We conducted a case-control study to examine
the merit of silver-coated tumour prostheses. We reviewed 85 patients
with Agluna-treated (silver-coated) tumour implants treated between
2006 and 2011 and matched them with 85 control patients treated
between 2001 and 2011 with identical, but uncoated, tumour prostheses. . In all, 106 men and 64 women with a mean age of 42.2 years (18.4
to 90.4) were included in the study. There were 50 primary reconstructions
(29.4%); 79 one-stage revisions (46.5%) and 41 two-stage revisions
for infection (24.1%). The overall post-operative infection rate of the silver-coated
group was 11.8% compared with 22.4% for the control group (p = 0.033,
chi-square test). A total of seven of the ten infected prostheses
in the silver-coated group were treated successfully with debridement,
antibiotics, and implant retention compared with only six of the
19 patients (31.6%) in the control group (p = 0.048, chi-square
test). Three patients in the silver-coated group (3.5%) and 13 controls
(15.3%) had chronic
Aims. The diagnosis of
Aims. We hypothesised that the synovial white blood cell (WBC) count
in patients with a late
Aims. It remains difficult to diagnose early postoperative
The number of arthroplasties being undertaken
is expected to grow year on year, and
Aims. Infection following total hip or knee arthroplasty is a serious
complication. We noted an increase in post-operative infection in
cases carried out in temporary operating theatres. We therefore
compared those cases performed in standard and temporary operating
theatres and examined the deep
Aims. We aimed to report the mid- to long-term rates of septic and aseptic failure after two-stage revision surgery for
Aims. There is a paucity of long-term studies analyzing risk factors for failure after single-stage revision for
Aims.
Aims. The number of revision arthroplasties being performed in the elderly is expected to rise, including revision for infection. The primary aim of this study was to measure the treatment success rate for octogenarians undergoing revision total hip arthroplasty (THA) for
Aims. Despite numerous studies focusing on
Aims. The diagnosis of
Aims. Fungal
Aims. The purpose of this study was to evaluate unexpected positive cultures in total hip arthroplasty (THA) revisions for presumed aseptic loosening, to assess the prevalence of low-grade infection using two definition criteria, and to analyze its impact on implant survival after revision. Methods. A total of 274 THA revisions performed for presumed aseptic loosening from 2012 to 2016 were reviewed. In addition to obtaining intraoperative tissue cultures from all patients, synovial and sonication fluid samples of the removed implant were obtained in 215 cases (79%) and 101 cases (37%), respectively. Histopathological analysis was performed in 250 cases (91%). Patients were classified as having low-grade infections according to institutional criteria and Musculoskeletal Infection Society (MSIS) International Consensus Meeting (ICM) 2013 criteria. Low-grade infections according to institutional criteria were treated with targeted antibiotics for six weeks postoperatively. Implant failure was defined as the need for re-revision resulting from
Aims. The aim of this study was to evaluate the diagnostic accuracy of the absolute synovial polymorphonuclear neutrophil cell (PMN) count for the diagnosis or exclusion of
Aims. Histology is widely used for diagnosis of persistent infection during reimplantation in two-stage revision hip and knee arthroplasty, although data on its utility remain scarce. Therefore, this study aims to assess the predictive value of permanent sections at reimplantation in relation to reinfection risk, and to compare results of permanent and frozen sections. Methods. We retrospectively collected data from 226 patients (90 hips, 136 knees) with
Aims. A higher failure rate has been reported in haematogenous
Aims. The aim of this study was to analyze the prevalence of culture-negative
Aims. The diagnosis of
Aims. One-stage exchange for
Aims. Single-stage revision total knee arthroplasty (rTKA) is gaining popularity in treating chronic
Aims. The aim of this study was to evaluate the optimal deep tissue specimen sample number for histopathological analysis in the diagnosis of
Aims. The management of
Aims. Use of molecular sequencing methods in
Aims.
Aims. Gram-negative
Aims. The aim of this study was to estimate the 90-day
Aims. Fungal and mycobacterial
Aims. Delayed postoperative inoculation of orthopaedic implants with persistent wound drainage or bacterial seeding of a haematoma can result in
Aims. The preoperative diagnosis of
Aims. As a proven and comprehensive molecular technique, metagenomic next-generation sequencing (mNGS) has shown its potential in the diagnosis of pathogens in patients with
Aims. Accurate diagnosis of chronic
Aims. The outcome of repeat septic revision after a failed one-stage exchange for
Aims. In cases of severe
Aims. Calprotectin (CLP) is produced in neutrophils and monocytes and released into body fluids as a result of inflammation or infection. The aim of this study was to evaluate the utility of blood and synovial CLP in the diagnosis of chronic
Aims. To describe the risk of
Aims. The aim of this study was to further evaluate the accuracy of ten promising synovial biomarkers (bactericidal/permeability-increasing protein (BPI), lactoferrin (LTF), neutrophil gelatinase-associated lipocalin (NGAL), neutrophil elastase 2 (ELA-2), α-defensin, cathelicidin LL-37 (LL-37), human β-defensin (HBD-2), human β-defensin 3 (HBD-3), D-dimer, and procalcitonin (PCT)) for the diagnosis of
Aims. Infection complicating primary total knee arthroplasty (TKA) is a common reason for revision surgery, hospital readmission, patient morbidity, and mortality. Increasing incidence of methicillin-resistant Staphylococcus aureus (MRSA) is a particular concern. The use of vancomycin as prophylactic agent alone or in combination with cephalosporin has not demonstrated lower
Aims. The success rates of two-stage revision arthroplasty for infection have evolved since their early description. The implementation of internationally accepted outcome criteria led to the readjustment of such rates. However, patients who do not undergo reimplantation are usually set aside from these calculations. The aim of this study was to investigate the outcomes of two-stage revision arthroplasty when considering those who do not undergo reimplantation, and to investigate the characteristics of this subgroup. Methods. A retrospective cohort study was conducted. Patients with chronic hip or knee
Aims.
Aims. Removal of infected components and culture-directed antibiotics are important for the successful treatment of chronic
Aims. The aim of this study was to determine the diagnostic accuracy of α defensin (AD) lateral flow assay (LFA) and enzyme-linked immunosorbent assay (ELISA) tests for
Aims. To analyse the effectiveness of debridement and implant retention
(DAIR) in patients with hip
Aims. Advocates of debridement, antibiotics and implant retention (DAIR)
in hip
The World Health Organization (WHO) and the Centre
for Disease Control and Prevention (CDC) recently published guidelines
for the prevention of surgical site infection. The WHO guidelines,
if implemented worldwide, could have an immense impact on our practices
and those of the CDC have implications for healthcare policy in
the United States. Our aim was to review the strategies for prevention of periprosthetic
joint infection in light of these and other recent guidelines. Cite this article: