A prospective multicentre study of 82 prosthetic joint infections treated with a standardised debridement and implant retention (DAIR) protocol followed by 6 weeks of antimicrobial therapy: favourable results.

Introduction: Prosthetic joint infection (PJI) is a much-feared complication in total joint arthroplasty. Debridement, antibiotics, irrigation and implant retention (DAIR) is often the preferred treatment in acute PJIs, but with varying results. The primary aim of this study was to evaluate the outcome of a high quality DAIR procedure performed according to a consistently applied surgical protocol in early postoperative and acute haematogenous PJIs in hip and knee, and secondary to study risk factors associated with failure.

Comparing two different orthogeriatric models of care for hip fracture patients: an observational prospective cross-sectional study.

Introduction: Patients with hip fractures are almost always operated with quite extensive surgery and are often frail with a high risk of complications, increased dependency, and death. Orthogeriatric interdisciplinary care has shown better results compared with orthopaedic care alone. The best way of delivering orthogeriatric care, however, is still largely unknown.

Postvaccination immune responses and risk of primary total hip arthroplasty-A population-based cohort study.

Objective: To investigate the relationship between individual postvaccination immune responses and subsequent risk of total hip arthroplasty (THA) due to idiopathic osteoarthritis (OA) or rheumatoid arthritis (RA).

Method: Results of tuberculin skin tests (TSTs) following the Bacille Calmette-Guerin (BCG) vaccination were used as a marker of individual immune responses. TST results from the mandatory mass tuberculosis screening program 1948-1975 (n = 236 770) were linked with information on subsequent THA during 1987-2020 from the Norwegian Arthroplasty Register.

Poor outcome after debridement and implant retention for acute hematogenous periprosthetic joint infection: a cohort study of 43 patients.

Background And Purpose: The management of acute hematogenous periprosthetic joint infection (AHI) is challenging and the optimal treatment is not clearly defined. The aim of this study was to evaluate the treatment outcome of AHI, and secondarily to investigate potential risk factors that affect outcome.

Patients And Methods: We retrospectively analyzed 43 consecutive AHIs in a total hip or knee arthroplasty between 2013 and 2020 at a single center.

Antibiotic-Loaded Bone Cement in Prevention of Periprosthetic Joint Infections in Primary Total Knee Arthroplasty: A Register-based Multicentre Randomised Controlled Non-inferiority Trial (ALBA trial).

Introduction: The current evidence on the efficacy of antibiotic-loaded bone cement (ALBC) in reducing the risk of periprosthetic joint infections (PJI) after primary joint reconstruction is insufficient. In several European countries, the use of ALBC is routine practice unlike in the USA where ALBC use is not approved in low-risk patients. Therefore, we designed a double-blinded pragmatic multicentre register-based randomised controlled non-inferiority trial to investigate the effects of ALBC compared with plain bone cement in primary total knee arthroplasty (TKA).

Increasing but levelling out risk of revision due to infection after total hip arthroplasty: a study on 108,854 primary THAs in the Norwegian Arthroplasty Register from 2005 to 2019.

Background and purpose - Focus on prevention, surveillance, and treatment of infection after total hip arthroplasty (THA) in the last decade has resulted in new knowledge and guidelines. Previous publications have suggested an increased incidence of surgical revisions due to infection after THA. We assessed whether there have been changes in the risk of revision due to deep infection after primary THAs reported to the Norwegian Arthroplasty Register (NAR) over the period 2005-2019.

Rifampin combination therapy in staphylococcal prosthetic joint infections: a randomized controlled trial.

Background: The evidence supporting rifampin combination therapy in prosthetic joint infections (PJI) is limited due to the lack of controlled studies. The aim of this study is to evaluate the effect of adding rifampin to conventional antimicrobial therapy in early staphylococcal PJIs treated with debridement and retention of the implant (DAIR).

Methods: In this multicenter randomized controlled trial, 99 patients with PJI after hip and knee arthroplasties were enrolled.

Late onset periprosthetic infection of the hip caused by the fish pathogen in a patient not associated with fish exposure.

is a fish pathogen, rarely causing opportunistic infections in humans. There are only a few cases reported in the literature, mainly endocarditis, suggesting an association with raw fish consumption. We report a case of a periprosthetic hip infection successfully treated with a two-stage revision surgery.

Compliance with national guidelines for antibiotic prophylaxis in hip fracture patients: a quality assessment study of 13 329 patients in the Norwegian Hip Fracture Register.

Objective: We assessed compliance with new guidelines for prophylactic antibiotics in hip fracture surgery in Norway introduced in 2013.

Design: The data from the Norwegian Hip Fracture Register was used to assess the proportion of antibiotics given according to the national guidelines.

Setting: All hospitals in Norway performing hip fracture surgery in the period from 2011 to 2016.

Virus transmission during orthopedic surgery on patients with COVID-19 - a brief narrative review.

Background and purpose - COVID-19 is among the most impactful pandemics that the society has experienced. Orthopedic surgery involves procedures generating droplets and aerosols and there is concern amongst surgeons that otherwise rational precautionary principles are being set aside due to lack of scientific evidence and a shortage of personal protective equipment (PPE). This narrative review attempts to translate relevant knowledge into practical recommendations for healthcare workers involved in orthopedic surgery on patients with known or suspected COVID-19.

Results after introduction of a hip fracture care pathway: comparison with usual care.

Background and purpose - We established a care pathway for hip fracture patients, a "Hip Fracture Unit" (HFU), aiming to provide better in-hospital care and thus improve outcome. We compared the results after introduction of the HFU with a historical control group.Patients and methods - The HFU consisted of a series of measures within the orthopedic ward, such as reducing preoperative waiting time, increased use of nerve blocks, early mobilization, and osteoporosis treatment.

Infection after Constrained Condylar Knee Arthroplasty: Incidence and microbiological findings in 100 consecutive complex primary and revision total knee arthroplasties.

To report incidence, microbiological findings, and treatment outcome of prosthetic joint infection (PJI) after constrained condylar knee arthroplasty. Retrospective study of 100 consecutive complex primary and revision total knee arthroplasties operated with constrained condylar knee arthroplasties between February 2006 and October 2015 at a single institution. Demographic and surgical data were registered, as well as data regarding infection, microbiology and treatment.

Reduced survival for uncemented compared to cemented total hip arthroplasty after operatively treated acetabular fractures.

Background: Post traumatic arthritis and avascular necrosis of the femoral head are common complications after operatively treated acetabular fractures. This may cause severe disabilities for the patient, necessitating a total hip arthroplasty. Even though an arthroplasty may provide good symptomatic relief, the long-term results are more uncertain and no consensus exists according to preferred prosthetic designs.

Posterior versus lateral approach for hemiarthroplasty after femoral neck fracture: Early complications in a prospective cohort of 583 patients.

Aim: To compare early complications after the posterior and the direct lateral (transgluteal) approach, when using hemiarthroplasty in the treatment of displaced femoral neck fractures in the elderly.

Patients And Methods: A prospective clinical study from four Norwegian hospitals, consisting of 583 patients with 1year follow-up. All the hospitals used the same uncemented femoral stem and bipolar heads.

Prosthetic joint infection-a devastating complication of hemiarthroplasty for hip fracture.

Background and purpose - Hemiarthroplasty is the most common treatment in elderly patients with displaced femoral neck fracture. Prosthetic joint infection (PJI) is a feared complication. The infection rate varies in the literature, and there are limited descriptive data available.

Effectiveness of gentamicin-containing collagen sponges for prevention of surgical site infection after hip arthroplasty: a multicenter randomized trial.

Background: Surgical site infection (SSI) is a feared complication in hip arthroplasty, especially following femoral neck fracture in the elderly, associated with substantially increased morbidity, mortality, and costs. Gentamicin-containing collagen sponges are widely used for prevention of SSIs, but their effectiveness in joint replacement surgery remains unclear.

Methods: We performed a multicenter, randomized trial between February 2011 and July 2013.

Haemophilic arthropathy: long-term outcomes in 107 primary total knee arthroplasties.

Background: Arthropathy of the knee is a frequent complication in patients with severe bleeding disorders leading to considerable pain and disability. Total knee arthroplasty (TKA) provides marked pain relief. However, a modest functional outcome and a high number of complications due to prosthetic infection and loosening are reported.

Preoperative waiting time increased the risk of periprosthetic infection in patients with femoral neck fracture.

Background And Purpose: Prosthetic joint infection (PJI) remains a devastating complication of arthroplasty. Today, most displaced femoral neck fractures in the elderly are treated with arthroplasty. We estimated the incidence of and risk factors for PJI in primary arthroplasty after femoral neck fracture.

Early prosthetic joint infections treated with debridement and implant retention: 38 primary hip arthroplasties prospectively recorded and followed for median 4 years.

Background And Purpose: Debridement and retention of the prosthesis is often attempted to treat early prosthetic joint infection (PJI). However, previous studies have found inconsistent results, with success rates ranging from 21% to 100%, and little has been written in the literature about hip function. We have therefore analyzed the clinical and functional outcome of early PJIs treated with this procedure.