Journal of Bone and Joint Infection最新文献

{"title":"Murine models of orthopedic infection featuring <i>Staphylococcus</i> <i>aureus</i> biofilm.","authors":"Aiken Dao,&nbsp;Alexandra K O'Donohue,&nbsp;Emily R Vasiljevski,&nbsp;Justin D Bobyn,&nbsp;David G Little,&nbsp;Aaron Schindeler","doi":"10.5194/jbji-8-81-2023","DOIUrl":"https://doi.org/10.5194/jbji-8-81-2023","url":null,"abstract":"<p><p><b>Introduction</b>: Osteomyelitis remains a major clinical challenge. Many published rodent fracture infection models are costly compared with murine models for rapid screening and proof-of-concept studies. We aimed to develop a dependable and cost-effective murine bone infection model that mimics bacterial bone infections associated with biofilm and metal implants. <b>Methods</b>: Tibial drilled hole (TDH) and needle insertion surgery (NIS) infection models were compared in C57BL/6 mice (female, <math><mrow><mi>N</mi> <mo>=</mo> <mn>150</mn></mrow> </math> ). Metal pins were inserted selectively into the medullary canal adjacent to the defect sites on the metaphysis. Free <i>Staphylococcus aureus</i> (ATCC 12600) or biofilm suspension (ATCC 25923) was locally inoculated. Animals were monitored for physiological or radiographic evidence of infection without prophylactic antibiotics for up to 14 d. At the end point, bone swabs, soft-tissue biopsies, and metal pins were taken for cultures. X-ray and micro-CT scans were performed along with histology analysis. <b>Results</b>: TDH and NIS both achieved a 100 % infection rate in tibiae when a metal implant was present with injection of free bacteria. In the absence of an implant, inoculation with a bacterial biofilm still induced a 40 %-50 % infection rate. In contrast, freely suspended bacteria and no implant consistently showed lower or negligible infection rates. Micro-CT analysis confirmed that biofilm infection caused local bone loss even without a metal implant as a nidus. Although a metal surface permissive for biofilm formation is impermeable to create progressive bone infections in animal models, the metal implant can be dismissed if a bacterial biofilm is used. <b>Conclusion</b>: These models have a high potential utility for modeling surgery-related osteomyelitis, with NIS being simpler to perform than TDH.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"8 2","pages":"81-89"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10134754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9391986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The concordance between preoperative synovial fluid culture and intraoperative tissue cultures in periprosthetic joint infection: a systematic review.","authors":"Thomas J A van Schaik, Lex D de Jong, Maurits P A van Meer, Jon H M Goosen, Matthijs P Somford","doi":"10.5194/jbji-7-259-2022","DOIUrl":"10.5194/jbji-7-259-2022","url":null,"abstract":"<p><p><b>Background</b>: this systematic review aims to evaluate the concordance between preoperative synovial fluid culture and intraoperative tissue cultures in patients with periprosthetic joint infection (PJI) undergoing total hip (THA) or knee arthroplasty (TKA) revision surgery. <b>Methods</b>: this review was conducted in accordance with the preferred reporting items for a systematic review and meta-analysis of diagnostic test accuracy studies (PRISMA-DTA) statement. Cochrane, Embase, PubMed, and Web of Science databases were searched to identify studies involving patients who had THA or TKA revision surgery for PJI and for whom preoperative synovial fluid culture and intraoperative tissue cultures were performed. Studies were only included if the diagnosis of PJI was based on the EBJIS (the European Bone and Joint Infection Society) or MSIS (Musculoskeletal Infection Society) criteria. Risk of bias was assessed using an amended version of Joanna Briggs Institute's (JBI) critical appraisal checklist for case series. <b>Results</b>: seven studies were included in this review comprising 1677 patients. All studies had a retrospective study design and five studies explored patients undergoing revision surgery of THA or TKA. Concordance rates varied between 52 % and 79 %, but different authors defined and calculated concordance differently. Six studies were judged as having an unclear to high risk of bias and one study as having a low risk of bias. <b>Conclusions</b>: the included studies showed a wide range of concordance rates between preoperative synovial fluid culture and intraoperative tissue cultures and the majority of studies had a high risk of bias. Higher-quality studies are warranted to obtain a more accurate estimate of this concordance rate. We recommend continuing the use of a system such as the EBJIS definition or MSIS criteria when diagnosing PJI.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"7 6","pages":"259-267"},"PeriodicalIF":1.8,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9832305/pdf/jbji-7-259.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10536112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of disc space aspirate cell counts and differentials in the diagnosis of native vertebral osteomyelitis.","authors":"Talha Riaz,&nbsp;Matthew Howard,&nbsp;Felix Diehn,&nbsp;Aaron Joseph Tande,&nbsp;Courtney Ross,&nbsp;Paul Huddleston,&nbsp;Elie Berbari","doi":"10.5194/jbji-7-213-2022","DOIUrl":"https://doi.org/10.5194/jbji-7-213-2022","url":null,"abstract":"<p><p><b>Background</b>: Aspiration of intervertebral disc space is often done to confirm the diagnosis of native vertebral osteomyelitis. A study has not been done examining the utility of cell counts and differentials of the aspirated fluid in diagnosing native vertebral osteomyelitis (NVO). <b>Methods</b>: In this feasibility study, we prospectively enrolled patients with a suspected diagnosis of NVO referred to the Division of Neuroradiology for image-guided needle aspiration of the intervertebral disc. In this study, manual cell count was done on the aspirated fluid, followed by a differential cytospin technique and touch prep. We obtained demographic, lab, and microbiologic data and used the receiver operating curve (ROC) for statistical analysis. <b>Results</b>: Over 12 months, we performed 17 aspirates on 14 patients. The median age was 70.5 years (range: 45-77). The median manual cell count on the aspirated fluid was 52 cells  <math><mrow><mi>µ</mi> <msup><mi>L</mi> <mrow><mo>-</mo> <mn>1</mn></mrow> </msup> </mrow> </math> (range: 0-6656), the median neutrophil percentage on the touch prep slide was 73 % (range: 5 %-100 %), and the median neutrophil percentage on the cytospin slide was 82 % (range: 0 %-100 %). Routine bacterial cultures were positive in five cases, and the 16S ribosomal RNA gene polymerase chain reaction was positive in two cases. The optimal cutoff for a cell count of 104 total nucleated cells offered a sensitivity and specificity of 86 %, and a neutrophil cutoff of 83 % was associated with a 71 % sensitivity and specificity. <b>Conclusion</b>: An image-guided aspirated specimen leukocyte differential of <math><mrow><mo>≥</mo> <mn>83</mn></mrow> </math>  % neutrophils or a leukocyte count of <math><mrow><mo>≥</mo> <mn>104</mn></mrow> </math>   <math><mrow><mi>µ</mi> <msup><mi>L</mi> <mrow><mo>-</mo> <mn>1</mn></mrow> </msup> </mrow> </math> was a sensitive and specific test for diagnosing patients with suspected NVO. Additionally, more extensive studies are warranted to confirm the findings.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"7 5","pages":"213-219"},"PeriodicalIF":0.0,"publicationDate":"2022-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9673032/pdf/jbji-7-213.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40479891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and outcomes of culture-negative prosthetic joint infections from the Prosthetic Joint Infection in Australia and New Zealand Observational (PIANO) cohort study.","authors":"Sarah Browning, Laurens Manning, Sarah Metcalf, David L Paterson, James O Robinson, Benjamin Clark, Joshua S Davis","doi":"10.5194/jbji-7-203-2022","DOIUrl":"10.5194/jbji-7-203-2022","url":null,"abstract":"<p><p><b>Introduction</b>: Culture-negative (CN) prosthetic joint infections (PJIs) account for approximately 10 % of all PJIs and present significant challenges for clinicians. We aimed to explore the significance of CN PJIs within a large prospective cohort study, comparing their characteristics and outcomes with culture-positive (CP) cases. <b>Methods</b>: The Prosthetic joint Infection in Australia and New Zealand Observational (PIANO) study is a prospective, multicentre observational cohort study that was conducted at 27 hospitals between 2014 and 2017. We compared baseline characteristics and outcomes of all patients with CN PJI from the PIANO cohort with those of CP cases. We report on PJI diagnostic criteria in the CN cohort and apply internationally recognized PJI diagnostic guidelines to determine optimal CN PJI detection methods. <b>Results</b>: Of the 650 patients with 24-month outcome data available, 55 (8.5 %) were CN and 595 were CP. Compared with the CP cohort, CN patients were more likely to be female (32 (58.2 %) vs. 245 (41.2 %); <math><mi>p</mi></math>   <math><mo>=</mo></math>  0.016), involve the shoulder joint (5 (9.1 %) vs. 16 (2.7 %); <math><mi>p</mi></math>   <math><mo>=</mo></math>  0.026), and have a lower mean C-reactive protein (142 mg L <math><msup><mi></mi> <mrow><mo>-</mo> <mn>1</mn></mrow> </msup> </math> vs. 187 mg L <math><msup><mi></mi> <mrow><mo>-</mo> <mn>1</mn></mrow> </msup> </math> ; <math><mi>p</mi></math>   <math><mo>=</mo></math>  0.016). Overall, outcomes were superior in CN patients, with culture negativity an independent predictor of treatment success at 24 months (adjusted odds ratio, aOR, of 3.78 and 95 %CI of 1.65-8.67). Suboptimal diagnostic sampling was common in both cohorts, with CN PJI case detection enhanced using the Infectious Diseases Society of America PJI diagnostic guidelines. <b>Conclusions</b>: Current PJI diagnostic guidelines vary substantially in their ability to detect CN PJI, with comprehensive diagnostic sampling necessary to achieve diagnostic certainty. Definitive surgical management strategies should be determined by careful assessment of infection type, rather than by culture status alone.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"7 5","pages":"203-211"},"PeriodicalIF":1.8,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9562689/pdf/jbji-7-203.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40559823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravenous antibiotic duration in the treatment of prosthetic joint infection: systematic review and meta-analysis.","authors":"Nour Bouji, Sijin Wen, Matthew J Dietz","doi":"10.5194/jbji-7-191-2022","DOIUrl":"10.5194/jbji-7-191-2022","url":null,"abstract":"<p><p><b>Introduction</b>: Long antibiotic courses, including intravenous (IV) and oral administrations, are utilized in prosthetic joint infection (PJI) treatment. This meta-analysis examines the non-inferiority of short courses ( <math><mo><</mo></math>  4 weeks) of IV antibiotics compared to long courses in treating PJI. Critical review of IV treatment is necessary due to the clinical, physical, and financial burden associated with it and its continued prolonged use in the US without much evidence to support the practice. <b>Methods</b>: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), databases were searched using predefined medical subject headings (MeSH). <b>Results</b>: The nine included studies reported 521 total hip arthroplasties (THAs) and 530 total knee arthroplasties (TKAs). There was no significant difference in the overall success rate in short- vs. long-duration IV antibiotics for PJI treatment: odds ratio (OR) of 1.65, 95 % confidence interval (CI) of 0.78-3.46, and <math><mrow><mi>p</mi> <mo>=</mo> <mn>0</mn></mrow> </math> .18. However, due to the moderate to high heterogeneity ( <math> <mrow><msup><mi>I</mi> <mn>2</mn></msup> <mo>=</mo> <mn>68</mn></mrow> </math>  %, <math><mi>p</mi></math>   <math><mo><</mo></math>  0.01) amongst studies, an adjusted success rate was calculated after the exclusion of two studies. This showed a statistically significant difference between both groups (OR of 2.45, 95 % CI of 1.21-4.96, <math><mi>p</mi></math>   <math><mo><</mo></math>  0.001) favoring a short course of antibiotics and reflecting a more homogenous population ( <math> <mrow><msup><mi>I</mi> <mn>2</mn></msup> <mo>=</mo> <mn>51</mn></mrow> </math>  %, <math><mrow><mi>p</mi> <mo>=</mo> <mn>0</mn></mrow> </math> .06). <b>Conclusion</b>: This study highlights the limited data available for evaluating IV antibiotic duration in the setting of PJI. We found that a shorter duration of IV antibiotics was non-inferior to a longer duration, with an improved OR of 2.45 for treatment success, likely shortening inpatient stay as well as lessening side effects and antimicrobial resistance with a lower cost to patients and overall healthcare.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"7 5","pages":"191-202"},"PeriodicalIF":0.0,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9562697/pdf/jbji-7-191.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40559822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lysins - a new armamentarium for the treatment of bone and joint infections?","authors":"Parham Sendi,&nbsp;Tristan Ferry","doi":"10.5194/jbji-7-187-2022","DOIUrl":"https://doi.org/10.5194/jbji-7-187-2022","url":null,"abstract":"<jats:p>\u0000 </jats:p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"7 5","pages":"187-189"},"PeriodicalIF":0.0,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9562687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40671247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulated large joint fluid model for evaluating intra-articular antibiotic delivery systems: initial evaluation using antibiotic-loaded calcium sulfate beads","authors":"E. McPherson, J. Jennings, Omar Yunis, M. Harris, M. Dipane, Nora L. Curtin, Madhav Chowdhry, A. Wassef, J. Bumgardner, Scott P. Noel","doi":"10.5194/jbji-7-117-2022","DOIUrl":"https://doi.org/10.5194/jbji-7-117-2022","url":null,"abstract":"Abstract Introduction: Local antimicrobial delivery via calcium sulfate (CaSO 4 ) beads is used as an adjunctive treatment for periprosthetic joint infection. There is limited clinical information describing the performance of antimicrobial-loaded CaSO 4 (ALCS) in large-scale applications. We developed a simulated large joint model to study properties of eluting ALCS. Methods: The in vitro testing platform was an adapted standardized model for tribological testing of prosthetic total hips and total knees (ASTM F732). The model was 70 mL total fluid volume, 25 % bovine serum, and 75 % phosphate-buffered saline, using ISO standard 14242-1 for human synovial fluid simulation. Four brands of CaSO 4 were evaluated. Each 10 mL of CaSO 4 was loaded with 1.2 grams (g) of tobramycin and 1 g of vancomycin powders. A 35 mL bead volume, equaling 175 beads, of each product was placed in incubated flasks. The test period was 6 weeks with scheduled interval fluid exchanges. Fluid samples were tested for antibiotic and calcium concentrations and pH. Results: Antibiotic elution showed an initial burst on Day 1, followed by a logarithmic reduction over 1 week. Tobramycin fully eluted within 2.5 weeks. Vancomycin showed sustained release over 6 weeks. Calcium ion concentrations were high, with gradual decrease after 3 weeks. All four CaSO 4 products were inherently acidic. Fluid became more acidic with the addition of antibiotics primarily driven by vancomycin. Discussion: Clinicians should be cognizant of tobramycin elution burst with ALCS in large loads. The main driver of acidic pH levels was vancomycin. We propose that joint complications may result from lowered fluid acidity, and we suggest clinical study of synovial pH.","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"7 1","pages":"117 - 125"},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41620885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prophylaxis and treatment of infection in long bones using an antibiotic-loaded ceramic coating with interlocking intramedullary nails","authors":"Emilie-Ann Downey, Kayla M. Jaime, Taylor J. Reif, A. Makhdom, S. Rozbruch, A. Fragomen","doi":"10.5194/jbji-7-101-2022","DOIUrl":"https://doi.org/10.5194/jbji-7-101-2022","url":null,"abstract":"Abstract Background: The study was done (1) to report on our recent experience with antibiotic-loaded calcium sulfate-coated interlocking intramedullary nails (CS-IMN) for infection prevention or infection eradication and (2) to compare the efficacy of CS-IMN versus antibiotic-loaded polymethylmethacrylate-coated IMN (PMMA-IMN) for infection eradication. Methods: We retrospectively reviewed the medical records of consecutive patients who underwent a limb salvage procedure for infection cure or infection prevention with PMMA-IMN or CS-IMN. We reviewed patient demographics, host-type, pre-operative infecting organisms, intraoperative cultures, as well as our main outcomes: infection control rate, achievement of union/fusion, and limb salvage. Results: 33 patients were treated with CS-IMN: 9 patients with goal of infection cure and 24 patients for infection prophylaxis. When used for infection prophylaxis, there was a 100 % ( 24/24 patients) prevention of infection rate, 95.5 % union rate ( 21/22 patients), and 100 % ( 24/24 patients) limb salvage rate. Nine patients were treated with CS-IMN to eradicate infection and were compared to a cohort of 28 patients who were treated with PMMA-IMN. The infection was eradicated in 7/9 patients (77.8 %) in the CS-IMN group versus 21/26 patients (80 %) in the PMMA-IMN group ( p=0.44 ). Bone union/fusion was achieved in 8/9 patients (88.9 %) in the CS-IMN group versus 21/24 patients (87.5 %) in the PMMA-IMN group ( p=0.11 ). The limb salvage rate in the CS-IMN group was 100 % ( 9/9 patients) versus 89 % ( 25/28 patients) in the PMMA-IMN group. Conclusions: CS-IMN are safe and easy to use, and we have therefore expended our indications for them. CS-IMN are very effective at infection prophylaxis in high-risk cases where infection is suspected. Early analysis suggests that CS-IMN are non-inferior to PMMA-IMN for infection eradication. This is our preliminary data that show this novel technique to be safe in a small cohort and may be as effective as the more established method. Future studies with larger cohorts of patients will be required to confirm these findings.","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"7 1","pages":"101 - 107"},"PeriodicalIF":0.0,"publicationDate":"2022-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48167873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardized quantification of biofilm in a novel rabbit model of periprosthetic joint infection","authors":"Anabelle Visperas, Daniel C Santana, Minseon Ju, Nathalie B. Milbrandt, Y. Tsai, S. Wickramasinghe, A. Klika, N. Piuzzi, A. Samia, C. Higuera-Rueda","doi":"10.5194/jbji-7-91-2022","DOIUrl":"https://doi.org/10.5194/jbji-7-91-2022","url":null,"abstract":"Abstract Periprosthetic joint infection (PJI) is one of the most devastating complications of total joint arthroplasty. The underlying pathogenesis involves the formation of bacterial biofilm that protects the pathogen from the host immune response and antibiotics, making eradication difficult. The aim of this study was to develop a rabbit model of knee PJI that would allow reliable biofilm quantification and permit the study of treatments for PJI. In this work, New Zealand white rabbits ( n=19 ) underwent knee joint arthrotomy, titanium tibial implant insertion, and inoculation with Xen36 (bioluminescent Staphylococcus aureus) or a saline control after capsule closure. Biofilm was quantified via scanning electron microscopy (SEM) of the tibial explant 14 d after inoculation ( n=3 noninfected, n=2 infected). Rabbits underwent debridement, antibiotics, and implant retention (DAIR) ( n=6 ) or sham surgery ( n=2 noninfected, n=6 infected) 14 d after inoculation, and they were sacrificed 14 d post-treatment. Tibial explant and periprosthetic tissues were examined for infection. Laboratory assays supported bacterial infection in infected animals. No differences in weight or C-reactive protein (CRP) were detected after DAIR compared to sham treatment. Biofilm coverage was significantly decreased with DAIR treatment when compared with sham treatment (61.4 % vs. 90.1 %, p<0 .0011) and was absent in noninfected control explants. In summary, we have developed an experimental rabbit hemiarthroplasty knee PJI model with bacterial infection that reliably produces quantifiable biofilm and provides an opportunity to introduce treatments at 14 d. This model may be used to better understand the pathogenesis of this condition and to measure treatment strategies for PJI.","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"7 1","pages":"91 - 99"},"PeriodicalIF":0.0,"publicationDate":"2022-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43722360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroplasty after septic arthritis of the native hip and knee: retrospective analysis of 49 joints","authors":"E. Portier, V. Zeller, Y. Kerroumi, B. Heym, S. Marmor, P. Chazerain","doi":"10.5194/jbji-7-81-2022","DOIUrl":"https://doi.org/10.5194/jbji-7-81-2022","url":null,"abstract":"Abstract Background: Arthroplasty after septic arthritis (SA) treatment raises diagnostic and therapeutic questions. The main objective was to evaluate infection-free survival of patients undergoing total knee arthroplasty (TKA) or total hip arthroplasty (THA) post-SA. Other objectives were to describe the population's characteristics, surgical strategies, results of preoperative examinations and cultures of intraoperative samples taken at implantation, and postoperative antibiotic therapy. Methods: This is a retrospective, observational, monocenter study, from January 2005 to May 2019, including all patients undergoing TKA or THA with prior or ongoing SA in the same joint. Infection–free survival was analyzed and reported. Results: Forty-seven patients, 29 men, 49 joints operated on (30 knees, 19 hips), were included. Median SA-to-arthroplasty interval was 32 [1–216] weeks. It was <2 years for 43 joints and <6 months for 19 joints. Six patients underwent arthroplasty while still on SA treatment. One-stage arthroplasty was done for 43 joints and two-stage arthroplasty for 6 joints. Eight (16 %) cultures of intraoperative specimens were positive. Median durations of postoperative antibiotic therapy were 10 d for sterile cultures and 82 d for those that were positive. At 2 years, infection-free survival rate was 95.9 % ( ±0.02 ). After a median follow-up of 47 [18–142] months, no SA relapse was observed, but five patients developed new periprosthetic joint infections (PJIs) with a different microorganism. Conclusion: Arthroplasty may be a post-SA option, even within a short period of time. One-stage arthroplasty can be done if synovectomy is thorough, intraoperative samples are taken and antibiotics are administered until those culture results become available. We observed no SA relapse, but new PJIs occurred.","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"7 1","pages":"81 - 90"},"PeriodicalIF":0.0,"publicationDate":"2022-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43968035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}