Management of an infected cementless cup with prosthetic retention and antibiotic therapy in a dog

Dan, Bernard; Kim, S. E.; Pozzi, Antonio

doi:10.1111/jsap.12261

Cited by 4 publications

(4 citation statements)

References 17 publications

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“…Of note, certain clinical conditions may also occur naturally in veterinary clinical practice (e.g. PJI, or infected non‐union/pin tract infection in pets) and could offer an avenue for efficacy assessment in future …”

Section: Key Aspects In Model Selection Animal Welfare Reporting Anmentioning

confidence: 99%

Recommendations for design and conduct of preclinical in vivo studies of orthopedic device‐related infection

Moriarty

Harris

Mooney

et al. 2019

Journal Orthopaedic Research

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Orthopedic device-related infection (ODRI), including both fracture-related infection (FRI) and periprosthetic joint infection (PJI), remain among the most challenging complications in orthopedic and musculoskeletal trauma surgery. ODRI has been convincingly shown to delay healing, worsen functional outcome and incur significant socio-economic costs. To address this clinical problem, ever more sophisticated technologies targeting the prevention and/or treatment of ODRI are being developed and tested in vitro and in vivo. Among the most commonly described innovations are antimicrobial-coated orthopedic devices, antimicrobial-loaded bone cements and void fillers, and dual osteo-inductive/antimicrobial biomaterials. Unfortunately, translation of these technologies to the clinic has been limited, at least partially due to the challenging and still evolving regulatory environment for antimicrobial drugdevice combination products, and a lack of clarity in the burden of proof required in preclinical studies. Preclinical in vivo testing (i.e. animal studies) represents a critical phase of the multidisciplinary effort to design, produce and reliably test both safety and efficacy of any new antimicrobial device. Nonetheless, current in vivo testing protocols, procedures, models, and assessments are highly disparate, irregularly conducted and reported, and without standardization and validation. The purpose of the present opinion piece is to discuss best practices in preclinical in vivo testing of antimicrobial interventions targeting ODRI. By sharing these experience-driven views, we aim to aid others in conducting such studies both for fundamental biomedical research, but also for regulatory and clinical evaluation.

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Section: Key Aspects In Model Selection Animal Welfare Reporting Anmentioning

confidence: 99%

Recommendations for design and conduct of preclinical in vivo studies of orthopedic device‐related infection

Moriarty

Harris

Mooney

et al. 2019

Journal Orthopaedic Research

View full text Add to dashboard Cite

show abstract

“…The methicillin-resistant Staphylococcus spp in our case was susceptible to clindamycin, which has an oral bioavailability in dogs of 73% (28). Surgical debridement with implant retention followed by appropriate antibiotic therapy has been described for treatment of an infected cementless total hip prosthesis (29). Revisions using cement can be susceptible to failure, probably due to poor bone stock which does not provide an adequate environment for fixation (30).…”

Section: A B Cmentioning

confidence: 81%

One-stage revision of an infected cementless total hip replacement

Ficklin¹,

Kowaleski²,

Kunkel³

et al. 2016

Vet Comp Orthop Traumatol

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A two-year-old, 44 kg dog with a right Helica cementless total hip replacement (THR) was radiographically diagnosed with implant loosening eight months after the index total hip replacement procedure. Subsequent synoviocentesis and synovial fluid culture revealed a methicillin-resistant coagulase-negative Staphylococcus spp infection of the right THR. A one-stage revision using a hybrid BFX cementless acetabular cup and CFX cemented femoral stem was performed. Vancomycin and micro-silver antimicrobial powder impregnated cement were used in the revision. At re-evaluation 27 months following the revision procedure, the patient did not exhibit any signs of lameness. Radiographic images confirmed stable implants, with bone ingrowth into the cup and no signs of implant loosening. Our report demonstrates the success of a one-stage THR revision when faced with a multi-drug resistant periprosthetic infection, when combined with the use of micro-silver antimicrobial powder and culture-based antibiotic impregnated cement therapy.

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“…Periprosthetic joint infection (PJI) is a rare but catastrophic complication following joint replacement surgery and can be difficult to both diagnose and manage 1–13 . In the human surgical field, the diagnosis for PJI is often redefined, b initial screening for PJIs involves laboratory tests from peripheral blood and synovial fluid 14–16 .…”

Section: Introductionmentioning

confidence: 99%

“…Periprosthetic joint infection (PJI) is a rare but catastrophic complication following joint replacement surgery and can be difficult to both diagnose and manage. [1][2][3][4][5][6][7][8][9][10][11][12][13] In the human surgical field, the diagnosis for PJI is often redefined, b initial screening for PJIs involves laboratory tests from peripheral blood and synovial fluid. [14][15][16] Serum acute phase protein concentrations such as C-reactive protein (CRP) are measured routinely as a screening tool to rule out the presence of PJIs following joint-replacement surgery.…”

Section: Introductionmentioning

confidence: 99%

Serum acute‐phase protein concentrations following uncomplicated total hip arthroplasty in dogs

Carvajal

Kim

2022

Veterinary Surgery

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Objectives: To establish preoperative and postoperative serum C reactive protein (CRP) and serum amyloid A (SAA) levels in dogs undergoing uncomplicated total hip arthroplasty (THA). Study design: Prospective clinical trial.Animals: Eighteen client-owned dogs.Methods: Dogs undergoing THA were recruited. Serum CRP and SAA levels were measured in all dogs the day prior to surgery, and 3 and 6 months following surgery. All dogs received a physical examination and underwent radiography at each visit, and dogs with complications were excluded from the study.For continuous numeric data, histograms were generated and evaluated for normality. A 1-way repeated measures ANOVA was performed to find differences between time points.Results: No complications were encountered in any of the recruited dogs. Median age was 30 months (12-66), and the median bodyweight was 27.3 kg (22.3-40.2). Mean CRP concentrations in the preoperative, 3-month, and 6-month periods were 3.8 mg/L ± 4.4, 0.8 mg/L ± 1.9, and 1.4 mg/L ± 1.4, respectively. The mean SAA concentrations in the preoperative, 3-month, and 6-month periods were 13.9 mg/L ± 8.8, 14.1 mg/L ± 12.6, and 18.4 mg/L ± 15.1, respectively. There were no differences for each parameter between time points. Conclusion: C-reactive protein and SAA levels were consistent with levels previously established for noninflammatory and normal conditions in dogs.Clinical significance: Postoperative CRP and SAA concentrations were low by 3 months following uncomplicated THA.

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Management of an infected cementless cup with prosthetic retention and antibiotic therapy in a dog

Cited by 4 publications

References 17 publications

Recommendations for design and conduct of preclinical in vivo studies of orthopedic device‐related infection

Recommendations for design and conduct of preclinical in vivo studies of orthopedic device‐related infection

One-stage revision of an infected cementless total hip replacement

Serum acute‐phase protein concentrations following uncomplicated total hip arthroplasty in dogs

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