Despite the availability of numerous tests, the diagnosis of periprosthetic infection (PJI) continues to be complex. Although several studies have suggested that coagulation-related markers, such as D-dimer and fibrinogen, may be promising tools in the diagnosis of prosthetic infections, their role is still controversial. The aim of this study is to evaluate the diagnostic accuracy of serum D-dimer and fibrinogen in patients with painful total knee replacement. 83 patients with painful total knee replacement and suspected peri-prosthetic infection were included. All patients underwent pre-operative blood tests to evaluate inflammation indices (ESR and CRP) and serum D-Dimer and Fibrinogen levels. The diagnostic performance of the tests was assessed using the ICM definition as the gold standard. The diagnostic accuracy of the D-dimer and fibrinogen was measured by assessing sensitivity, specificity and by calculating the area under the ROC curve.Aim
Method
The treatment of osteomyelitis often requires extensive surgical debridement and removal of all infected tissues and foreign bodies. Resulting bone loss can then eventually be managed with antibacterial bone substitutes, that may also serve as a regenerative scaffold. Aim of the present study is to report the clinical results of a continuous series of patients, treated at our centre with an antibacterial bioglass*. From November 2010 to May 2016, a total of 106 patients, affected by osteomyelitis, were included in this prospective, single centre, observational study. Inclusion criteria were the presence of osteomyelitis with a contained bone defect or segmental defects < 10 mm, with adequate soft tissue coverage. All patients underwent a one-stage procedure, including surgical debridement and bone void filling with the bioactive glass*, with systemic antibiotic therapy and no local antibiotics. Clinical, radiographic and laboratory examinations were performed at 3, 6 and 12 months and yearly thereafter.Aim
Method
Aim of this study is to present the first clinical trial on an antibiotic-loaded fast-resorbable hydrogel coating In this prospective, multi-centre, randomized, controlled, prospective study, a total of 260 patients were randomly assigned, in five European orthopaedic centres, to receive the antibiotic-loaded DAC coating or to a control group, without coating. Pre- and post-operative assessment of laboratory tests, wound healing, clinical scores and x-rays were performed at fixed time intervals.Aim
Method
Implant-related infections, including peri-prosthetic joint infection (PJI) and infected osteosynthesis, are biofilm-related. Intra-operative diagnosis and pathogen identification is currently considered the diagnostic benchmark; however the presence of bacterial biofilm(s) may have a detrimental effect on pathogen detection with traditional microbiological techniques. Sonication and chemical biofilm debonding have been proposed to overcome, at least partially, this issue, however little is known about their possible economical impact. Aim of this study was to examine direct and indirect hospital costs connected with the routine use of anti-biofilm microbiological techniques applied to hip and knee PJIs. In a first part of the study, the “Turn Around Time (TAT)” and direct costs comparison between a system to find bacteria on removed prosthetic implantsAim
Method
