Mortality After Septic Versus Aseptic Revision Total Hip Arthroplasty: A Matched-Cohort Study

Choi, Heeyoul; Beecher, Benjamin; Bedair, Hany

doi:10.1016/j.arth.2013.02.041

Cited by 39 publications

(32 citation statements)

References 23 publications

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“…Patients who undergo revision surgery for PJI have a higher risk of unplanned readmission [19] and longer length of stay [23] compared with patients who undergo revision surgery for other causes, which implies that PJI has a major effect on a patient's health. One study showed that revision for PJI in THAs or TKAs is associated with higher mortality than aseptic revision [27], but not all studies have found this association [4,24]. None of the previous published studies exclusively investigated the associated between revision for early postoperative PJI in primary THA and mortality.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, one study including THA and TKA showed that there is an increased mortality risk within 1 year after revision for PJI [27]. However, not all studies have identified PJI to be associated with a higher mortality risk [4,24], and so far studies of PJI and mortality have been based on a mixture of THA and TKA [24,27], patients from a single institution [4,24,27], and without a maximum defined interval from primary THA surgery to revision for PJI [4,24,27].…”

Section: Introductionmentioning

confidence: 99%

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Increased Mortality After Prosthetic Joint Infection in Primary THA

Gundtoft

Pedersen

Varnum

et al. 2017

Clinical Orthopaedics &Amp; Related Research

161

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Increased Mortality After Prosthetic Joint Infection in Primary THA

Gundtoft

Pedersen

Varnum

et al. 2017

Clinical Orthopaedics &Amp; Related Research

161

View full text Add to dashboard Cite

show abstract

“…Of these procedures, up to 1.7% of primary total hip arthroplasties (THA) and 2% of primary total knee arthroplasties (TKA) will result in periprosthetic joint infection (PJI) . The increasing infection burden is a concern both medically and financially as PJIs have a 5‐year mortality of 33% and an increased cost of care greater than $100,000 …”

mentioning

confidence: 99%

Topical adjuvants incompletely remove adherent Staphylococcus aureus from implant materials

Ernest

Machi

Karolcik

et al. 2017

Journal Orthopaedic Research

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Adjuvant treatments including Betadine, Dakin's solution (sodium hypochlorite), or hydrogen peroxide (H O ) have been attempted to eradicate prosthetic joint infection caused by biofilm or intracellular bacteria. The purpose of this study was to evaluate the in vitro abilities of chemical adjuvants to decrease Staphylococcus aureus (S. aureus) biofilm presence on orthopaedic implant grade materials, including titanium, stainless steel, and cobalt chrome. S. aureus biofilms were grown for 48 h and evaluated for baseline colony forming units/centimeter squared (CFU/cm ) and compared to treatments with Betadine, Dakin's solution, H O , or 1% chlorine dioxide (ClO ). Control discs (n = 18) across all metals had an average of 4.2 × 10 CFU/cm . All treatments had statistically significant reductions in CFU/cm when compared to respective control discs (p < 0.05). For all metals combined, the most efficacious treatments were Betadine and H O , with an average 98% and 97% CFU/cm reduction, respectively. There were no significant differences between reductions seen with Betadine and H O , but both groups had statistically greater reductions than Dakin's solution and ClO . There was no change in antibiotic resistance patterns after treatment. Analysis of S. aureus biofilms demonstrated a statistically significant reduction in biofilm after a five-minute treatment with the modalities, with an average two log reduction in CFU/cm . Statement of clinical significance: While statistically significant reductions in CFU/cm were accomplished with chemical adjuvant treatments, the overall concentration of bacteria never fell below 10 CFU/cm , leading to questionable clinical significance. Further techniques to eradicate biofilm should be investigated. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1599-1604, 2018.

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“…This complication remains relatively rare, with a reported incidence of 1% to 2% for primary hip and knee arthroplasty. [4][5][6] Ninetyday mortality following management of chronic PJI is significantly higher than that associated with aseptic revision. Management of these efforts is similar to the treatment provided by centers that specialize in oncology, bariatric surgery, and cardiac care, which typically use established care pathways.…”

mentioning

confidence: 99%

Best Practices for Centers of Excellence in Addressing Periprosthetic Joint Infection

Dietz

Springer

Barnes

et al. 2015

Journal of the American Academy of Orthopaedic Surgeons

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Periprosthetic joint infection is a rare and devastating complication. Management of this complication often requires a multidisciplinary approach similar to that used for the care of patients with cancer. Several studies have reported better outcomes following total joint arthroplasties performed at specialized hospitals than those performed at general hospitals. Specialized institutions use care pathways that aid the multidisciplinary team in decision making. During the recent Musculoskeletal Infection symposium, specific issues were discussed with regard to the treatment of periprosthetic joint infection, including medical optimization, systematic approaches to infection management, and the importance of establishing registries to aid in the creation of Centers of Excellence. A Center of Excellence in periprosthetic infection could provide better overall outcomes with lower financial, physical, and emotional costs to patients.

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Mortality After Septic Versus Aseptic Revision Total Hip Arthroplasty: A Matched-Cohort Study

Cited by 39 publications

References 23 publications

Increased Mortality After Prosthetic Joint Infection in Primary THA

Increased Mortality After Prosthetic Joint Infection in Primary THA

Topical adjuvants incompletely remove adherent Staphylococcus aureus from implant materials

Best Practices for Centers of Excellence in Addressing Periprosthetic Joint Infection

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