Periprosthetic Joint Infection

Zimmerli, Werner

doi:10.1002/9781118581742.ch8

Cited by 4 publications

(2 citation statements)

References 113 publications

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“…The traditional classification in early (<3 months), delayed (3–24 months) and late infection (>2 years after implantation) is clinically not useful. Therefore, we propose a classification guiding the optimal surgical management . Acute haematogenous PJI has a duration of not more than 3 weeks after an uneventful postoperative period.…”

Section: Periprosthetic Joint Infectionmentioning

confidence: 99%

Orthopaedic biofilm infections

Zimmerli

Sendi

2017

APMIS

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251

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Zimmerli W, Sendi P. Orthopaedic biofilm infections. APMIS 2017; 125: 353-364. Many infections of the musculoskeletal system are biofilm infections that develop on non-living surfaces. Microorganisms adhere either on dead bone (sequesters) or implants. As a rule for a curative concept, chronic osteomyelitis or implant-associated bone infection must be treated with a combination of surgery and antimicrobial therapy. If an implant is kept in place, or a new device is implanted before complete healing of infection, a biofilm-active antibiotic should be used. Rifamycins are active against biofilms of staphylococci, and fluoroquinolones against those of Gramnegative bacilli. In this review, the management of chronic osteomyelitis, periprosthetic joint infection and implantassociated osteomyelitis of long bones is presented.

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Section: Periprosthetic Joint Infectionmentioning

confidence: 99%

Orthopaedic biofilm infections

Zimmerli

Sendi

2017

APMIS

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251

200

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“…Along with osteonecrosis, bone resorption and osseointegration, a foreign body response also occurs around the implant . All these cellular changes make the peri‐implanted bone tissue a perfect locus resistentiae minoris for bacterial infection .…”

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confidence: 99%

Early implant‐associated osteomyelitis results in a peri‐implanted bacterial reservoir

Jensen

Koch

Aalbæk

et al. 2016

APMIS

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Implant‐associated osteomyelitis (IAO) is a common complication in orthopedic surgery. The aim of this study was to elucidate how deep IAO can go into the peri‐implanted bone tissue within a week. The study was performed in a porcine model of IAO. A small steel implant and either 104 CFU/kg body weight of Staphylococcus aureus or saline was inserted into the right tibial bone of 12 pigs. The animals were consecutively killed on day 2, 4 and 6 following implantation. Bone tissue around the implant was histologically evaluated. Identification of S. aureus was performed immunohistochemically on tissue section and with scanning electron microscopy and peptide nucleic acid in situ hybridization on implants. The distance of the peri‐implanted pathological bone area (PIBA), measured perpendicular to the implant, was significantly larger in infected animals compared to controls (p = 0.0014). The largest differences were seen after 4 and 6 days of inoculation, where PIBA measurements of up to 6 mm were observed. Positive S. aureus bacteria were identified on implants and from 25 μm to 6 mm into PIBA. This is important knowledge for optimizing outcomes of surgical debridement in osteomyelitis.

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Coating of bone implants with silica, hyperbranched polyethyleneimine, and gentamicin prevents development of osteomyelitis in a porcine model

Jensen

Blirup-Plum

et al. 2022

Materialia

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Periprosthetic Joint Infection

Cited by 4 publications

References 113 publications

Orthopaedic biofilm infections

Orthopaedic biofilm infections

Early implant‐associated osteomyelitis results in a peri‐implanted bacterial reservoir

Coating of bone implants with silica, hyperbranched polyethyleneimine, and gentamicin prevents development of osteomyelitis in a porcine model

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