Review
Biochemistry & Molecular Biology
Corneliu Ovidiu Vrancianu, Bogdan Serban, Irina Gheorghe-Barbu, Ilda Czobor Barbu, Roxana Elena Cristian, Mariana Carmen Chifiriuc, Catalin Cirstoiu
Summary: The number of implanted prosthetic joints is increasing due to longer life spans and increased mobility in older individuals. Unfortunately, the number of periprosthetic joint infections (PJIs), a severe complication after joint replacement surgery, is also on the rise. Efficient protocols for managing these infections can lead to preventive measures and effective diagnostic methods using laboratory tests. This review discusses current methods for PJI diagnosis and emerging synovial biomarkers used for prognosis, prophylaxis, and early detection of periprosthetic infections, as well as factors contributing to treatment failure.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Orthopedics
Jonathan S. Yu, Troy D. Bornes, Mark P. Youssef, Kathleen W. Tam, Allina A. Nocon, Peter K. Sculco, Alberto V. Carli
Summary: By studying a large cohort of patients who underwent joint replacement surgery, it was found that combination testing of serum biomarkers can improve the specificity and sensitivity of infection diagnosis. However, compared to single markers, C-reactive protein (CRP) demonstrated superior diagnostic utility.
JOURNAL OF ARTHROPLASTY
(2023)
Article
Orthopedics
Nour Bouji, Ethan Meadows, John M. Hollander, Murugesan Velayutham, Elizabeth Stewart, Jacob Herriott, Matthew J. Dietz
Summary: This study evaluated the impact of simulated prosthetic joint infection on local tissue mitochondrial function. The results showed that maximal respiration and oxygen consumption in mitochondria from infected limbs were significantly lower, while the activity of mitochondrial complexes was similar between the infected and noninfected groups. This study highlights the role of prosthetic joint infection in mitochondrial dysfunction and oxidative tissue damage in mammalian cells.
JOURNAL OF ORTHOPAEDIC RESEARCH
(2023)
Article
Orthopedics
Shay Warren, Gregory W. Charville, Robert Manasherob, Derek F. Amanatullah
Summary: This study examines the expression of PD-1 and PD-L1 in periprosthetic tissue of patients with PJI and aseptic failure, finding that PD-L1 expression is upregulated in PJI patients and associated with recurrent infection.
JOURNAL OF ORTHOPAEDIC RESEARCH
(2022)
Article
Geriatrics & Gerontology
Jeffrey M. Caterino, Julie A. Stephens, Randell Wexler, Carlos A. Camargo, Katherine M. Hunold, Lai Wei, David Hains, Lauren T. Southerland, Jason J. Bischof, Andrew Schwaderer
Summary: The study found that there were no significant differences in urinary antimicrobial peptide (AMPs) levels between older and younger adults, but older adults had lower levels of a specific AMP, hBD-2. This finding has implications for the potential use of urinary AMPs as diagnostic markers and will facilitate further exploration into the role of innate immunity in urinary tract infection susceptibility in older adults.
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES
(2023)
Article
Orthopedics
Colleen M. Wixted, Lefko T. Charalambous, Billy I. Kim, Ayden Case, Edward F. Hendershot, Jessica L. Seidelman, Thorsten M. Seyler, William A. Jiranek
Summary: This study aimed to quantify the sensitivity of D-dimer for the diagnosis of acute and chronic periprosthetic joint infection (PJI) and evaluate its lab values in the 90-day postoperative window. The results showed that D-dimer had a higher sensitivity for chronic PJI and limited diagnostic utility for acute PJI.
JOURNAL OF ARTHROPLASTY
(2023)
Article
Medicine, General & Internal
Han-Kook Yoon, Ju-Hyung Yoo, Hyun-Cheol Oh, Joong-Won Ha, Sang-Hoon Park
Summary: This study retrospectively analyzed over 7000 cases of periprosthetic joint infection (PJI) after total knee arthroplasty. The incidence rate of PJI was 0.5%, and Staphylococcus aureus was the most commonly isolated pathogen. The success rate of the I&D and implant retention procedure (DAIR) was 82.6%, but lower than two-stage exchange arthroplasty.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Orthopedics
Christoph Theil, Jan Schwarze, Maria Anna Smolle, Jan Puetzler, Burkhard Moellenbeck, Kristian Nikolaus Schneider, Martin Schulze, Sebastian Klingebiel, Georg Gosheger
Summary: This retrospective study found that there is a certain risk of dislocation for dual-mobility acetabular components in two-stage surgery for periprosthetic joint infection (PJI). The overall risk of dislocation was 17% at 5 years, and the risk of revision for dislocation was 12% at 5 years. The overall risk of all-cause implant revision was 20% at 5 years.
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH
(2023)
Review
Medicine, General & Internal
Christos Koutserimpas, Symeon Naoum, Vasileios Giovanoulis, Konstantinos Raptis, Kalliopi Alpantaki, Konstantinos Dretakis, Georgia Vrioni, George Samonis
Summary: Fungal hip prosthetic joint infections (PJIs) are rare but severe infections. This review analyzed all published cases of fungal hip PJIs to provide comprehensive information on demographics, causative fungi, treatment options, and infection outcomes.
Article
Medicine, General & Internal
Vasileios Giovanoulis, Angelo V. Vasiliadis, Christos Koutserimpas, George Samonis, Cecile Batailler, Tristan Ferry, Sebastien Lustig
Summary: This study reports an extremely rare fungal infection caused by Candida lusitaniae after revised total knee replacement. The patient was successfully treated with multiple strategies, highlighting the importance of a multidisciplinary approach for managing severe infections.
Article
Orthopedics
Han Yin, Duliang Xu, Dawei Wang
Summary: In this study, NGS was found to have higher accuracy and sensitivity than bacterial culture and serological biomarkers for diagnosing PJI. NGS showed potential as a diagnostic method with higher accuracy and sensitivity.
BMC MUSCULOSKELETAL DISORDERS
(2021)
Article
Cell & Tissue Engineering
E. Lenguerrand, M. R. Whitehouse, A. D. Beswick, S. K. Kunutsor, J. C. J. Webb, S. Mehendale, M. Porter, A. W. Blom
Summary: This study compared the risks of re-revision and mortality between two-stage and single-stage revision surgeries in patients with infected primary hip arthroplasty. The results showed that two-stage revision had a lower risk of unplanned re-revision, especially in the early postoperative period. However, single-stage revision had a lower overall number of revision procedures and comparable mortality rates.
BONE & JOINT RESEARCH
(2023)
Article
Orthopedics
David Kugelman, Mackenzie Roof, Alexander Egol, Isabella Guanche, Antonia F. Chen, Ran Schwarzkopf, Vinay K. Aggarwal
Summary: This study compared the outcomes of real-component (RC) and all-cement (AC) articulating spacers for total hip arthroplasty (THA) periprosthetic joint infection (PJI) treatment. The RC group showed shorter hospital stays and higher likelihood of being discharged home compared to the AC group, with no significant differences in reinfection and reoperation rates between the two spacer constructs.
JOURNAL OF ARTHROPLASTY
(2022)
Article
Multidisciplinary Sciences
Jiahao Wang, Zhen Zhang, Jingyi Li, Biying Huang, Zichao Jiang, Yixiao Pan, Tailai He, Yihe Hu, Long Wang
Summary: The administration of TXA has been found to reduce biofilm formation, which can protect against implant-associated infection.
SCIENTIFIC REPORTS
(2022)
Article
Health Care Sciences & Services
Miguel Moreno-Romero, Alejandro Ordas-Bayon, Alejandro Gomez-Rice, Miguel A. A. Ortega, Basilio J. De La Torre J. de la Torre Escuredo
Summary: Partial two-stage reconstruction is a promising technique for the treatment of chronic periprosthetic joint infection in patients with a well-fixed stem and complex re-revision acetabular procedures. Further prospective studies and prolonged follow-ups are required to confirm our results.
JOURNAL OF PERSONALIZED MEDICINE
(2023)
Article
Orthopedics
Cameron K. Ledford, Arun R. Kumar, Christian G. Guier, Kristin M. Fruth, Mark W. Pagnano, Daniel J. Berry, Matthew P. Abdel
Summary: This study evaluated the implant survivorship, complications, and clinical outcomes of primary total knee arthroplasty (TKA) performed in patients with metabolic syndrome (MetS). The results showed that MetS did not significantly increase the risk of reoperation after TKA, but MetS patients with a BMI >40 had a two-fold increased risk of revision and reoperation for periprosthetic joint infection (PJI).
JOURNAL OF ARTHROPLASTY
(2023)
Article
Orthopedics
Courtney E. Baker, Brian P. Chalmers, Michael J. Taunton, Adam W. Amundson, Daniel J. Berry, Matthew P. Abdel
Summary: This study examined mortality, medical complications, implant survivorship, and clinical outcomes in patients with pulmonary hypertension (HTN) undergoing total hip arthroplasty (THA). The results showed that patients with HTN had an increased risk of death and a higher rate of medical complications within 90 days of surgery.
JOURNAL OF ARTHROPLASTY
(2023)
Article
Orthopedics
Sean P. Ryan, Christopher N. Warne, Douglas R. Osmon, Aaron J. Tande, Cameron K. Ledford, Meredith Hyun, Daniel J. Berry, Matthew P. Abdel
Summary: Recent evidence suggests that extended postoperative prophylactic oral antibiotics after two-stage exchange arthroplasty can be beneficial in treating periprosthetic joint infections. A retrospective review was conducted to determine the reinfection rates with and without a short course of oral antibiotics after two-stage exchange procedures. The study found that patients who received oral antibiotics for less than 2 weeks after reimplantation had a lower reinfection rate compared to those who did not receive antibiotics.
JOURNAL OF ARTHROPLASTY
(2023)
Article
Orthopedics
Cody R. Fisher, Jordan E. Krull, Aditya Bhagwate, Thao Masters, Kerryl E. Greenwood-Quaintance, Matthew P. Abdel, Robin Patel
Summary: Cellularity predicted using CIBERSORTx can differentiate between infectious and non-infectious arthroplasty failure by evaluating the underlying immune response without the need for phenotypic assessment of cell composition.
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME
(2023)
Article
Orthopedics
Harold I. Salmons, Daniel Karczewski, Cameron K. Ledford, Nicholas A. Bedard, Cody C. Wyles, Matthew P. Abdel
Summary: This study investigated the effect of femoral head length on the risk of revision and reoperation after cobalt chromium-on-highly crosslinked polyethylene THAs. The results showed that altering the femoral head length did not have a significant effect on outcomes, and surgeons should consider other factors such as hip stability and center of rotation when selecting femoral head lengths.
JOURNAL OF ARTHROPLASTY
(2023)
Article
Orthopedics
Richard D. Rames, Cory G. Couch, Rafael J. Sierra, Daniel J. Berry, Robert T. Trousdale, Matthew P. Abdel
Summary: Based on a cadaveric radiographic study, it was found that the flush rim design of modular dual-mobility liners can accurately detect malseating in 95% of cases, while the elevated rim design is more difficult to identify malseating on plain radiographs.
JOURNAL OF ARTHROPLASTY
(2023)
Article
Orthopedics
Aaron R. Owen, Adam W. Amundson, Dirk R. Larson, Christopher M. Duncan, Hugh M. Smith, Rebecca L. Johnson, Michael J. Taunton, Mark W. Pagnano, Daniel J. Berry, Matthew P. Abdel
Summary: This study compared the effects of spinal anesthesia and general anesthesia in revision total knee arthroplasties. The results showed that patients who received spinal anesthesia had lower postoperative pain, shorter length of stay, and fewer complications compared to those who received general anesthesia. Spinal anesthesia was associated with reduced opioid requirements, decreased cases of altered mental status and intensive care unit admissions, and fewer re-revisions and reoperations.
JOURNAL OF ARTHROPLASTY
(2023)
Article
Orthopedics
Harold I. Salmons, Jacob W. Bettencourt, Cody C. Wyles, Douglas R. Osmon, Daniel J. Berry, Matthew P. Abdel
Summary: Most data on irrigation and debridement with component retention (IDCR) as a treatment for acute periprosthetic joint infections (PJIs) focuses on primary total joint arthroplasties (TJAs). However, the incidence of PJI is greater after revisions. We investigated the outcomes of IDCR with suppressive antibiotic therapy (SAT) following aseptic revision TJAs.
JOURNAL OF ARTHROPLASTY
(2023)
Article
Orthopedics
Daniel Karczewski, Harold I. Salmons, Nelson Leung, Dirk R. Larson, Daniel J. Berry, Matthew P. Abdel
Summary: This study analyzed the outcomes of primary total hip arthroplasty (THA) in dialysis-dependent patients. The results showed a high 5-year mortality rate but a low cumulative incidence of revision or reoperation. Renal metrics remained consistent after the surgery, but only a quarter of the patients successfully received a renal transplant.
JOURNAL OF ARTHROPLASTY
(2023)
Article
Orthopedics
Emmanuel Gibon, David G. Lewallen, Dirk R. Larson, Michael J. Stuart, Mark W. Pagnano, Matthew P. Abdel
Summary: This study investigated the impact of three different tibial designs on total knee arthroplasties (TKAs). The results showed that cementless and hybrid monoblock tibial components had better implant survivorship compared to the traditional modular cemented tibia. At 10-year follow-up, the traditional modular cemented tibia had a higher incidence of aseptic tibial loosening, while the other two groups did not. Clinical outcomes were similar and excellent in all three groups.
JOURNAL OF ARTHROPLASTY
(2023)
Article
Biochemical Research Methods
Cody R. Fisher, Kiran K. Mangalaparthi, Kerryl E. Greenwood-Quaintance, Matthew P. Abdel, Akhilesh Pandey, Robin Patel
Summary: This pilot study aimed to differentiate Staphylococcus aureus-associated periprosthetic joint infection (PJI) and non-infected arthroplasty failure (NIAF) using proteomic profiling. The results showed that proteomic profiling can distinguish between infected and non-infected samples and identified differentially abundant proteins. Further research with a larger sample size and diverse types of non-infected samples is needed.
PROTEOMICS CLINICAL APPLICATIONS
(2023)
Article
Orthopedics
D. Karczewski, M. P. Siljander, D. R. Larson, M. J. Taunton, D. G. Lewallen, M. P. Abdel
Summary: This study compared implant survivorship and clinical outcomes in patients with sequelae of poliomyelitis undergoing total knee arthroplasties (TKAs). The results showed that the survival rate of TKAs was slightly higher in limbs with poliomyelitis, but the risk of complications, such as reoperation and arthrofibrosis, was also higher in these patients.
BONE & JOINT JOURNAL
(2023)
Article
Orthopedics
Aaron R. Owen, Adam W. Amundson, Kristin M. Fruth, Christopher M. Duncan, Hugh M. Smith, Rebecca L. Johnson, Michael J. Taunton, Mark W. Pagnano, Daniel J. Berry, Matthew P. Abdel
Summary: Through a retrospective study, it was found that spinal anesthesia, compared to general anesthesia, can provide better pain control, shorter length of stay, and reduced complications in a large cohort of revision total hip arthroplasties.
JOURNAL OF ARTHROPLASTY
(2023)
Article
Orthopedics
B. M. Wooster, N. I. Kennedy, E. M. Dugdale, R. J. Sierra, K. I. Perry, D. J. Berry, M. P. Abdel
Summary: This study examined the outcomes of primary total hip arthroplasties with highly cross-linked polyethylene (HXLPE) in patients with inflammatory arthritis. The results showed that this procedure had excellent survivorship and good functional outcomes regardless of the fixation method used.
BONE & JOINT JOURNAL
(2023)
Article
Orthopedics
J. R. Harmer, C. C. Wyles, S. Q. Duong, R. J. Morgan, H. Maradit-Kremers, M. P. Abdel
Summary: The study aims to investigate the prevalence of depressive and anxiety disorders prior to total hip and total knee arthroplasty and their impact on infection rates, revision rates, and reoperation rates. Data from a single academic medical center were analyzed and showed that depressive and anxiety disorders were common before both procedures and were associated with higher risks of infection, revision, reoperation, and patient dissatisfaction. These findings highlight the importance of mental health optimization in arthroplasty patients, similar to other preoperative factors such as diabetic control.
BONE & JOINT JOURNAL
(2023)
