Increased short- and long-term mortality amongst patients with early periprosthetic knee joint infection.

Background: Periprosthetic joint infection (PJI) following total knee arthroplasty (TKA) is a severe complication in terms of disability, morbidity, and cost. We performed a study to investigate whether early PJI (within 90 days of primary TKA) is associated with increased mortality. Secondary aims were to compare mortality rates over time and between surgical treatment methods.

Similar periprosthetic joint infection rates after and before a national infection control program: a study of 45,438 primary total knee arthroplasties.

Background and purpose - Strenuous efforts to minimize postoperative infection rates have been made, including the Swedish nationwide initiative Prosthesis Related Infections Shall be Stopped (PRISS). This study calculated the incidence rate of periprosthetic joint infection (PJI) following primary total knee arthroplasty (TKA) before and after PRISS. Patients and methods - All 45,438 primary TKAs registered in the Swedish Knee Arthroplasty Register (SKAR) during 2007-2008 and 2012-2013 were included.

Anti-rheumatic treatment and prosthetic joint infection: an observational study in 494 elective hip and knee arthroplasties.

Background: Surgical site infections are more frequent among patients with rheumatic disease. To what extent this is related to immunosuppressive antirheumatic drugs is unclear, as is the value of discontinuing medication perioperatively. The aim of study was to assess the rate of surgical site infections after knee and hip replacement in patients with inflammatory joint disease, with an emphasis on periprosthetic joint infection, and to investigate the influence of treatment with disease-modifying antirheumatic drugs (DMARDs) in this regard.

A population-based study on the treatment and outcome of enterococcal prosthetic joint infections. A consecutive series of 55 cases.

Aim: Enterococci cause 2-11% of all prosthetic joint infections (PJI) and are generally considered difficult to treat. However, study-results are not consistent. In this study we present a population-based case series of 55 cases with enterococcal PJI, investigating treatment and outcome, as well as describing the affected patient population regarding demography and co-morbidities.

Why are antiepileptic drugs continued after successful epilepsy surgery in adults?

Objective: Studies have demonstrated that a substantial number of patients continue treatment with antiepileptic drugs (AEDs) for many years after epilepsy surgery despite seizure freedom. In this study, we aimed to investigate why AED treatment is maintained in patients three and seven years after successful epilepsy surgery. To our knowledge, an analysis of this specific subgroup of completely seizure-free patients has not been done before.

Higher risk of revision for infection using systemic clindamycin prophylaxis than with cloxacillin.

Background and purpose - Clindamycin has not been compared with other antibiotics for prophylaxis in arthroplasty. Since 2009, the Swedish Knee Arthroplasty Register (SKAR) has been collecting information on the prophylactic antibiotic regime used at every individual operation. In Sweden, when there is allergy to penicillin, clindamycin has been the recommended alternative.

[Infection of a total knee replacement following repeated joint aspiration - a case report].

Unlabelled: An 80-year old male presented with an infected knee replacement following repeated joint aspirations. They were carried out due to recurrent hemarthrosis resulting from an initially missed quadriceps tendon injury. The infection was eradicated first after arthrodesis.

[Acute ischemic stroke in female adolescent - Case report].

During soccer practice a fifteen year old girl experienced a sudden onset of pain in the left side of her neck and collapsed. Upon arrival at the emergency room she had right hemiparesis and expressive aphasia. On CT angiography a left carotid arterial dissection was suspected.

75% success rate after open debridement, exchange of tibial insert, and antibiotics in knee prosthetic joint infections.

Background And Purpose: Prosthetic joint infection (PJI) is a leading cause of early revision after total knee arthroplasty (TKA). Open debridement with exchange of tibial insert allows treatment of infection with retention of fixed components. We investigated the success rate of this procedure in the treatment of knee PJIs in a nationwide material, and determined whether the results were affected by microbiology, antibiotic treatment, or timing of debridement.

The process of translating family nursing knowledge into clinical practice.

Purpose: To report on approaches that were used to assist with implementation of family systems nursing (FSN) at a university hospital level in Northern Europe.

Design And Methods: A quasi-experimental research design was used for the first phase of the study. For the second phase, a cross-sectional research design was used.

Bacterial colonization and resistance patterns in 133 patients undergoing a primary hip- or knee replacement in Southern Sweden.

Background And Purpose: Prosthetic joint infections can be caused by bacteria derived from the patient's skin. The aim of the study was: (1) to determine which bacteria colonize the nose and groin in patients planned for primary hip or knee arthroplasty, (2) to determine the antimicrobial resistance patterns, and (3) to monitor changes in bacterial colonization and resistance patterns connected to surgery.

Patients And Methods: 2 weeks before scheduled primary hip or knee arthroplasty, culture samples were taken from the anterior nares and from the groin of 133 consecutive patients.

Timing of preoperative antibiotics for knee arthroplasties: Improving the routines in Sweden.

Background: A slight increase in revisions for infected joint arthroplasties has been observed in the Nordic countries since 2000 for which the reasons are unclear. However, in 2007 a Swedish study of the timing for prophylactic antibiotics in a random sample of knee arthroplasties found that only 57% of the patients had received the antibiotic during the optimal time interval 45-15 minutes before surgery. The purpose of the report was to evaluate the effect of measures taken to improve the timing of prophylactic antibiotics.

Inadequate timing of prophylactic antibiotics in orthopedic surgery. We can do better.

Background And Purpose: There are rising concerns about the frequency of infection after arthroplasty surgery. Prophylactic antibiotics are an important part of the preventive measures. As their effect is related to the timing of administration, it is important to follow how the routines with preoperative prophylactic antibiotics are working.

Microbiology of the infected knee arthroplasty: report from the Swedish Knee Arthroplasty Register on 426 surgically revised cases.

Surgically revised deep infected primary knee arthroplasties reported to the Swedish knee arthroplasty register during the years 1986-2000 were studied with respect to microbiology, antimicrobial susceptibility pattern and changes over time. In early, delayed and late infections, coagulase-negative staphylococci (CoNS) were most prevalent (105/299, 35.1%), and twice as common as Staphylococcus aureus (55/299, 18.

Higher early mortality with simultaneous rather than staged bilateral TKAs: results from the Swedish Knee Arthroplasty Register.

Unlabelled: Patients with knee osteoarthritis (OA) often present with symptoms that warrant bilateral TKAs. There are potential benefits to operating on both knees on the same day, but the safety of simultaneous bilateral TKAs has been questioned. To evaluate whether there were any differences in 30-day mortality between patients having simultaneous bilateral TKAs and those having staged bilateral TKAs, we analyzed data from the Swedish Knee Arthroplasty Register and the Swedish Cause of Death Register.

Five-year follow-up of socket movements and loosening after revision with impacted morselized allograft bone and cement: a radiostereometric and radiographic analysis.

In 1999, we reported on the 2-year results of a series of 21 first-time socket revisions using impacted morselized allograft bone. Seven still migrated between 1.5 and 2 years.

Quality of life after hip revision with impaction bone grafting on a par with that 4 years after primary cemented arthroplasty.

Background: There have been few studies evaluating patient-reported quality of life outcomes after hip revision with impaction bone grafting.

Patients And Methods: The inclusion criteria were aseptic loosening after primary arthroplasty performed for osteoarthrosis, and first-time revision with impacted morselized allograft bone and cemented Exeter stem. During a 4-year period, 35 patients were eligible and all were included.

Movement pattern of the Exeter femoral stem; a radiostereometric analysis of 22 primary hip arthroplasties followed for 5 years.

Background: The design of the Exeter stem may facilitate distal migration, but radiostereometric analysis (RSA) studies have been limited to 2 years of follow-up.

Patients And Methods: We followed migration of the Exeter femoral stems in 22 primary hip arthroplasties for 5 years with RSA.

Results: All stems migrated distally and the median migration at 2 years was 1.