Missed low-grade infection in suspected aseptic loosening has no consequences for the survival of total hip arthroplasty.

Background And Purpose: Aseptic loosening and infection are 2 of the most common causes of revision of hip implants. Antibiotic prophylaxis reduces not only the rate of revision due to infection but also the rate of revision due to aseptic loosening. This suggests under-diagnosis of infections in patients with presumed aseptic loosening and indicates that current diagnostic tools are suboptimal.

Incidence of low-grade infection in aseptic loosening of total hip arthroplasty.

Purpose: We investigated the hypothesis that many total hip arthroplasty revisions that are classified as aseptic are in fact low-grade infections missed with routine diagnostics.

Methods: In 7 Dutch hospitals, 176 consecutive patients with the preoperative diagnosis of aseptic loosening of their total hip arthroplasty were enrolled. During surgery, between 14 and 20 tissue samples were obtained for culture, pathology, and broad-range 16S rRNA PCR with reverse line blot hybridization.

Factors associated with reduced early survival in the Oxford phase III medial unicompartment knee replacement.

The aim of this study was to determine the prognostic value of preoperative patellofemoral osteoarthritis, BMI and age for implant survival of unicompartmental knee arthroplasty (UKA) performed in patients meeting strict admission criteria. The data and radiographs of 437 unilateral Oxford phase III procedures (Biomet, Bridgend, UK) were analysed. All procedures were carried out or supervised by 13 specialised knee surgeons in three different hospitals.

In vivo pharmacokinetics of a gentamicin-loaded collagen sponge in acute periprosthetic infection: serum values in 19 patients.

Background: The in vivo pharmacokinetics of gentamycin- loaded collagen fleeces in humans have not been described in the current literature. We therefore analyzed in vivo pharmacokinetics of these fleeces when used in the treatment of periprosthetic infections.

Patients And Methods: Gentamycin concentrations were measured in 19 consecutive patients with an acute periprosthetic infection.

Toxic serum gentamicin levels after the use of gentamicin-loaded sponges in infected total hip arthroplasty.

Background: At our clinic, total hip arthroplasties with an acute postoperative infection are treated with surgical debridement and application of several gentamicin-loaded sponges, each with an equivalent of 130 mg gentamicin. We studied the possible systemic effect of this local application of gentamicin.

Patients And Methods: All 12 patients treated during 1997-2001 were included.