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prosthetic joint infection of the hip and knee due to Mycobacterium species:A systematic review

World Journal of Orthopedics 2022年第5期13卷 503-514页

作者： Asep Santoso Krisna Yuarno Phatama Sholahuddin Rhatomy Nicolaas Cyrillus Budhiparama Department of Orthopaedic and Traumatology Universitas Sebelas MaretSurakarta and Prof.Dr.R.Soeharso Orthopaedic HospitalSukoharjo 57162Indonesia Department of Orthopaedic and Traumatology Universitas BrawijayaSaiful Anwar General HospitalMalang 65112Indonesia Department of Orthopaedic and Traumatology Universitas Gadjah MadaYogyakarta and Dr.Soeradji Tirtonegoro General HospitalKlaten 57424Indonesia Nicolaas Institute of Constructive Orthopaedic Research and Education Foundation at Medistra Hospital Jakarta 12950Indonesia Faculty of Medicine Universitas AirlanggaJawa Timur 60132Indonesia Department of Orthopaedics Leiden University Medical CenterLeiden 2333Netherlands

BACKGROUND Mycobacterium species(Mycobacterium sp)is an emerging cause of hip and knee prosthetic joint infection(PJI),and different species of this organism may be responsible for the *** To evaluate the profile of hip and knee Mycobacterium PJI cases as published in the past 30 *** A literature search was performed in PubMed using the MeSH terms“Prosthesis joint infection”AND“Mycobacterium”for studies with publication dates from January 1,1990,to May 30,*** avoid missing any study,another search was performed with the terms“Arthroplasty infection”AND“Mycobacterium”in the same period as the previous *** Preferred Reporting Items for Systematic Reviews and Meta-Analyses chart was used to evaluate the included studies for further *** total,51 studies were included for further evaluation of thecases,type of pathogen,and treatment of PJI caused by Mycobacterium *** Seventeen identified Mycobacterium sp were reportedly responsible for hip/knee PJI in 115 hip/knee PJI cases,whereas in two cases there was no mention of any specific Mycobacterium *** tuberculosis(***)was detected in 50/115(43.3%)of the *** mycobacteria(NTM)included ***(26/115,22.6%),***(10/115,8.6%),***(8/115,6.9%),and ***(8/115,6.9%).Majority of the cases(82/114,71.9%)had an onset of infection>3 mo after the index surgery,while in 24.6%(28/114)the disease had an onset in≤3 *** intraoperative PJI diagnosis was made in 4 cases(3.5%).Overall,prosthesis removal was needed in 77.8%(84/108)of the cases to treat the *** infection rate was controlled in 88/102(86.3%)patients with Mycobacterium *** infection occurred in 10/108(9.8%)patients,while 4/108(3.9%)patients died due to the *** At least 17 Mycobacterium sp can be responsible for hip/knee *** *** is the most common causal pathogen,NTM should be considered as an emerging cause of hi

关键词： Mycobacterium species prosthetic joint infection Hip Knee Systematic review

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Risk of methicillin-resistant staphylococcus aureus prosthetic joint infection in elective total hip and knee arthroplasty following eradication therapy

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World Journal of Orthopedics 2021年第11期12卷 842-849页

作者： Benjamin Pal Kapur Xenia Tonge Gunasekaran Kumar Trauma and Orthopaedics Royal Liverpool University Teaching HospitalsLiverpool L78XPMerseysideUnited Kingdom

BACKGROUND prosthetic joint infection(PJI)is a devastating complication requiring prolonged treatment and multiple operations,leading to significant morbidity for the *** are routinely tested for methicillin-resistant staphylococcus aureus(MRSA)*** positive patients are given eradication *** hypothesise that patients who are MRSA positive pre-operatively,have increased risk of developing *** To identify deep wound infection(PJI)rates in patients who are colonised MRSA positive compared with those who are not colonised;and long term clinical and radiological *** All patients who underwent total hip and knee replacements(THR/TKR)between December 2009 and December 2019 were *** who were also identified as being MRSA positive at pre-operative assessment were then *** of prescribing eradication treatment was *** records,including consultation letters,operation notes and microbiology results were reviewed *** of outcomes for each MRSA positive patient was made with 2 MRSA negative patients undergoing the same operation of a similar age by the same *** Screening identified 42 knee and 32 hip arthroplasty patients as MRSA positive,84 MRSA negative knee and 64 hip patients were *** were matched with medical co-morbidities in each *** follow up was 5 *** was identified in 4/32(12.5%)of THR MRSA positive and 3/42(7%)of TKR *** patients had PJI within one year of *** MRSA positive patients are given eradication therapy ***,no confirmation of eradication is *** who have MRSA colonisation preoperatively,in our study had a significantly increased risk of PJI,when compared to negative *** would recommend establishing true eradication after treatment prior to arthroplasty.

关键词： Hip Knee prosthetic joint infection

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Systematic review of single stage revision for prosthetic joint infection

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World Journal of Orthopedics 2020年第12期11卷 559-572页

作者： Zachary C Lum Christopher Thomas Holland John P Meehan Department of Orthopaedic Surgery Davis Medical CenterUniversity of CaliforniaSacramentoCA 95817United States Department of Orthopaedics University of CaliforniaDavis Medical CenterSacramentoCA 95817United States

While advanced technology,increased medical knowledge and improved surgical technique has improved patient outcomes in total joint arthroplasty,prosthetic joint infection still remains one of the leading causes of increased healthcare costs,medical resources and societal burdens in orthopaedic *** stage arthroplasty revision remains the gold standard for treatment of prosthetic joint *** of single stage revision arthroplasty for infection argue that it results in lower healthcare costs while improving patient reported functional outcomes and with equivalent success *** we review the history of single stage revision arthroplasty,discuss the key principles,highlight the indications and contraindications,and review the reported outcomes with a focus on future developments of single stage revision arthroplasty for hip and knee periprosthetic joint infections.

关键词： prosthetic joint infection Single stage Revision total joint arthroplasty Total knee arthroplasty infection

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Technetium-99m-labeled annexin V imaging for detecting prosthetic joint infection in a rabbit model

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The Journal of Biomedical Research 2015年第3期29卷 224-231页

作者： Cheng Tang Feng Wang Yanjie Hou Shanshan Lu Wei Tian Yan Xu Chengzhe Jin Liming Wang Department of Orthopedic Surgery Nanjing First HospitalNanjing Medical University Department of Nuclear Medicine Nanjing First HospitalNanjing Medical University Department of Radiation Oncology the First Affiliated Hospital of Shanxi Medical University Department of Radiology the First Affiliated Hospital of Nanjing Medical University

Accurate and timely diagnosis of prosthetic joint infection is essential to initiate early treatment and achieve a favorable outcome. In this study, we used a rabbit model to assess the feasibility of technetium-99m-labeled annexin V for detecting prosthetic joint infection. Right knee arthroplasty was performed on 24 New Zealand rabbits. After surgery, methicillin-susceptible Staphylococcus aureus was intra-articularly injected to create a model of prosthetic joint infection （the infected group, n = 12）. Rabbits in the control group were injected with sterile saline （n= 12）. Seven and 21 days after surgery, technetium-99m-labeled annexin V imaging was per- formed in 6 rabbits of each group. Images were acquired 1 and 4 hours after injection of technetium-99m- labeled annexin V （150 MBq）. The operated-to-normal-knee activity ratios were calculated for quantitative ana- lysis. Seven days after surgery, increased technetium-99m-labeled annexin V uptake was observed in all cases. However, at 21 days a notable decrease was found in the control group, but not in the infected group. The operated-to-normal-knee activity ratios of the infected group were 1.84 ±0.29 in the early phase and 2.19 ±0.34 in the delay phase, both of which were significantly higher than those of the control group （P=0.03 and P=0.02）. The receiver operator characteristic curve analysis showed that the operated-to-normal-knee activity ratios of the delay phase at 21 days was the best indicator, with an accuracy of 80%. In conclusion, technetium- 99m-labeled annexin V imaging could effectively distinguish an infected prosthetic joint from an uninfected prosthetic joint in a rabbit model.

关键词： prosthetic joint infection annexin V technetium-99m diagnosis

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Periprosthetic joint infections in femoral neck fracture patients treated with hemiarthroplasty–should we use antibiotic-loaded bone cement?

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World Journal of Orthopedics 2022年第2期13卷 150-159页

作者： Diana Crego-Vita Daniel Aedo-Martín Rafael Garcia-Cañas Andrea Espigares-Correa Coral Sánchez-Pérez Christof Ernst Berberich Department of Orthopaedic and Trauma Surgery Hospital Central de la Defensa Gómez UllaMadrid 28047Spain Department of Orthopaedic and Trauma Surgery Hospital Universitario del HenaresUniversidad Francisco de VitoriaCoslada 28822MadridSpain Department of Orthopeadic and Trauma Surgery Hospital Central de la Defensa Gómez UllaMadrid 28047Spain Department of Orthopeadic and Trauma Surgery General University Hospital Gregorio MaranonMadrid 28007Spain Department of Medical Training Heraeus Medical GmbHWehrheim 612173HessenGermany

BACKGROUND Hemiarthroplasty is the most common treatment in elderly patients with displaced intra-capsular femoral neck fracture(FNF).prosthetic joint infection(PJI)is one of the most feared and frequent complications post-surgery because of the frail health status of these patients and the need for fast track ***,priorities should lie in effective preventive strategies to mitigate this *** To determine how much the implementation of the routine use of antibioticloaded bone cement(ALBC)as a relatively easy-to-apply amendment to the surgical practice reduces the infection rate in our hemiarthroplasty *** We retrospectively assessed all demographic,health status and treatment-related data of our FNF patients undergoing cemented hemiarthroplasty in the period from 2011 to 2017;241 patients were further analyzed after exclusion of patients with cancer-related sequelae and those who died before the end of the 1-year observation *** PJI rate as diagnosed on basis of the Musculoskeletal infection Society(MSIS)criteria 2011 was determined for each included patient and compared in function of the bone cement used for hip stem *** were split into a group receiving a plain bone cement in the period from January 2011 to June 2013(non-ALBC group)and into a group receiving an ALBC in the period July 2013 to December 2017(ALBC group).Data analysis was performed with statistical *** further calculated the cost-efficacy of the implementation of routine use of ALBC in the second group balancing the inhospital infection related treatment costs with the extra costs of use of *** In total 241 FNF patients who received cemented hemiarthroplasty in the period from January 2011 to January 2017 were eligible for inclusion in this retrospective *** were 8 PJI cases identified in the ALBC group among n=94 patients,whereas 28 PJI cases were observed in the non-ALBC group among n=147 *** statistical analysis

关键词： prosthetic joint infection Femoral neck fracture patients Hemiarthroplasty Antibiotic-loaded bone cement Prophylaxis Cost-efficacy

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Dual antibiotic loaded bone cement in patients at high infection risks in arthroplasty: Rationale of use for prophylaxis and scientific evidence

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World Journal of Orthopedics 2021年第3期12卷 119-128页

作者： Christof Ernst Berberich Jérome Josse Frédéric Laurent Tristan Ferry Department of Medical Training Heraeus Medical GmbHWehrheim 612173HessenGermany Institut des Sciences Pharmaceutiques et Biologiques de Lyon(ISPB) International Center for Research in InfectiologyInserm U1111CNRS UMR5308ENS de LyonUCBL1Lyon 69008France Interregional Reference Center for the Management of Complex Osteo-Articular infections Hospices Civils de LyonLyon 69008France Bacteriology Laboratory Institute of Infectious AgentsCroix-Rousse HospitalHospices Civils de LyonLyon 69008France Infectious and Tropical Diseases Department Croix-Rousse HospitalHospices Civils de LyonLyon 69008France

In view of the demographic changes and projected increase of arthroplasty procedures worldwide,the number of prosthetic joint infection cases will naturally ***,in order to counteract this trend more rigid rules and a stricter implementation of effective preventive strategies is of highest *** the absence of a"miracle weapon"priorities should lie in evidence-based measures including preoperative optimization of patients at higher infection risks,the fulfilment of strict hygiene rules in the operating theatre and an effective antibiotic prophylaxis *** of a"one size fits all"philosophy,it has been proposed to adjust the antibiotic prophylaxis protocol to major infection risks taking into account important patient-and procedure-related risk factors.A stronger focus on the local application mode via use of high dose dual antibioticloaded bone cement in such risk situations may have its advantages and is easy to apply in the *** more potent antimicrobial growth inhibition in vitro and the strong reduction of the prosthetic joint infection rate in risk for infection patients with aid of dual antibiotic-loaded bone cement in clinical studies align with this hypothesis.

关键词： prosthetic joint infection Antibiotic-loaded bone cement Single low dose antibiotic-loaded bone cement Dual high dose antibiotic-loaded bone cement Antibiotic prophylaxis Risk-for-infection patients

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