Infection in total hip replacement: meta-analysis

Senthi, Surendra; Munro, Jacob T.; Pitto, Rocco P.

doi:10.1007/s00264-010-1144-z

Cited by 142 publications

(116 citation statements)

References 45 publications

(45 reference statements)

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“…45 Most of these risk factors can be mitigated by appropriate nosocomial hygiene practices, and through the use of perioperative antibiotic prophylaxis. 3,6,9,46,47 However, no strategy has proven effective in completely eliminating the risk of infections related to implant surgery. Strategies to discourage bacterial adhesion to implants have included antibacterial surface coatings and treatments, and the development and use of nanostructured surfaces, or a combination of these methods.…”

Section: Discussionmentioning

confidence: 99%

Decreased bacteria activity on Si3N4 surfaces compared with PEEK or titanium

Gorth¹,

Puckett²,

Ercan³

et al. 2012

IJN

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A significant need exists for orthopedic implants that can intrinsically resist bacterial colonization. In this study, three biomaterials that are used in spinal implants -titanium (Ti), polyether-ether-ketone (PEEK), and silicon nitride (Si 3 N 4 ) -were tested to understand their respective susceptibility to bacterial infection with Staphylococcus epidermidis, Staphlococcus aureus, Pseudomonas aeruginosa, Escherichia coli and Enterococcus. Specifically, the surface chemistry, wettability, and nanostructured topography of respective biomaterials, and the effects on bacterial biofilm formation, colonization, and growth were investigated. Ti and PEEK were received with as-machined surfaces; both materials are hydrophobic, with net negative surface charges. Two surface finishes of Si 3 N 4 were examined: as-fired and polished. In contrast to Ti and PEEK, the surface of Si 3 N 4 is hydrophilic, with a net positive charge. A decreased biofilm formation was found, as well as fewer live bacteria on both the as-fired and polished Si 3 N 4 . These differences may reflect differential surface chemistry and surface nanostructure properties between the biomaterials tested. Because protein adsorption on material surfaces affects bacterial adhesion, the adsorption of fibronectin, vitronectin, and laminin on Ti, PEEK, and Si 3 N 4 were also examined. Significantly greater amounts of these proteins adhered to Si 3 N 4 than to Ti or PEEK. The findings of this study suggest that surface properties of biomaterials lead to differential adsorption of physiologic proteins, and that this phenomenon could explain the observed in-vitro differences in bacterial affinity for the respective biomaterials. Intrinsic biomaterial properties as they relate to resistance to bacterial colonization may reflect a novel strategy toward designing future orthopedic implants.

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Section: Discussionmentioning

confidence: 99%

Decreased bacteria activity on Si3N4 surfaces compared with PEEK or titanium

Gorth¹,

Puckett²,

Ercan³

et al. 2012

IJN

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“…Periprosthetic joint infections (PJI) after total joint replacement are a severe complication resulting in high morbidity for the patient as well as extensive costs for the health care system [1,2]. The frequency of PJI is estimated to be 0.4-2 % in primary total arthroplasty [3], rising up to 5-15 % in high risk patients and in revision surgery [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of an interdisciplinary therapy algorithm in patients with prosthetic joint infections

Wimmer

Randau

Petersdorf

et al. 2013

International Orthopaedics (SICOT)

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Purpose Current concepts in the treatment of prosthetic joint infections include prosthetic retention and exchange strategies according to published recommendations. A useful algorithm should fit for each type of prosthetic joint infection, even the most complicated situations. We present the outcome of 147 patients with prosthetic joint infections of the hip or the knee joint in an unselected population in clinical routine. Methods Between November 2006 and November 2009, 147 consecutive patients with prosthetic joint infections of the hip or knee were treated according to an algorithm based on the concept published by Zimmerli et al. in 2004. Causative organism, duration of infection, patient comorbidities, surgical treatment, antibiotic treatment, and outcome of treatment were analysed retrospectively. According to the criteria duration of infection, stability of prosthesis, local and systemic risk factors, and susceptibility of the causative pathogen, patients were treated either with debridement and retention or a longinterval two-stage procedure. Results A pathogen could be detected in 82.8 % of the patients, gram-positive cocci being most common. Twentyseven patients were treated with debridement and retention and 120 were treated with a two-stage procedure. In 68 cases difficult-to-treat pathogens could be detected, a polymicrobial infection was found in 51 patients. Definitely free of infection were 71.6 % after a two-stage procedure, and 70.4 % after debridement and retention. Conclusions Our data indicates that the applied algorithm is suitable to be applied as a day-to-day routine, and we confirmed that published results from the literature can be reproduced in an inhomogeneous patient cohort.

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“…2 By 2030, the number of procedures in the United States is projected to increase by 174% to nearly 600,000 procedures per year, while hip revision procedures are expected to double by the year 2026; 3 furthermore, MRSA infections in periprosthetic surgeries have had a historic occurrence of 1-2% in primary surgeries and rises to 3-4% in revision surgeries 1,4 and with the rise in the procedures the use of AICBs are also expected to increase. The combination of calcium beads with antibiotics is an off-label use and guidelines for AICBs are only specified for the use of the calcium beads alone.…”

Section: Discussionmentioning

confidence: 99%