Chronic infection of unicompartmental knee arthroplasty: one-stage conversion to total knee arthroplasty.

Background: The main reasons for revision of unicompartmental knee arthroplasty (UKA) are loosening, wear, extension of osteoarthritis to another compartment, and infection. There have been no studies of the management of infected UKA, whose incidence varies from 0.2% to 1%.

Outcome of patients over 80 years of age on prolonged suppressive antibiotic therapy for at least 6 months for prosthetic joint infection.

Objectives: To describe elderly patients treated with prolonged suppressive antibiotic therapy for a prosthetic joint infection (PJI) in cases where the infected prosthesis could not be removed.

Methods: All patients aged ≥80 years with a documented PJI and treated with prolonged suppressive antibiotic therapy for more than 6 months were included retrospectively in this study. The following events were noted: failure including persisting infection, relapse, new infection, treatment discontinuation due to severe adverse events, and related death, and also unrelated death.

Ceramic-on-ceramic total hip arthroplasty: is squeaking related to an inaccurate three-dimensional hip anatomy reconstruction?

Many factors were incriminated in the squeaking generation in ceramic-on-ceramic total hip arthroplasty (THA), including the cup positioning and design. However, the influence of the stem orientation has not been investigated and the true three-dimensional hip anatomy has never been compared to the contralateral healthy hip. Three patients, who underwent unilateral ceramic-on-ceramic THA, complained of squeaking.

One-stage exchange arthroplasty for chronic periprosthetic hip infection: results of a large prospective cohort study.

Background: Exchange arthroplasty of one or two stages is required for the treatment of chronic periprosthetic joint infections. Two-stage exchange is costly and has high morbidity with limited patient mobility between procedures. One-stage exchange has been promoted by several European teams as the preferred alternative.

Continuous high-dose vancomycin combination therapy for methicillin-resistant staphylococcal prosthetic hip infection: a prospective cohort study.

Few data are available on treatment and outcome of methicillin-resistant (MR) staphylococcal prosthetic joint infections. Vancomycin remains the treatment of choice for these infections, but its efficacy and safety in bone-and-joint infections are insufficiently documented. We conducted a prospective cohort study on 60 patients treated between November 2002 and December 2008 for chronic MR staphylococcal (44 S.

Infected total hip arthroplasty revision: one- or two-stage procedure?

Introduction: Better outcomes have been reported for two-stage total hip arthroplasty (THA) revision for infection. However, one-stage revision arthroplasty remains an attractive alternative option since it requires only one operation. A decision tree has been developed by the authors in order to determine which type of surgical procedure can be performed safely.

Investigation into three dimensional hip anatomy in anterior dislocation after THA. Influence of the position of the hip rotation centre.

Background: The components position is a major factor under the surgeon's control in determining the risk of dislocation post total hip arthroplasty. The aim of this study was to investigate the proper three-dimensional components position including the centre of rotation in the case of anterior dislocation.

Methods: Among 1764 consecutive patients who underwent total hip arthroplasty using a direct anterior approach, 27 experienced anterior dislocation.

Monitoring the one year postoperative infection rate after primary total hip replacement.

Purpose: Infection of a total hip replacement is potentially a devastating complication. Statistical process control methods have been generating interest as a means of improving the quality of healthcare, and we report our experience with the implementation of such a method to monitor the one year infection rate after primary total hip replacement.

Method: Infection was defined as the growth of the same organism in cultures of at least two aspirates or intra-operative specimens, or growth of one pathogen in a patient with local signs of infection such as erythema, abscess or draining sinus tract.

Total hip arthroplasty dislocation rate following isolated cup revision using Hueter's direct anterior approach on a fracture table.

Introduction: Instability is a major complication after revision total hip arthroplasty. Studies in the literature have shown that the dislocation rate after primary arthroplasties by anterior approach on a fracture table is satisfactory, but the rate of instability following revision surgery is not known.

Hypothesis And Aims: We hypothesized that the Hueter direct anterior approach would result in a lower rate of postoperative dislocation following revision surgery.

Infected total hip arthroplasty treated by an irrigation-debridement/component retention protocol. A prospective study in a 12-case series with minimum 2 years' follow-up.

Introduction: Treatment of infection after total hip replacement (THR) is complex and costly. Debridement with component retention is an attractive solution. Success rates in the literature vary widely (18-90%) according to patient selection criteria.

Arthrodesis with internal fixation of the infected ankle.

Arthrodesis may be necessary to avoid amputation when treating an infected tibiotalar joint. In such cases, external or hybrid fixation is usually used. In this retrospective study, we report our experience in treating tibiotalar joint infection by arthrodesis with internal fixation.

Arthroplasty following a septic arthritis history: a 53 cases series.

Introduction: The most feared complication of arthroplasty after septic arthritis (active or quiescent) on a degenerative joint is septic failure, but this risk is difficult to assess. The aim of the present study was to analyze the results of arthroplasties after septic arthritis of native knee and hip joints, in terms of functional results and infection control and to seek eventual risk factors of failure.

Patients And Methods: Fifty-three cases of septic arthritis treated by arthroplasty (31 knees and 22 hips) were retrospectively included.

Osteomyelitis in adults: an underrecognized clinical entity in immunocompetent hosts. A report of six cases.

Objective: Osteomyelitis is rare in adults and typically occurs in patients with risk factors such as sickle cell disease or immune deficiency. Cases in immunocompetent adults without sickle cell disease are extremely rare. The objective of this work was to describe the epidemiological, clinical, laboratory, and radiological features and the management of long-bone osteomyelitis in immunocompetent adults without sickle cell disease.

Total hip arthroplasty revision due to infection: a cost analysis approach.

Introduction: The treatment of total hip arthroplasty (THA) infections is long and costly. However,the number of studies in the literature analysing the real cost of THA revision in relation to their etiology, including infection, is limited. The aim of this retrospective study was to determine the cost of revision of infected THA and to compare these costs to those of primary THA and revision of non-infected THA.

Continuous clindamycin infusion, an innovative approach to treating bone and joint infections.

The feasibility, safety, and efficacy of prolonged, continuous, intravenous clindamycin therapy were retrospectively evaluated for 70 patients treated for bone and joint infections, 40% of whom were treated as outpatients. The median treatment duration was 40 days, the median daily clindamycin dose was 2,400 mg, and three moderate-grade adverse events occurred. The median serum clindamycin concentrations on days 3 to 14 and days 8 to 28 were 5 and 6.

Undetected fracture of an alumina ceramic on ceramic hip prosthesis.

An unusual case of undetected ceramic fracture was discovered by coincidence during total hip arthroplasty revision for sepsis. To our knowledge, this kind of fracture has never been described before. The cup liner was broken in 2 parts, consisting of a large outer annulus and a smaller round central piece that was detached from the superior and posterior part of the cup, creating a hole in the cup.

Outcome of group B streptococcal prosthetic hip infections compared to that of other bacterial infections.

Background: Outcome of streptococcal prosthetic hip infection is often thought to be better than that caused by other pathogens. That supposition was not confirmed in our experience with group B streptococcal prosthetic joint infection.

Objective: We compared outcomes of group B streptococcal and other-pathogen prosthetic hip infections.

Continuous cefazolin infusion to treat bone and joint infections: clinical efficacy, feasibility, safety, and serum and bone concentrations.

Cefazolin has been used for many years to treat bone and joint infections. Because of its time-dependent antimicrobial activity, continuous infusion would potentially be beneficial. We report on the feasibility, safety, and efficacy of prolonged continuous intravenous cefazolin therapy in a cohort of 100 patients, their serum cefazolin levels, and the concomitant bone cefazolin concentrations in 8 of them.

Dislocation after total hip arthroplasty using Hueter anterior approach.

A prospective study including 1764 hips has been carried out to evaluate the frequency of dislocation while using the Hueter anterior approach and the correlated factors. The dislocation group was compared with the patients without dislocation. We observed 27 dislocations (1.

[Infection on continuous bone of lower limb: 127 cases].

Purpose Of The Study: Infection on continuous bone is a specific diagnostic and therapeutic entity. Treatment requires debridement of infected and necrotic soft tissue and bone, dead space management, effective antibiotic therapy in the bone and good skin coverage with well-vascularized tissues. Results of treatment of infection on continuous bone of the lower limb are presented in this series.

[Dental care and joint prostheses].

Purpose Of The Study: Infectious dental foci and oral dental care constitute one of the leading causes of arthroplasty infection after infections involving the skin and the urinary tract. There is however no formal evidence confirming the relationship between oral or dental care and arthroplasty infection.

Material And Methods: We reviewed 44 cases of arthroplasty infection secondary to dental infections and searched for data in the literature.

Propionibacterium acnes: an agent of prosthetic joint infection and colonization.

Background: Prosthetic joint infection (PJI) can present a diagnostic challenge, especially with slow-growing and poorly virulent bacteria.

Objective: To describe the epidemiological, clinical and biological characteristics of Propionibacterium acnes PJI, their treatments and outcomes and compare 2 clinical pictures (according to the time PJI symptoms appeared after the index operation: < or = 2 years, > 2 years).

Methods: We conducted a cohort study on P.

[Results of reimplantation for infected total knee arthroplasty: 107 cases].

Purpose Of The Study: The purpose of this study was to assess the results of reimplantations of total knee arthroplasties complicated by infection. Outcome was assessed in terms of eradicated infection and function.

Material And Methods: This retrospective multicentric study included 107 cases of infected total knee arthroplasties treated by changing the implants.