Variations in clinical practice of one-stage septic revisions in chronic hip and knee periprosthetic joint infections: an international questionnaire study.

Introduction: Recent studies have increasingly provided evidence that one-stage septic revisions for hip and knee are a safe treatment option for periprosthetic joint infections (PJI) in selected patients. However, there is still a wide treatment variation concerning indications and execution among different practices. This study aimed to describe these differences.

Incisional Wound Irrigation for the Prevention of Surgical Site Infection: A Systematic Review and Network Meta-Analysis.

Importance: Surgical site infections (SSIs) are common postoperative complications and associated with significant morbidity, mortality, and costs. Prophylactic intraoperative incisional wound irrigation is used to reduce the risk of SSIs, and there is great variation in the type of irrigation solutions and their use.

Objective: To compare the outcomes of different types of incisional prophylactic intraoperative incisional wound irrigation for the prevention of SSIs in all types of surgery.

Multiplex PCR test as an intra-operative diagnostic tool for periprosthetic joint infection in presumed aseptic revision hip and knee arthroplasty: a 1-year follow-up study of 200 cases.

Automated custom-made multiplex PCR techniques (mPCR) have become commercially available and are designed for intra-operative screening of concurrent periprosthetic joint infections (PJIs). The purpose of this study was to evaluate the value of a positive mPCR test in presumed aseptic revision total hip (THA) and knee (TKA) arthroplasties after a 1-year follow-up. In an earlier study, such an automated mPCR technique (Unyvero ITI G2; Curetis, Holzgerlingen, Germany) was tested on intra-operatively obtained synovial fluid in 200 patients with a presumed aseptic TKA or THA revision.

Biochemical markers in emergency thoracic surgery in penetrating trauma.

Background: Violent interpersonal acts account for a large proportion of unnatural deaths in South Africa. A significant proportion of unnatural deaths are due to penetrating thoracic trauma and preventable haemorrhage. Current indications for emergent thoracotomy are unreliable.

No difference in bacterial contamination of hip capsule sutures and control sutures in hip arthroplasty surgery.

Background: Perioperative preventive measures are important to further reduce the rate of periprosthetic joint infections (PJI) in patients undergoing total hip arthroplasty (THA). During THA surgery, joint capsule sutures are commonly placed to optimize exposure and reinsertion of the capsule. Bacterial contamination of these sutures during the procedure poses a potential risk for postoperative infection.

Prolonged use of linezolid in bone and joint infections: a retrospective analysis of adverse effects.

Objectives: Antibiotic treatment for bone and joint infections generally lasts for 6 weeks or longer. Linezolid may be a good option for treating bone and joint infections, but there is an increased risk of potential serious adverse drug events (ADEs) when used for more than 28 days. The aim of this study was to obtain detailed information on the type and time to occurrence of the patient-reported ADEs, the dynamics of haematopoiesis over time, and the reasons for early discontinuation of linezolid when used for an intended maximum duration of 12 weeks.

Debridement, Antibiotics and Implant Retention: A Systematic Review of Strategies for Treatment of Early Infections after Revision Total Knee Arthroplasty.

Goal: The purpose of this review is to provide a systematic and comprehensive overview of the available literature on the treatment of an early prosthetic joint infection (PJI) after revision total knee arthroplasty (TKA) and provide treatment guidelines.

Methods: This systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The search was conducted using the electronic databases of PubMed, Trip, Cochrane, Embase, LILACS and SciElo.

Incisional negative pressure wound therapy for the prevention of surgical site infection: an up-to-date meta-analysis and trial sequential analysis.

Background: The evidence on prophylactic use of negative pressure wound therapy on primary closed incisional wounds (iNPWT) for the prevention of surgical site infections (SSI) is confusing and ambiguous. Implementation in daily practice is impaired by inconsistent recommendations in current international guidelines and published meta-analyses. More recently, multiple new randomised controlled trials (RCTs) have been published.

The concordance between preoperative synovial fluid culture and intraoperative tissue cultures in periprosthetic joint infection: a systematic review.

: this systematic review aims to evaluate the concordance between preoperative synovial fluid culture and intraoperative tissue cultures in patients with periprosthetic joint infection (PJI) undergoing total hip (THA) or knee arthroplasty (TKA) revision surgery. : this review was conducted in accordance with the preferred reporting items for a systematic review and meta-analysis of diagnostic test accuracy studies (PRISMA-DTA) statement. Cochrane, Embase, PubMed, and Web of Science databases were searched to identify studies involving patients who had THA or TKA revision surgery for PJI and for whom preoperative synovial fluid culture and intraoperative tissue cultures were performed.

Assessment of antimicrobial mismatches in empirical treatment in early PJI after aseptic revision arthroplasty.

Background: In early periprosthetic joint infection (PJI), 'debridement, antibiotics and implant retention' (DAIR) is a widely accepted form of treatment. Empirical antimicrobial treatment is started while culture results of tissue samples taken during debridement are pending.

Objectives: In this retrospective study we assessed the antimicrobial mismatch rate between empirical treatment and the susceptibility of the causative microorganisms of PJI after aseptic revision arthroplasty.

Efficacy of different preoperative skin antiseptics on the incidence of surgical site infections: a systematic review, GRADE assessment, and network meta-analysis.

Background: Surgical site infection (SSI) is the most common postoperative complication and substantially increases health-care costs. Published meta-analyses and international guidelines differ with regard to which preoperative skin antiseptic solution and concentration has the highest efficacy. We aimed to compare the efficacy of different skin preparation solutions and concentrations for the prevention of SSIs, and to provide an overview of current guidelines.

Higher 1-year risk of implant removal for culture-positive than for culture-negative DAIR patients following 359 primary hip or knee arthroplasties.

: To date, the value of culture results after debridement, antibiotics, and implant retention (DAIR) for early (suspected) prosthetic joint infection (PJI) as risk indicators in terms of prosthesis retention is not clear. At the 1-year follow-up, the relative risk of prosthesis removal was determined for culture-positive and culture-negative DAIR patients after primary total hip or knee arthroplasty. The secondary aim of this work was to explore differences in patient characteristics, infection characteristics, and outcomes between these two groups.

Patient-reported outcome measures, complication rates, and re-revision rates are not associated with the indication for revision total hip arthroplasty : a prospective evaluation of 647 consecutive patients.

Aims: The aim of this study was to explore the relationship between reason for revision total hip arthroplasty (rTHA) and outcomes in terms of patient-reported outcome measures (PROMs).

Methods: We reviewed a prospective cohort of 647 patients undergoing full or partial rTHA at a single high-volume centre with a minimum of two years' follow-up. The reasons for revision were classified as: infection; aseptic loosening; dislocation; structural failure; and painful THA for other reasons.

Debridement, antibiotics, and implant retention after revision arthroplasty : antibiotic mismatch, timing, and repeated DAIR associated with poor outcome.

Aims: Debridement, antibiotics, and implant retention (DAIR) is a widely accepted form of surgical treatment for patients with an early periprosthetic joint infection (PJI) after primary arthroplasty. The outcome of DAIR after revision arthroplasty, however, has not been reported. The aim of this study was to report the success rate of DAIR after revision arthroplasty with a follow-up of two years.

Mismatch in Capture of Periprosthetic Joint Infections Between the Dutch Arthroplasty Register (LROI) and a Detailed Regional Periprosthetic Joint Infection Registry.

Background: National arthroplasty registries are important sources for periprosthetic joint infection (PJI) data and report an average incidence ranging from 0.5% to 2.0%.

Appraisal and coping predict health and well-being during the COVID-19 pandemic: An international approach.

COVID-19 has had a devastating impact on people worldwide. We conducted an international survey (n = 3646) examining the degree to which people's appraisals and coping activities around the pandemic predicted their health and well-being. We obtained subsamples from 12 countries-Bangladesh, Bulgaria, China, Colombia, India, Israel, the Netherlands, Norway, Peru, Portugal, Turkey and the United States.

Ruling out underlying infection in 200 presumed aseptic knee and hip revision arthroplasties using a multiplex PCR system.

Ruling out an infection in one-stage knee and hip revisions for presumed aseptic failure by conventional tissue cultures takes up to 14 days. Multiplex polymerase chain reaction (mPCR) is a quick test (4-5 h) for detecting pathogens. The purpose of this study was to evaluate the diagnostic accuracy of an automated mPCR of synovial fluid obtained intraoperatively in unsuspected knee and hip revisions.

Reinfection and re-revision rates of 113 two-stage revisions in infected TKA.

: Two-stage revision is the most frequently performed revision procedure of a (suspected) periprosthetic joint infection (PJI) after total knee arthroplasty (TKA). The reported results of this treatment show large variability between studies, ranging between 0 - 40 percent failure. The purposes of this study were to determine long term (1) reinfection rate, (2) re-revision rates for any reason, and (3) the reinfection rate of patients with positive cultures at reimplantation.

Evaluation One Year after DAIR Treatment in 91 Suspected Early Prosthetic Joint Infections in Primary Knee and Hip Arthroplasty.

Introduction: Early recognition and appropriate initial treatment with debridement, antibiotics and implant retention (DAIR) if a suspicion of an early prosthetic joint infection (PJI) is present can eradicate infection on first attempt and prevent implant failure. We evaluated the outcome after 1 year of patients treated with DAIR after primary total knee arthroplasty (TKA) or total hip arthroplasty (THA). Furthermore, we determined preoperative, microbiology, and treatment factors related to failure after DAIR.

The unsuspected prosthetic joint infection : incidence and consequences of positive intra-operative cultures in presumed aseptic knee and hip revisions.

Aims: Positive cultures are not uncommon in cases of revision total knee and hip arthroplasty (TKA and THA) for presumed aseptic causes. The purpose of this study was to assess the incidence of positive intra-operative cultures in presumed aseptic revision of TKA and THA, and to determine whether the presence of intra-operative positive cultures results in inferior survival in such cases.

Patients And Methods: A retrospective cohort study was assembled with 679 patients undergoing revision knee (340 cases) or hip arthroplasty (339 cases) for presumed aseptic causes.

Optimal pitching axis location of flapping wings for efficient hovering flight.

Flapping wings can pitch passively about their pitching axes due to their flexibility, inertia, and aerodynamic loads. A shift in the pitching axis location can dynamically alter the aerodynamic loads, which in turn changes the passive pitching motion and the flight efficiency. Therefore, it is of great interest to investigate the optimal pitching axis for flapping wings to maximize the power efficiency during hovering flight.

Low sensitivity of implant sonication when screening for infection in revision surgery.

Background and purpose - Prosthetic-joint infection (PJI) is the most serious complication of arthroplasty, and accurate identification of a potentially responsible microorganism is essential for successful antibiotic treatment. We therefore determined the diagnostic accuracy of sonication and compared it with tissue culture as a screening tool in detecting prosthetic joint infection in revision arthroplasty. Patients and methods - 252 consecutive revision arthroplasty cases were enrolled.