Clinical Faceoff: One- Versus Two-Stage Exchange Arthroplasty for Prosthetic Joint Infections

Wongworawat, Montri D.

doi:10.1007/s11999-013-2882-1

Cited by 34 publications

(25 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although there are reports of effectively treating PJI involving resistant organisms and/or a sinus tract with a one‐stage exchange procedure, such cases are generally managed with two‐stage procedures, as the presence of a sinus tract may contaminate pre‐operative cultures and inhibit the prerequisite identification of the offending organism. In the case of culture‐negative PJI, one‐stage exchange arthroplasty may also be contraindicated …”

Section: Question 1: What Are the Indications And Contraindications Fmentioning

confidence: 99%

“…The immunocompromised patient or the presence of medical comorbidities, including metastatic disease, advanced cardiac disease, and renal and/or liver dysfunction, have been shown to impact the infection eradication success rates and certainly influence morbidity and mortality. It is unknown if the presence of these comorbidities constitute a contraindication for one‐stage exchange arthroplasty surgery …”

Section: Question 2: What Are the Indications For Two‐stage Exchange mentioning

confidence: 99%

“…The presence of compromised soft tissues that may limit adequate implant coverage is an indication for two‐stage exchange arthroplasty. The use of tissue expanders, development of musculocutaneous flaps, and possible need for repeat debridement may all be indicated and require further time between initial resection and reimplantation …”

Section: Question 2: What Are the Indications For Two‐stage Exchange mentioning

confidence: 99%

See 2 more Smart Citations

One‐stage Versus Two‐stage Exchange

2014

Journal Orthopaedic Research

View full text Add to dashboard Cite

Section: Question 1: What Are the Indications And Contraindications Fmentioning

confidence: 99%

Section: Question 2: What Are the Indications For Two‐stage Exchange mentioning

confidence: 99%

Section: Question 2: What Are the Indications For Two‐stage Exchange mentioning

confidence: 99%

See 1 more Smart Citation

One‐stage Versus Two‐stage Exchange

2014

Journal Orthopaedic Research

View full text Add to dashboard Cite

“…Currently, there are no national guidelines or Department of Health advice on how best to manage patients with PJI. This may in part be due to a lack of consensus about the best way to treat PJI (Kunutsor et al, ; Kunutsor, Whitehouse, Lenguerrand, et al, ; Wongworawat, ). The current provision of NHS orthopaedic services is varied (Briggs, ) and it is uncertain what services are currently provided for PJI patients and how they are provided.…”

Section: Introductionmentioning

confidence: 99%

A UK national survey of care pathways and support offered to patients receiving revision surgery for prosthetic joint infection in the highest volume NHS orthopaedic centres

Moore

Whitehouse

Gooberman-Hill

et al. 2017

Musculoskeletal Care

View full text Add to dashboard Cite

BackgroundDeep prosthetic joint infection (PJI) is a devastating complication of joint replacement surgery. It is difficult to treat, and patients often require multiple major revision surgeries to eradicate the infection. Treatment can have negative and long‐term impact on patients' quality of life. Understanding current service provision provides valuable information needed to design and evaluate support interventions for patients.AimThis survey aimed to identify usual care pathways and support in UK National Health Service (NHS) orthopaedic centres for patients receiving revision surgery for PJI after hip or knee replacement.MethodsThe 20 highest volume NHS orthopaedic centres treating prosthetic joint infection after hip or knee replacement were approached. Consultant orthopaedic surgeons specializing in treating PJI were invited to participate in a telephone or email survey about usual care provision and support for PJI.FindingsSixteen centres completed the survey. Findings showed a high degree of variation nationally in follow‐up time‐points after revision surgery. Multidisciplinary approaches to care focused more on clinical care and physical rehabilitation than social and psychological care. Patient management and referral to support services also varied and barriers to referrals included lack of availability or access to services, lack of knowledge of services, shortage of staff, and complexities of referring outside of the hospital catchment area.ConclusionsOur findings suggest that future development of interventions should focus on more inclusive and patient‐centred multidisciplinary approaches to care. Such interventions could more completely address psychological and social as well as physical aspects of patients' recovery.

show abstract

“…[18,19] Bütün ekipmanın dikkatli bir şekilde çıkarılması, çimento ve etkilenen yumuşak dokuların zorunlu agresif debridmanı, bu teknikte gereklidir. [20] Tek aşamalı değişim için %73-100 arasında başarı oranları bildirilmiştir. [21][22][23] Yine, ABD ve Kuzey Avrupa'da yapılan çalışmalarda da başarılı sonuçlar bildirilmiştir.…”

unclassified

Periprostetik eklem enfeksiyonlarında tek aşamalı revizyon

Yıldırım¹,

İpteç²

2016

TOTBID

View full text Add to dashboard Cite

Türk Ortopedi ve Travmatoloji Birliği Derneği ya da kalça eklemi oluşturmaktır. [8] Periprostetik eklem enfeksiyon tedavisinin modern biçimi ancak hasta merkezli yaklaşımla sağlanabilir. [9] Artroplastilerde enfeksiyon, ortopedik cerrahı zorlayan komplikasyonların başında gelir. Değişim artroplastisi, periprostetik enfeksiyon tedavisinde etkin bir yöntem olarak kullanılmaktadır. Kronik enfeksiyonun cerrahi yönetiminde, Kuzey Amerika ve Birleşik Krallık'ta, iki aşamalı değişim altın standart prosedür olarak uygulanmaktadır. Bu prosedür, ilk aşamada; enfekte implantın çıkarılması, radikal debridmanı, geçici antibiyotikli çimentonun ilk aşamada yerleştirilmesini içerir. Sonraki rekonstrüksiyon aşamasında; kalıcı protez ile çimentonun yerleştirilmesini, belirlenmiş bir periyod boyunca, altı hafta veya daha fazla sistemik antibiyotik tedavisini gerektirir. [10,11] Tek aşamalı değişim artroplastisi, ilk olarak 1981'de Bucholz tarafından, sonra da 1985'te Freeman tarafından tanımlanmış ve birçok Avrupa merkezinde umut verici sonuçlarla birlikte popülerlik kazanmıştır. [12-14] B ütün artroplastiler için enfeksiyon oranı ortalama %1,25 olarak bildirilmiştir. [1] Kalça ve diz artroplastisi sonrası periprostetik enfeksiyon oranı, nadir olarak, primer kalça artroplasti hastalarının %0,3-2,9'unda, primer diz artroplastilerinin ise %0,5-2'sinde meydana gelmektedir. [2-4] Yaşam beklentisinin ve yaşlı nüfusun fonksiyonel beklentilerinin artmasının sonucu olarak; Birleşik Devletler'de, 2030 yılında yıllık olarak, primer kalça ve diz artroplasti uygulamalarının sayısının, sırasıyla, %174 ve %673 artacağı tahmin edilmektedir. Bu nedenle, periprostetik eklem enfeksiyonları, gelecekte öngörülebilir bir ekonomik yük ve önemli bir komplikasyon olmaya devam edecektir. [5] Periprostetik eklem enfeksiyonları; total kalça artroplastisi revizyonu için üçüncü en sık (%14,8), total diz artroplastisi için ise en sık (%25,2) revizyon nedeni olarak karşımıza çıkmaktadır. [6,7] Revizyon prosedürünün esas hedefi, enfeksiyonu ortadan kaldırmak ve ağrısız, işlevsel ve stabil bir diz Periprostetik eklem enfeksiyonlarında tek aşamalı revizyon Single stage revision in the treatment of periprosthetic joint infections

show abstract

Clinical Faceoff: One- Versus Two-Stage Exchange Arthroplasty for Prosthetic Joint Infections

Cited by 34 publications

References 11 publications

One‐stage Versus Two‐stage Exchange

One‐stage Versus Two‐stage Exchange

A UK national survey of care pathways and support offered to patients receiving revision surgery for prosthetic joint infection in the highest volume NHS orthopaedic centres

Periprostetik eklem enfeksiyonlarında tek aşamalı revizyon

Contact Info

Product

Resources

About