Journal of Bone and Joint Infection最新文献

{"title":"Vertebral osteomyelitis and epidural abscess due to Listeria monocytogenes – case report and review of literature","authors":"Olayinka Adebolu, J. Sommer, A. Idowu, N. Lao, Talha Riaz","doi":"10.5194/jbji-7-75-2022","DOIUrl":"https://doi.org/10.5194/jbji-7-75-2022","url":null,"abstract":"Abstract We describe a case of native vertebral osteomyelitis (NVO) secondary to Listeria monocytogenes in a patient with polymyalgia rheumatica receiving chronic steroids. Treatment required surgical debridement of the epidural phlegmon and combination therapy with intravenous ampicillin and gentamicin.","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"7 1","pages":"75 - 79"},"PeriodicalIF":0.0,"publicationDate":"2022-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46183887","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":"Severe acidosis due to 5-oxoprolinase inhibition by flucloxacillin in a patient with shoulder prosthesis joint infection","authors":"Julia Elisabeth Lenz, V. Alt, T. Dienemann","doi":"10.5194/jbji-7-71-2022","DOIUrl":"https://doi.org/10.5194/jbji-7-71-2022","url":null,"abstract":"Abstract We report a case of a 64-year-old female patient with severe metabolic acidosis. Inhibition of 5-oxoprolinase by flucloxacillin was found to be the cause of the metabolic derailment.","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"7 1","pages":"71 - 74"},"PeriodicalIF":0.0,"publicationDate":"2022-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49242298","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":"The presence of a draining sinus is associated with failure of re-implantation during two-stage exchange arthroplasty","authors":"A. Gabrielli, Alan E. Wilson, R. Wawrose, M. Dombrowski, M. O’Malley, B. Klatt","doi":"10.5194/jbji-7-55-2022","DOIUrl":"https://doi.org/10.5194/jbji-7-55-2022","url":null,"abstract":"Abstract Background: Reinfection rates after two-stage exchange arthroplasty for prosthetic joint infection (PJI) have been reported as high as 33 % in the literature. Understanding risk factors for treatment failure will help to preoperatively counsel patients on the likelihood of successful treatment and possibly influence the surgeon's treatment algorithm. This study aimed to delineate whether the presence of a draining sinus tract is associated with risk of failure of two-stage exchange arthroplasty. Methods: We performed a single institution, multi-center retrospective chart review of outcomes of patients treated for PJI with two-stage exchange arthroplasty between June 2006 and May 2016. For patients treated prior to 2011, PJI was defined based on the preoperative work-up and intraoperative findings as determined by the attending surgeon. After 2011, PJI was defined using MSIS consensus criteria. All patients had a minimum of follow-up of 2 years or treatment failure prior to 2 years. Treatment failure was defined as reinfection or failure to complete two-stage exchange secondary to persistent infection or other host factors. Operative reports and clinical notes were reviewed to assess for presence of a draining sinus tract. Results: 240 patients were treated for PJI with intended two-stage exchange arthroplasty. The overall rate of treatment failure was 29.6 % ( 71/240 ), while the overall rate of reinfection was 13.3 % ( 32/240 ). A total of 39 patients did not complete second stage revision; final treatment for these patients was amputation, fusion, or chronic antibiotic suppression. A total of 52 of 240 patients (21.7 %) had a draining sinus tract at presentation. Patients with a sinus tract were significantly less likely to be replanted compared to those without a sinus tract at presentation (13.3 % vs. 26.9 %, p=0.02 ). However, when accounting for all mechanisms of treatment failure, including reinfection following replantation, there was no statistically significant difference detected between the sinus and no-sinus groups (27.7 % vs. 36.5 %, p=0.22 ). Discussion: A draining sinus tract represents a chronic, deep infectious process with ultimate compromise of overlying soft tissues. Thus we hypothesized it would be associated with failure in a two-stage exchange arthroplasty. These data demonstrate that patients with a draining sinus are significantly less likely to undergo re-implantation. This provides evidence to the paucity of data surrounding draining sinuses and two-stage PJI treatment.","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"7 1","pages":"55 - 60"},"PeriodicalIF":0.0,"publicationDate":"2022-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48091422","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":"Has the time come for regional periprosthetic joint infection centers in the United States? A first-year experience","authors":"M. Adrados, Michael M. Valenzuela, B. Springer, S. Odum, T. Fehring, Jesse E. Otero","doi":"10.5194/jbji-7-51-2022","DOIUrl":"https://doi.org/10.5194/jbji-7-51-2022","url":null,"abstract":"Abstract Several fields of orthopedics have concluded benefits from volume thresholds. We postulate that we could similarly optimize periprosthetic joint infection (PJI) treatment by creating a regional referral center, concentrating expertise and resources. Here, we review our reasoning and our first-year experience of a PJI referral center in the United States.","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"7 1","pages":"51 - 53"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43082914","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":"Septic arthritis and osteomyelitis of the pubic symphysis – a retrospective study of 26 patients","authors":"R. L. Hansen, M. Bue, A. Borgognoni, K. Petersen","doi":"10.5194/jbji-7-35-2022","DOIUrl":"https://doi.org/10.5194/jbji-7-35-2022","url":null,"abstract":"Abstract Introduction: Septic arthritis and osteomyelitis of the pubic symphysis (SAS) are rare conditions with nonspecific symptoms leading to diagnostic delay and treatment. Aim: We draw awareness to this condition elucidating the diagnostic procedures, surgical intervention and antibiotic management. Methods: This entail a retrospective follow-up study of 26 consecutive patients, median age of 71 years (range: 48–89) surgically treated for septic arthritis of the pubic symphysis between 2009 and 2020. Patient files, diagnostic imaging and bacterial cultures were evaluated. Results: Before diagnosed with SAS, 21 of the patients had previous pelvic surgery (16 due to malign conditions, 5 due to benign conditions), while 5 of the patients were not previously operated. Median follow-up period after SAS surgery was 18.5 months (range: 8 to 144.5 months). Dominating symptoms were severe suprapubic/pubic pain ( n   =  26), gait difficulties ( n   =  10) and intermittent fever ( n   =  9). Diagnostic delay was between 1 and 12 months. The diagnostic imaging included magnetic resonance imaging (MRI) ( n   =  24), computer tomography (CT) ( n   =  17) and/or PET-CT ( n   =  10), predominantly displaying bone destruction/erosion of the symphysis ( n   =  13), abscess ( n   =  12) and/or fistula ( n   =  5) in the adjacent muscles. All patients underwent surgical debridement with resection of the symphysis and received a minimum of 6 weeks antibiotic treatment. Fourteen patients presented with monocultures and 4 patients with polycultures. Five patients underwent at least one revision surgery. Twenty-three patients experienced postoperative pain relief at 6 weeks follow-up, and 19 patients were ambulant without walking aids. Conclusion: SAS are rare conditions and should be suspected in patients with infection, pubic pain and impaired gait, especially after pelvic surgery. Bone infection, abscess and fistula near the symphysis can be visualized with proper imaging, most frequently with MRI. For most patients in this cohort surgical debridement combined with a minimum of 6 weeks antibiotic treatment resulted in pain relief, improved walking ability and a low recurrence rate.","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"7 1","pages":"35 - 42"},"PeriodicalIF":0.0,"publicationDate":"2022-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44411672","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":"Early periprosthetic hip joint infection managed by cementless one-stage revision - a case series.","authors":"Kristoffer Riemer, Jeppe Lange","doi":"10.5194/jbji-7-43-2022","DOIUrl":"10.5194/jbji-7-43-2022","url":null,"abstract":"<p><p><b>Background</b>: Early periprosthetic hip joint infection (PJI) is traditionally treated with debridement, antibiotics, and implant retention (DAIR). However, infection control rates after DAIR-treated periprosthetic hip joint infection do not exceed 77 %. Cementless one-stage revision of chronic PJI by the Cementless One-stage Revision of Infected Hip Arthroplasty (CORIHA) protocol has been evaluated positively with a 91 % success rate. We wanted to evaluate the effectiveness of cementless one-stage revision following the CORIHA protocol for early PJI in elective primary total hip arthroplasty, regarding risk of re-operation with exchange of implants. <b>Methods</b>: We identified 18 patients in our center with early ( <math><mrow><mo>≤</mo> <mn>6</mn></mrow> </math> -week postoperative) PJI after primary total hip arthroplasty (THA) treated with one-stage cementless revision in the period January 2012-March 2018. Treatment followed the CORIHA protocol. Primary outcome was retention of implants at the most recent follow-up. Patients were followed for a minimum of 3 years. <b>Results</b>: Mean follow-up time was 60 months (39-105). All patients retained their implants, but two required superficial soft tissue debridement due to persistent wound seepage. <b>Conclusion</b>: Cementless one-stage revision appears to be an effective treatment of early PJI after primary THA and at least an equal choice of treatment compared with DAIR. Whether the potential benefit of a lower re-revision rate for postoperative PJI outweighs the increased surgical complexity of the CORIHA procedure needs further evaluation.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"7 1","pages":"43-50"},"PeriodicalIF":1.8,"publicationDate":"2022-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8892566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41664974","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":"Black pus from a worn-out elbow arthroplasty.","authors":"Marjan Wouthuyzen-Bakker,&nbsp;Alexander L Boerboom","doi":"10.5194/jbji-7-33-2022","DOIUrl":"https://doi.org/10.5194/jbji-7-33-2022","url":null,"abstract":"<jats:p>\u0000 </jats:p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"7 1","pages":"33-34"},"PeriodicalIF":0.0,"publicationDate":"2022-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8830416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39612166","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":"Diagnosis of vertebral osteomyelitis.","authors":"Julian Maamari,&nbsp;Aaron J Tande,&nbsp;Felix Diehn,&nbsp;Don Bambino Geno Tai,&nbsp;Elie F Berbari","doi":"10.5194/jbji-7-23-2022","DOIUrl":"https://doi.org/10.5194/jbji-7-23-2022","url":null,"abstract":"<p><p>Native vertebral osteomyelitis (NVO) is a potentially fatal infection which has seen a gradual increase in its incidence over the past decades. The infection is insidious, presenting with symptoms of back pain. Fever is present in about 60 % of patients. Prompt diagnosis of NVO is important to prevent the development of complications. Numerous laboratory and imaging tools can be deployed to accurately establish the diagnosis. Imaging techniques such as magnetic resonance, nuclear imaging, and computed tomography are essential in diagnosing NVO but can also be useful in image-guided biopsies. Laboratory tools include routine blood tests, inflammatory markers, and routine culture techniques of aspirated specimens. Recent advances in molecular techniques can assist in identifying offending pathogen(s). In this review, we detail the arsenal of techniques that can be utilized to reach a diagnosis of NVO.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"7 1","pages":"23-32"},"PeriodicalIF":0.0,"publicationDate":"2022-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8814828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39777971","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":"Local antibiotic treatment with calcium sulfate as carrier material improves the outcome of debridement, antibiotics, and implant retention procedures for periprosthetic joint infections after hip arthroplasty - a retrospective study.","authors":"Katharina Reinisch,&nbsp;Michel Schläppi,&nbsp;Christoph Meier,&nbsp;Peter Wahl","doi":"10.5194/jbji-7-11-2022","DOIUrl":"https://doi.org/10.5194/jbji-7-11-2022","url":null,"abstract":"<p><p><b>Purpose</b>: Debridement, antibiotics, and implant retention (DAIR) is an established treatment modality in periprosthetic joint infections (PJIs), but success rates vary. This study compared the success of DAIR for PJIs after a total hip arthroplasty (THA), with or without local antibiotic delivery with CaSO <math><msub><mi></mi> <mn>4</mn></msub> </math> as the carrier material. <b>Methods</b>: A retrospective review of DAIR for PJIs after THA performed between 2010 and 2018, including 41 patients is conducted. A total of 27 patients were treated by DAIR with local antibiotics with CaSO <math><msub><mi></mi> <mn>4</mn></msub> </math> as the carrier material, and 14 patients were treated by a standard DAIR. The endpoints were treatment failure, defined as the need for a reoperation, either a second DAIR or a prosthesis removal or exchange due to persistent or recurrent infection, the initiation of a long-term suppressive antibiotic treatment, or death related to infection. <b>Results</b>: Considering any reoperation as an outcome, 11 of 14 cases treated without AB-CaSO <math><msub><mi></mi> <mn>4</mn></msub> </math> (79 %) and 4 of the 27 cases treated with AB-CaSO <math><msub><mi></mi> <mn>4</mn></msub> </math> failed (15 %). Considering revision as an outcome, 9 out of 14 cases treated without AB-CaSO <math><msub><mi></mi> <mn>4</mn></msub> </math> (64 %) and 4 of the 27 cases treated with AB-CaSO <math><msub><mi></mi> <mn>4</mn></msub> </math> (15 %) failed. A Kaplan-Meier survival analysis showed that local antibiotic delivery with CaSO <math><msub><mi></mi> <mn>4</mn></msub> </math> as the carrier material led to a significantly longer infection-free survival, considering any surgical revision ( <math><mrow><mi>p</mi> <mo><</mo> <mn>0.0001</mn></mrow> </math> ; hazard ratio 8.9 (95 % CI 2.8-28.2)) or revision with component exchange ( <math><mrow><mi>p</mi> <mo>=</mo> <mn>0.0015</mn></mrow> </math> ; hazard ratio 5.6 (95 % CI 1.7-18.2)) as the endpoint. <b>Conclusion</b>: The addition of local antibiotics with CaSO <math><msub><mi></mi> <mn>4</mn></msub> </math> as the carrier material to DAIR for PJIs after THA significantly increases success rates, such as infection-free survival, any reoperation, and revision with component exchange in particular.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"7 1","pages":"11-21"},"PeriodicalIF":0.0,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8795886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39580431","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":"Nuclear imaging does not have clear added value in patients with low a priori chance of periprosthetic joint infection. A retrospective single-center experience.","authors":"Karsten D Ottink, Stefan J Gelderman, Marjan Wouthuyzen-Bakker, Joris J W Ploegmakers, Andor W J M Glaudemans, Paul C Jutte","doi":"10.5194/jbji-7-1-2022","DOIUrl":"10.5194/jbji-7-1-2022","url":null,"abstract":"<p><p><b>Background</b>: A low-grade periprosthetic joint infection (PJI) may present without specific symptoms, and its diagnosis remains a challenge. Three-phase bone scintigraphy (TPBS) and white blood cell (WBC) scintigraphy are incorporated into recently introduced diagnostic criteria for PJI, but their exact value in diagnosing low-grade PJI in patients with nonspecific symptoms remains unclear. <b>Methods</b>: In this retrospective study, we evaluated patients with a prosthetic joint of the hip or knee who underwent TPBS and/or WBC scintigraphy between 2009 and 2016 because of nonspecific symptoms. We reviewed and calculated diagnostic accuracy of the TPBS and/or WBC scintigraphy to diagnose or exclude PJI. PJI was defined based on multiple cultures obtained during revision surgery. In patients who did not undergo revision surgery, PJI was ruled out by clinical follow-up of at least 2 years absent of clinical signs of infection based on MSIS 2011 criteria. <b>Results</b>: A total of 373 patients were evaluated, including 340 TPBSs and 142 WBC scintigraphies. Thirteen patients (3.5 %) were diagnosed with a PJI. TPBS sensitivity, specificity, and positive and negative predictive values (PPV, NPV) were 71 %, 65 %, 8 % and 98 %, respectively. Thirty-five percent of TPBS showed increased uptake. Stratification for time intervals between the index arthroplasty and the onset of symptoms did not alter its diagnostic accuracy. WBC scintigraphy sensitivity, specificity, PPV and NPV were 30 %, 90 %, 25 % and 94 %, respectively. <b>Conclusion</b>: Nuclear imaging does not have clear added value in patients with low a priori chance of periprosthetic joint infection.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"7 1","pages":"1-9"},"PeriodicalIF":1.8,"publicationDate":"2022-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8759077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39834067","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}