How Often Is Rifampin Therapy Initiated and Completed in Patients With Periprosthetic Joint Infections?

Background: Rifampin therapy is indicated for the treatment of staphylococcal periprosthetic joint infection (PJI) in patients who have undergone debridement, antibiotics, and implant retention (DAIR) or one-stage revision as per the Infectious Diseases Society of America (IDSA) guideline. Given the well-established effectiveness of rifampin as adjunctive therapy in staphylococcal PJI, it is crucial to evaluate its utilization in practice and identify factors that contribute to its underuse or incomplete administration, as these deviations may undermine treatment efficacy and patient outcomes.

Questions/purposes: Among patients who met clear indications for rifampin use having undergone DAIR or one-stage revision for staphylococcal PJI, (1) what proportion of patients did not receive it? (2) What proportion of patients started it but did not complete the planned course? (3) Where documented in the medical record, what were the common reasons for not using it or prematurely discontinuing it, and in what percentage of the patients' charts was no reason given? (4) What proportion of patients were taking a medication that put them at risk for a drug-drug interaction (DDI)?

Methods: Using an institutional database, patients who underwent DAIR or revision arthroplasty for PJI from January 2013 to April 2023 were identified (n = 935).

Coronal plane deformity in total knee arthroplasty is associated with increased operative time and disposition to skilled nursing facility.

Purpose: Studies demonstrate similar long-term Total Knee Arthroplasty (TKA) outcomes in patients with significant versus minimal preoperative coronal plane deformity. Limited short-term outcomes data, which determine costs of care, exist.

Methods: We retrospectively explored the impact of preoperative coronal plane deformity on operative time, length of stay (LOS), and discharge to skilled nursing facility (SNF) in TKA.

Referral, enrollment, and health care use in a comprehensive patient-centered management program for osteoarthritis of the hip and knee.

Objective: Osteoarthritis management programs (OAMPs) have become a more common way to deliver patient-centered care. However, there is limited information on real-world use of these programs to guide implementation, payment policy, accessibility, and scaling in the United States. This paper describes 5-year use metrics for the Duke Joint Health Program, an OAMP embedded within a US academic health system.

Unsuspected Positive Intra-Operative Cultures in Aseptic Revision Hip Arthroplasty: Prevalence, Management, and Infection-Free Survivorship.

Background: This study aimed to describe the management and outcomes of aseptic revision total hip arthroplasty (arTHA) with unsuspected intraoperative positive cultures (UPCs) compared to those with sterile cultures.

Methods: A single tertiary center's institutional database was retrospectively reviewed for arTHA from January 2013 to October 2023. Preoperative Musculoskeletal Infection Society scores were assigned to patients based on available infectious workup, and those who met the criteria for periprosthetic joint infection (PJI), received antibiotic spacers, or had less than 1-year follow-up were excluded.