Peri-prosthetic joint infection (PJI) is a significant complication following total knee arthroplasty (TKA). Early identification and management are essential to prevent severe morbidity and mortality in these patients. Long-term complications of PJI include the need for multiple operations, disability, joint stiffness, reduced range of motion, and increased mortality. Clinical signs, inflammatory markers, imaging, tissue sampling, and synovial fluid analysis are required to diagnose PJI. Debridement antibiotics and implant retention (DAIR) is an effective management option, but single- or two-stage exchange arthroplasty may be ultimately required. All cases of PJI in TKA must be discussed in a multi-disciplinary (MDT) meeting. This review incorporates the updated British Orthopaedic Association (BOA) standard and speciality standard to provide an up-to-date guideline on the early identification and management of PJI. We highlight that adhering to the BOA guidelines and adopting an MDT approach are essential for optimal patient outcomes.
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http://dx.doi.org/10.7759/cureus.73315 | DOI Listing |
Arch Orthop Trauma Surg
January 2025
Department of Public Health, Orthopedic Unit, "Federico II" University, Naples, Italy.
Background: Two-stage revision in infected total knee arthroplasty increases the risk of blood loss and the need for transfusion. The present study aimed to test the hemostatic efficacy of a bipolar sealer to reduce blood loss and transfusion requirements after the first stage in patients affected by peri-prosthetic knee infections.
Methods: Twenty-four patients undergoing 2-stage arthroplasty for infected TKA using a bipolar sealer (Haemodiss, Kylix, Naples, IT) were compared with 24 patients of a historical control group in which conventional electrocautery was used.
J Nanobiotechnology
December 2024
Department of Orthopaedic Surgery, Orthopaedic Institute, The First Affiliated Hospital, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, 215006, China.
Peri-prosthesis osteolysis (PPO) represents the most severe complication of total joint arthroplasty (TJA) surgery and imposes the primary cause of prosthesis failure and subsequent revision surgery. Antiresorptive therapies are usually prescribed to treat PPO, especially for elderly people. Nevertheless, the efficacy of anti-osteoporotic medications remains constrained.
View Article and Find Full Text PDFCureus
November 2024
Trauma and Orthopaedics, Whittington Health NHS Trust, London, GBR.
Peri-prosthetic joint infection (PJI) is a significant complication following total knee arthroplasty (TKA). Early identification and management are essential to prevent severe morbidity and mortality in these patients. Long-term complications of PJI include the need for multiple operations, disability, joint stiffness, reduced range of motion, and increased mortality.
View Article and Find Full Text PDFCureus
October 2024
Orthopedic Surgery, North Kansas City Hospital, Kansas City, USA.
An 83-year-old male, status one year post-primary right reverse shoulder arthroplasty, presented with clinical and radiographic signs of shoulder instability. The patient subsequently underwent revision reverse shoulder arthroplasty with postoperative cultures growing in all five tissue samples. He was placed on temporary fluconazole since he demanded to leave the hospital during a holiday weekend with plans to get readmitted later.
View Article and Find Full Text PDFViruses
October 2024
AO Research Institute Davos, 7270 Davos, Switzerland.
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