Periprosthetic joint infections: state-of-the-art.

In general, periprosthetic joint infection (PJI) is regarded as one of the most common complications of total joint arthroplasty (TJA) and may lead to surgical failure, revision surgery, amputation or death. Nowadays, PJI has become a global health concern, which brings a great burden to public healthcare. In addition, there are still obstacles to achieve high success rates in the prevention, diagnosis and treatment of PJI.

Dynamics of Synovial Fluid Markers Following Single-Stage Exchange and Debridement, Antibiotics, and Implant Retention Procedure With Topical Antibiotic Infusion in Treating Periprosthetic Joint Infection.

Background: Periprosthetic joint infection (PJI) is a severe complication following total joint arthroplasty. This study aimed to investigate the dynamics of synovial fluid markers following single-stage exchange arthroplasty or debridement, combined with antibiotics and implant retention with topical antibiotic infusion for PJI.

Methods: This retrospective study analyzed patient records at a tertiary hospital from March 1, 2018, to May 1, 2023.

The Association of Glycemic Control Medication Regimens and Preoperative Fructosamine Among Total Joint Artrhoplasty Patients.

Background: Although glycated hemoglobin A1C (HbA1c) has classically been used for glycemic control screening before surgery, fructosamine, a short-term glucose variability indicator, has been reported to be a more accurate predictor of postoperative periprosthetic joint infection among patients with diabetes mellitus (DM). Given the variability of diabetic medication management, this study aims to identify the associated effect of glycemic control medication regimen (GCMR) on the incidence rate and associated odds of abnormal preoperative fructosamine levels among diabetic primary total knee arthroplasty or total hip arthroplasty patients.

Methods: Between 2017 and 2018, consecutive series of total hip arthroplasty and total knee arthroplasty patients were identified, and the final cohort included only diabetic patients.

Should Surgical Drains Be Used After Routine Primary Total Knee or Total Hip Arthroplasty?

Response/recommendation: The use of surgical drains in routine primary total knee and total hip arthroplasty is not recommended.

Level Of Evidence: High.

Expert Voting: Agree 83.

Evidence-based Approach for Prevention of Surgical Site Infection.

Periprosthetic joint infection (PJI) is regarded as a critical factor contributing to the failure of primary and revision total joint arthroplasty (TJA). With the increasing prevalence of TJA, a significant increase in the incidence of PJI is expected. The escalating number of cases, along with the significant economic strain imposed on healthcare systems, place emphasis on the pressing need for development of effective strategies for prevention.

Local Antibiotic Infusion in Periprosthetic Joint Infection Following Total Hip Arthroplasty.

Local antibiotic infusion has emerged as a promising adjunctive therapy, delivering high concentrations of antibiotics directly to the infection site. This approach aims to enhance eradication of pathogens while minimizing systemic side effects associated with prolonged antibiotic use. This narrative review encompassed 10 articles focused on all three procedures of surgical intervention for periprosthetic joint injection (PJI) following total hip arthroplasty (THA): debridement, antibiotics, and implant retention (DAIR), single-stage revision arthroplasty, and two-stage revision arthroplasty.

Does Focused Gluteus Medius Muscle Stretching After Total Hip Arthroplasty Work? An Electromyographic Study.

Background: The hypothesis of this randomized prospective study was that focused stretching of the gluteus medius muscle, in addition to generalized physical therapy, is likely to improve muscle reaction time and positively impact the return to function of the patient after primary total hip arthroplasty.

Methods: We prospectively recruited 28 patients undergoing primary total hip arthroplasty from January 2021 to January 2023. The control group (13 patients) received a conventional rehabilitation protocol, while the intervention group (15 patients) received focused stretching exercises of the gluteus medius muscle in addition to the conventional rehabilitation protocol.

In Vivo Intra-Articular Antibiotic Concentrations at 24 Hours After TKA Fall Below the Minimum Inhibitory Concentration for Most Bacteria: A Randomized Study of Commercially Available Bone Cement.

Background: The use of antibiotic-loaded bone cement (ALBC) to help reduce the risk of infection after primary total knee arthroplasty (TKA) is controversial. There is a paucity of in vivo data on the elution characteristics of ALBC. We aimed to determine whether the antibiotic concentrations of 2 commercially available ALBCs met the minimum inhibitory concentration (MIC) and minimum biofilm eradication concentration (MBEC) for common infecting organisms.

Nasal microbiome and the effect of nasal decolonization with a novel povidone-iodine antiseptic solution: a prospective and randomized clinical trial.

The aim of this study was to assess the profile of nasal microbiome and evaluate the effect of a specific nasal decolonization solution on the microbiome. We conducted a randomized, placebo-controlled, and parallel-group clinical study of 50 volunteers aged 18 years and older. The subjects were randomly assigned to receive a nasal antiseptic solution, containing povidone-iodine as the main ingredient, (n = 25) or a control solution (n = 25).