plain bone cement in primary total knee arthroplasty for preventing periprosthetic joint infection

引用

Chinese Journal of Traumatology 2022年第6期25卷 325-330页

作者： Ting Xu Ke-Liang Wu Ke Jie Foshan Hospital of Traditional Chinese Medicine Foshan 528000Guangdong ProvinceChina Shenzhen Traditional Chinese Medicine Hospital Shenzhen 518000Guangdong ProvinceChina

Purpose:Antibiotic-loaded bone cement(ALBC)was usually used to prevent periprosthetic joint infection(PJI)in primary total knee arthroplasty(PTKA),but whether to use ALBC or plain bone cement in PTKA remains unclear.We aimed to compare the occurrence rate of PJI using two different cements,and to investigate the efficacy of different antibiotic types and doses administered in preventing surgical site infection(SSI)with ALBC.Methods:The availability of ALBC for preventing PJI was evaluated by using a systematic review and meta-analysis referring to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Existing articles until December 2021 involving PTKA patients with both ALBC and plain bone cement cohorts were scanned by searching"total knee arthroplasty","antibiotic-loaded cement","antibiotic prophylaxis","antibiotic-impregnated cement"and"antibiotic-laden cement"in the database of PubMed/MEDLINE,Embase,Web of Science and the Cochrane Library.Subgroup analysis included the effectiveness of different antibiotic types and doses in preventing SSI with ALBC.The modified Jadad scale was employed to score the qualities of included articles.Results:Eleven quantitative studies were enrolled,including 34,159 knees undergoing PTKA.The meta-analysis results demonstrated that the use of prophylactic ALBC could significantly reduce the prevalence of deep incisional SSI after PTKA,whereas there was no significant reduction in the rate of superficial incisional SSI.Moreover,gentamicin-loaded cement was effective in preventing deep incisional SSI,and the use of high-dose ALBC significantly reduced the rate of deep incisional SSI after PTKA.Besides,no significant adverse reactions and complications were stated during the use of ALBC in PTKA.Conclusion:The preventive application of ALBC during PTKA could reduce the rates of deep PJI.Furthermore,bone cement containing gentamicin and high-dose ALBC could even better prevent deep infection after PTKA.However,the existing related articles are mostly single

关键词： Surgical site infection Antibiotic-loaded cement Plain bone cement periprosthetic joint infection Primary total knee arthroplasty Meta

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Fungal periprosthetic joint infection:Rare but challenging problem

引用

Chinese Journal of Traumatology 2022年第2期25卷 63-66页

作者： Emanuele Chisari Feitai Lin Jun Fei Javad Parvizi Rothman Orthopaedic Institute at Thomas Jefferson University PhiladelphiaPA19107USA Department of Emergency Medicine of Army Medical Center Army Medical UniversityChongqing400042China State Key Laboratory of Trauma Burns and Combined InjuryArmy Medical UniversityChongqing400042China

periprosthetic joint infection (PJI) is the most difficult complication following total joint arthroplasty. Most of the etiological strains, accounting for over 98% of PJI, are bacterial species, with Staphylococcus aureus and Coagulase-negative staphylococci present in between 50% and 60% of all PJIs. Fungi, though rare, can also cause PJI in 1%—2% of cases and can be challenging to manage. The management of this uncommon but complex condition is challenging due to the absence of a consistent algorithm. Diagnosis of fungal PJI is difficult as isolation of the organisms by traditional culture may take a long time, and some of the culture-negative PJI can be caused by fungal organisms. In recent years, the introduction of next-generation sequencing has provided opportunity for isolation of the infective organisms in culture-negative PJI cases. The suggested treatment is based on consensus and includes operative and non-operative measures. Two-stage revision surgery is the most reliable surgical option for chronic PJI caused by fungi. Pharmacological therapy with antifungal agents is required for a long period of time with antibiotics and included to cover superinfections with bacterial species. The aim of this review article is to report the most up-to-date information on the diagnosis and treatment of fungal PJI with the intention of providing clear guidance to clinicians, researchers and surgeons.

关键词： Fungi periprosthetic joint infection Diagnosis and treatment

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Preoperative and postoperative risk factors for periprosthetic joint infection in primary total hip arthroplasty:A 1-year experience

引用

World Journal of Orthopedics 2022年第10期13卷 903-910页

作者： Giuseppe Ferdinando Tella Cesare Donadono Francesco Castagnini Barbara Bordini Monica Cosentino Michele Di Liddo Francesco Traina Ortopedia-Traumatologia e Chirurgia protesica e dei reimpianti d'anca e di ginocchio IRCCS Istituto Ortopedico RizzoliBologna 40125Italy Laboratorio di Tecnologia Medica IRCCS Istituto Ortopedico RizzoliBologna 40125Italy

BACKGROUND periprosthetic joint infection(PJI)in primary total hip replacement(THR)is one of the most important threats in orthopedic surgery,so one important surgeon’s target is to avoid or early diagnose a PJI.Although the incidence of PJI is very low(0.69%)in our department,with an average follow-up of 595 d,this infection poses a serious threat due to the difficulties of treatment and the lower functional outcomes after healing.AIM To study the incidence of PJI in all operations occurring in the year 2016 in our department to look for predictive signs of potential infection.METHODS We counted 583 THR for 578 patients and observed only 4 cases of infection(0.69%)with a mean follow-up of 596 d(min 30,max 1451).We reviewed all medical records to collect the data:duration and time of the surgery,presence,type and duration of the antibiotic therapy,preoperative diagnosis,blood values before and after surgery,transfusions,presence of preoperative drugs(in particularly anticoagulants and antiaggregant,corticosteroids and immunosuppressants),presence of some comorbidities(high body mass index,blood hypertension,chronic obstructive pulmonary disease,cardiac ischemia,diabetes,rheumatological conditions,previous local infections).RESULTS No preoperative,intraoperative,or postoperative analysis showed a higher incidence of PJI.We did not find any class with evident major odds of PJI.In our study,we did not find any border value to predict PJI and all patients had similar values in both groups(non-PJI and PJI).Only some categories,such as female patients,showed more frequency of PJI,but this difference related to sex was not statistically significant.CONCLUSION We did not find any category with a higher risk of PJI in THR,probably due to the lack of few cases of infection.

关键词： Primary total hip replacement periprosthetic joint infection Preoperative risk factors Postoperative risk factors Preoperative and postoperative blood value Total hip arthroplasty

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Synovial Fluid C-reactive Protein as a Diagnostic Marker for periprosthetic joint infection： A Systematic Review and Meta-analysis

引用

Chinese Medical Journal 2016年第16期129卷 1987-1993页

作者： Chi Wang Qi Wang Rui Li Jin-Yan Duan Cheng-Bin Wang Department of Clinical Laboratory Chinese People's Liberation Army General Hospital Beijing 100853 China Outpatient Department of Chinese People's Liberation Army Beijing 101123 China Department of Orthopedics Chinese People's Liberation Army General Hospital Beijing 100853 China

Background： periprosthetic joint infection （PJI） is the main cause of failure following total joint arthroplasty. Until now, the diagnosis of PJI is still confronted with technical limitations, and the question of whether synovial fluid biomarker, C-reactive protein （CRP）, can provide high value in the diagnosis of PJl remains unanswered and, therefore, was the aim of the study. Methods： First, we conducted a systematic review on CRP in the diagnosis of PJI by searching online databases using keywords such as ＂periprosthetic joint infection＂, ＂synovial fluid＂, and ＂C-reactive protein＂. Eligible studies providing sufficient data to construct 2 × 2 contingency tables were then selected based on the list of criteria and the quality of included studies was assessed subsequently. Finally, the reported sensitivity, specificity, diagnostic odds ratio （DOR）, summary receiver operating characteristic （SROC） curve, and the area under the SROC （AUSROC） were pooled together and used to evaluate overall diagnostic performance. Results： Seven studies were included in our review, six of which comprising a total of 456 participants were further investigated in our meta-analysis. The pooled sensitivity, specificity, and DOR were 0.92 （95% confidence interval [CI]： 0.86-0.96）, 0.90 （95% CI： 0.87-0.93）, and 101.40 （95% CI： 48.07-213.93）, respectively. The AUSROC was 0.9663 （standard error, 0.0113）. Conclusions： Synovial fluid CRP is a good biomarker for the diagnosis of PJI with high sensitivity and specificity.

关键词： C-reactive Protein periprosthetic joint infection Synovial Fluid

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Candidal periprosthetic joint infection after primary total knee arthroplasty combined with ipsilateral intertrochanteric fracture: A case report

引用

World Journal of Clinical Cases 2020年第21期8卷 5401-5408页

作者： Jun Xin Qing-Shan Guo Hua-Yu Zhang Zhi-Yang Zhang Tomer Talmy Yu-Zhuo Han Yu Xie Qiu Zhong Si-Ru Zhou Yang Li Department of Trauma Surgery State Key Laboratory of TraumaBurns and Combined InjuriesMedical Center of Trauma and War InjuryDaping HospitalArmy Medical University of PLAChongqing 400042China The Institute of Research in Military Medicine The Hebrew University of JerusalemHadassah Medical CenterJerusalem 91120Israel Department of Clinical Laboratory Daping HospitalArmy Medical University of PLAChongqing 400042China

BACKGROUND Candidal periprosthetic joint infection is a rare and difficult to diagnose complication of total knee arthroplasty.The treatment of such complications is inconclusive and may include prosthesis removal,debridement,arthrodesis,and extensive antifungal therapy to control the infection.CASE SUMMARY A 62-year-old male with a history of total knee arthroplasty(TKA)in his left knee presented with ipsilateral knee pain and a sinus discharge 20 mo after TKA.The patient was previously evaluated for left knee pain,swelling,and a transient fever one month postoperatively.Prothesis removal and insertion of a cement spacer were performed in a local hospital six months prior to the current presentation.Medical therapy included rifampicin and amphotericin which were administered for 4 wk following prosthesis removal.A second debridement was performed in our hospital and Candida parapsilosis was detected in the knee joint.Fourteen weeks following the latter debridement,the patient suffered a left intertrochanteric fracture and received closed reduction and internal fixation with proximal femoral nail anterotation.Two weeks after fracture surgery,a knee arthrodesis with autograft was performed using a double-plate fixation.The patient recovered adequately and was subsequently discharged.At the two-year follow-up,the patient has a stable gait with a pain-free,fused knee.CONCLUSION Fungal periprosthetic joint infection following TKA may be successfully and safely treated with prosthesis removal,exhaustive debridement,and arthrodesis after effective antifungal therapy.Ipsilateral intertrochanteric fractures of the affected knee can be safely fixated with internal fixation if the existing infection is clinically excluded and aided by the investigation of serum inflammatory markers.

关键词： infection periprosthetic joint infection Intertrochanteric fracture Fungal Arthrodesis Case report

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Good accuracy of the alpha-defensin lateral flow test for hip periprosthetic joint infection: A pilot study in a retrospective cohort of 52 patients

引用

World Journal of Orthopedics 2020年第1期11卷 36-46页

作者： Jesse WP Kuiper Pieter Pander Stan J Vos Department of Orthopedic Surgery Noordwest ZiekenhuisgroepAlkmaar 1815 JDNetherlands Centre for Orthopedic Research Alkmaar Noordwest ZiekenhuisgroepAlkmaar 1815 JDNetherlands

BACKGROUND The alpha-defensin lateral flow(ADLF)test is a new diagnostic tool for periprosthetic joint infection(PJI).Test accuracy for combined cohorts of hip and knee PJI has been reported to be good.AIM To assess the accuracy of the ADLF test for hip PJI,and to compare three different diagnostic criteria for PJI.METHODS A cohort of 52 patients was identified,with a painful or poor-functioning total hip-or hemi-arthroplasty,that underwent aspiration and a subsequent ADLF test.PJI was diagnosed with Musculoskeletal infection Society(MSIS)criteria,and sensitivity,specificity,overall accuracy,positive predictive value and negative predictive value were calculated.Furthermore,test specifics were compared with the European Bone and joint infection Society(EBJIS)and 2018 International Consensus Meeting(ICM)criteria for PJI.RESULTS Using MSIS criteria,sensitivity was 100%(CI:54%-100%)and specificity was 89%(CI:76%-96%).Six true positives and 5 false positives were found,including one case of metallosis.Using EBJIS criteria,more PJIs were found(11 vs 6),sensitivity was lower(71%,CI:42%-92%)and specificity was higher(97%,CI:86%-100%),with 4 false negatives and one false positive result.Using 2018 ICM criteria,sensitivity was 91%(62%-100%)and specificity 100%(91%-100%).The results in this cohort are comparable to previous studies.CONCLUSION Overall test accuracy of the ADLF test was good in this cohort,with a sensitivity of 100%and specificity of 89%.Using different PJI definition criteria,sensitivity and specificity changed slightly but overall accuracy remained around 90%.Using the ADLF test in metallosis cases can result in false positive results and should be performed with caution.

关键词： periprosthetic Arthroplasty Replacement Hip infection periprosthetic joint infection Alpha-defensin Synovasure

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

基于ResNet深度网络模型的髋关节置换术后并发症分类研究

引用

建模与仿真 2024年第2期13卷 1873-1884页

作者：满孝壮王博永王俏杰李梅程云章沈灏上海交通大学附属第六人民医院放射科，上海上海理工大学健康科学与工程学院，上海上海交通大学附属第六人民医院骨科，上海

目的：分析基于ResNet迁移学习模型鉴别髋关节置换术后假体周围感染与松动的价值。方法：本研究的数据来源于2015年1月至2022年12月期间，在上海第六人民医院骨科接受全髋关节翻修手术的206例患者。这些患者因髋关节置换术后出现假体周... 详细信息

目的：分析基于ResNet迁移学习模型鉴别髋关节置换术后假体周围感染与松动的价值。方法：本研究的数据来源于2015年1月至2022年12月期间，在上海第六人民医院骨科接受全髋关节翻修手术的206例患者。这些患者因髋关节置换术后出现假体周围感染或假体松动的情况而接受了翻修手术，收集患者髋关节置换术后X线图像。使用迁移学习方法对髋关节假体周围感染和松动进行鉴别，分别建立ResNet18、ResNet50迁移学习模型，并使用SHAP方法对模型进行可视化分析。结果：通过对两种不同网络的模型进行迁移学习实验对比，得到了以下结果：基于ResNet18网络的迁移学习模型在鉴别髋关节置换术后假体周围感染与松动方面表现出显著优势，模型的准确率达到了91.30%，灵敏度为95.94%，特异度为87.50%，AUC为93.94%。这些指标表明了该模型在对这两种并发症进行区分时的准确性和可靠性。实验还进行了Delong检验，ResNet18网络模型与ResNet50模型之间的AUC差异具有统计学意义(p < 0.05)。结论：本文旨在建立迁移学习诊断模型，为早期临床髋关节置换术后假体周围感染与松动的诊断提供一种方法。

关键词：深度学习迁移学习关节置换假体周围感染假体无菌性松动 Deep Learning Transfer Learning joint Replacement periprosthetic joint infection Aseptic Loosening of Prosthesis

来源：博看期刊评论

在线全文

博看期刊

学校读者我要写书评

暂无评论

Antibiotic-free antimicrobial poly (methyl methacrylate) bone cements:A state-of-the-art review

引用

World Journal of Orthopedics 2022年第4期13卷 339-353页

作者： Gladius Lewis Department of Mechanical Engineering University of MemphisMemphisTN 38152United States

Prosthetic joint infection(PJI)is the most serious complication following total joint arthroplasty,this being because it is associated with,among other things,high morbidity and low quality of life,is difficult to prevent,and is very challenging to treat/manage.The many shortcomings of antibiotic-loaded poly(methyl methacrylate)(PMMA)bone cement(ALBC)as an agent for preventing and treating/managing PJI are well-known.One is that microorganisms responsible for most PJI cases,such as methicillin-resistant S.aureus,have developed or are developing resistance to gentamicin sulfate,which is the antibiotic in the vast majority of approved ALBC brands.This has led to many research efforts to develop cements that do not contain gentamicin(or,for that matter,any antibiotic)but demonstrate excellent antimicrobial efficacy.There is a sizeable body of literature on these socalled“antibiotic-free antimicrobial”PMMA bone cements(AFAMBCs).The present work is a comprehensive and critical review of this body.In addition to summaries of key trends in results of characterization studies of AFAMBCs,the attractive features and shortcomings of the literature are highlighted.Shortcomings provide motivation for future work,with some ideas being formulation of a new generation of AFAMBCs by,example,adding a nanostructured material and/or an extract from a natural product to the powder and/or liquid of the basis cement,respectively.

关键词： periprosthetic joint infection Poly(methyl methacrylate)bone cement Antibiotic-loaded poly(methyl methacrylate)bone cement bone cement Antibiotic-free antimicrobial poly(methyl methacrylate)bone cement bone cement

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：