Journal of Bone and Joint Infection最新文献

{"title":"Pyogenic spinal infections warrant a total spine MRI.","authors":"Cristian Balcescu,&nbsp;Khalid Odeh,&nbsp;Alexander Rosinski,&nbsp;Brandon Nudelman,&nbsp;Adam Schlauch,&nbsp;Ishan Shah,&nbsp;Victor Ungurean,&nbsp;Priya Prasad,&nbsp;Jeremi Leasure,&nbsp;Flora Stepansky,&nbsp;Amit Piple,&nbsp;Dimitriy Kondrashov","doi":"10.5194/jbji-8-1-2023","DOIUrl":"https://doi.org/10.5194/jbji-8-1-2023","url":null,"abstract":"<p><p><b>Study design</b>: retrospective case series. <b>Objective</b>: the presenting clinical symptoms of spinal infections are often nonspecific and a delay in diagnosis can lead to adverse patient outcomes. The morbidity and mortality of patients with multifocal spinal infections is significantly higher compared to unifocal infections. The purpose of the current study was to analyse the risk factors for multifocal spinal infections. <b>Methods</b>: we conducted a retrospective review of all pyogenic non-tuberculous spinal infections treated surgically at a single tertiary care medical center from 2006-2020. The medical records, imaging studies, and laboratory data of 43 patients during this time period were reviewed and analysed after receiving Institutional Review Board approval. Univariate and multivariate analyses were performed to identify factors associated with a multifocal spinal infection. <b>Results</b>: 15 patients (35 %) had multifocal infections. In univariate analysis, there was a significant association with chronic kidney disease ( <math><mrow><mi>p</mi> <mo>=</mo> <mn>0.040</mn></mrow> </math> ), gender ( <math><mrow><mi>p</mi> <mo>=</mo> <mn>0.003</mn></mrow> </math> ), a white blood cell count ( <math><mrow><mi>p</mi> <mo>=</mo> <mn>0.011</mn></mrow> </math> ), and cervical ( <math><mrow><mi>p</mi> <mo><</mo> <mn>0.001</mn></mrow> </math> ) or thoracic ( <math><mrow><mi>p</mi> <mo><</mo> <mn>0</mn></mrow> </math> .001) involvement. In multivariate analysis, both cervical and thoracic involvement remained statistically significant ( <math><mrow><mi>p</mi> <mo>=</mo> <mn>0.001</mn></mrow> </math> and <math><mrow><mi>p</mi> <mo><</mo> <mn>0.001</mn></mrow> </math> , respectively). <b>Conclusions</b>: patients with infections in the thoracic or cervical region are more likely to have a multifocal infection. Multifocal pyogenic spinal infections remain a common entity and a total spine MRI should be performed to aid in prompt diagnosis.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"8 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9850241/pdf/jbji-8-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9134269","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":"Evaluating the utility of inflammatory markers in the diagnosis of soft tissue abscesses of the forearm and hand.","authors":"Sarah R Blumenthal,&nbsp;Adnan N Cheema,&nbsp;Steven E Zhang,&nbsp;Benjamin L Gray,&nbsp;Nikolas H Kazmers","doi":"10.5194/jbji-8-119-2023","DOIUrl":"https://doi.org/10.5194/jbji-8-119-2023","url":null,"abstract":"<p><p>Upper extremity abscesses frequently present to the acute care setting with inconclusive physical examination and imaging findings. We sought to investigate the diagnostic accuracy of inflammatory markers including white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). A retrospective cohort study was performed to identify subjects <math><mrow><mo>≥</mo> <mn>18</mn></mrow> </math>  years treated with surgical debridement of upper extremity abscesses at our institution between January 2012 and December 2015. In this study, 188 patients were screened, and 72 met the inclusion criteria. A confirmed abscess as defined by culture positivity was present in 67 (93.1 %) cases. The sensitivity of WBC, ESR, or CRP individually was 0.45, 0.71, and 0.81. The specificity of WBC, ESR, or CRP individually was 0.80, 0.80, and 0.40. In combination all three markers when positive had a sensitivity of 0.26 and specificity of 1.0. These values were similar among patients with diabetes and those with obesity. With the highest sensitivity and lowest specificity, CRP exhibited the most utility as a screening test (level IV).</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"8 2","pages":"119-123"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10077572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9626427","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":"Sex-specific analysis of clinical features and outcomes in staphylococcal periprosthetic joint infections managed with two-stage exchange arthroplasty.","authors":"Eibhlin Higgins,&nbsp;Don Bambino Geno Tai,&nbsp;Brian Lahr,&nbsp;Gina A Suh,&nbsp;Elie F Berbari,&nbsp;Kevin I Perry,&nbsp;Matthew P Abdel,&nbsp;Aaron J Tande","doi":"10.5194/jbji-8-125-2023","DOIUrl":"https://doi.org/10.5194/jbji-8-125-2023","url":null,"abstract":"Abstract Background: Differences in susceptibility and response to infection between males and females are well established. Despite this, sex-specific analyses are under-reported in the medical literature, and there is a paucity of literature looking at differences between male and female patients with periprosthetic joint infection (PJI). Whether there are sex-specific differences in presentation, treatment tolerability, and outcomes in PJI has not been widely evaluated. Methods: We undertook a retrospective case-matched analysis of patients with staphylococcal PJI managed with two-stage exchange arthroplasty. To control for differences other than sex which may influence outcome or presentation, males and females were matched for age group, causative organism category (coagulase-negative staphylococci vs. Staphylococcus aureus), and joint involved (hip vs. knee). Results: We identified 156 patients in 78 pairs of males and females who were successfully matched. There were no significant baseline differences by sex, except for greater use of chronic immunosuppression among females (16.4 % vs. 4.1 %; p=0.012 ). We did not detect any statistically significant differences in outcomes between the two groups. Among the 156 matched patients, 16 recurrent infections occurred during a median follow-up time of 2.9 (IQR 1.5–5.3) years. The 3-year cumulative incidence of relapse was 16.1 % for females, compared with 8.8 % for males ( p=0.434 ). Conclusions: Success rates for PJI treated with two-stage exchange arthroplasty are high, consistent with previously reported literature. This retrospective case-matched study did not detect a significant difference in outcome between males and females with staphylococcal PJI who underwent two-stage exchange arthroplasty.","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"8 2","pages":"125-131"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10134758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9398086","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 fracture-related infection in patients without clinical confirmatory criteria: an international retrospective cohort study.","authors":"Niels Vanvelk,&nbsp;Esther M M Van Lieshout,&nbsp;Jolien Onsea,&nbsp;Jonathan Sliepen,&nbsp;Geertje Govaert,&nbsp;Frank F A IJpma,&nbsp;Melissa Depypere,&nbsp;Jamie Ferguson,&nbsp;Martin McNally,&nbsp;William T Obremskey,&nbsp;Charalampos Zalavras,&nbsp;Michael H J Verhofstad,&nbsp;Willem-Jan Metsemakers","doi":"10.5194/jbji-8-133-2023","DOIUrl":"https://doi.org/10.5194/jbji-8-133-2023","url":null,"abstract":"<p><p><b>Background</b>: fracture-related infection (FRI) remains a serious complication in orthopedic trauma. To standardize daily clinical practice, a consensus definition was established, based on confirmatory and suggestive criteria. In the presence of clinical confirmatory criteria, the diagnosis of an FRI is evident, and treatment can be started. However, if these criteria are absent, the decision to surgically collect deep tissue cultures can only be based on suggestive criteria. The primary study aim was to characterize the subpopulation of FRI patients presenting without clinical confirmatory criteria (fistula, sinus, wound breakdown, purulent wound drainage or presence of pus during surgery). The secondary aims were to describe the prevalence of the diagnostic criteria for FRI and present the microbiological characteristics, both for the entire FRI population. <b>Methods</b>: a multicenter, retrospective cohort study was performed, reporting the demographic, clinical and microbiological characteristics of 609 patients (with 613 fractures) who were treated for FRI based on the recommendations of a multidisciplinary team. Patients were divided in three groups, including the total population and two subgroups of patients presenting with or without clinical confirmatory criteria. <b>Results</b>: clinical and microbiological confirmatory criteria were present in 77 % and 87 % of the included fractures, respectively. Of patients, 23 % presented without clinical confirmatory criteria, and they mostly displayed one (31 %) or two (23 %) suggestive clinical criteria (redness, swelling, warmth, pain, fever, new-onset joint effusion, persisting/increasing/new-onset wound drainage). The prevalence of any suggestive clinical, radiological or laboratory criteria in this subgroup was 85 %, 55 % and 97 %, respectively. Most infections were monomicrobial (64 %) and caused by <i>Staphylococcus aureus</i>. <b>Conclusion</b>: clinical confirmatory criteria were absent in 23 % of the FRIs. In these cases, the decision to operatively collect deep tissue cultures was based on clinical, radiological and laboratory suggestive criteria. The combined use of these criteria should guide physicians in the management pathway of FRI. Further research is needed to provide guidelines on the decision to proceed with surgery when only these suggestive criteria are present.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"8 2","pages":"133-142"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10134751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9398084","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":"<i>Cutibacterium acnes</i> in spine tissue: characteristics and outcomes of non-hardware-associated vertebral osteomyelitis.","authors":"Matteo Passerini,&nbsp;Julian Maamari,&nbsp;Don Bambino Geno Tai,&nbsp;Robin Patel,&nbsp;Aaron J Tande,&nbsp;Zelalem Temesgen,&nbsp;Elie F Berbari","doi":"10.5194/jbji-8-143-2023","DOIUrl":"https://doi.org/10.5194/jbji-8-143-2023","url":null,"abstract":"<p><p><i>Cutibacterium acnes</i> isolation from spine tissue can be challenging because the organism can represent a contaminant. There is a paucity of data regarding the role of <i>C. acnes</i> in non-hardware-associated vertebral osteomyelitis (VO). Herein we evaluate the clinical and microbiological characteristics, treatment, and outcome of patients with <i>C. acnes</i> VO. Data were retrospectively collected from adults with a positive spine culture for <i>C. acnes</i> at Mayo Clinic, Rochester (MN), from 2011 to 2021. Patients with spinal hardware and polymicrobial infections were excluded. Of the subjects, 16 showed radiological and clinical findings of VO: 87.5 % were male, the average age was 58 years (<math><mrow><mo>±</mo><mn>15</mn></mrow></math> SD), and back pain was the predominant symptom. Of the lesions, 89.5 % involved the thoracic spine. Of the subjects, 69 % had experienced an antecedent event at the site of VO. In five subjects, <i>C. acnes</i> was isolated after 7 d of anaerobic culture incubation. Thirteen subjects were treated with parenteral <math><mi>β</mi></math>-lactams, and three with oral antimicrobials, without any evidence of recurrence. Twenty-one subjects were not treated for VO, as <i>C. acnes</i> was considered a contaminant; at follow-up, none had evidence of progressive disease. <i>C. acnes</i> should be part of microbiological differential diagnosis in patients with suspected VO, especially in the context of a prior spinal procedure. Anaerobic spine cultures should undergo prolonged incubation to enable recovery of <i>C. acnes</i>. <i>C. acnes</i> VO may be managed with oral or parenteral antimicrobial therapy. Without clinical and radiological evidence of VO, a single positive culture of <i>C. acnes</i> from spine tissue frequently represents contaminants.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"8 2","pages":"143-149"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10176096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9480276","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":"Systemic rifampicin shows accretion to locally implanted hydroxyapatite particles in a rat abdominal muscle pouch model.","authors":"Sujeesh Sebastian,&nbsp;Jintian Huang,&nbsp;Yang Liu,&nbsp;Mattias Collin,&nbsp;Magnus Tägil,&nbsp;Deepak Bushan Raina,&nbsp;Lars Lidgren","doi":"10.5194/jbji-8-19-2023","DOIUrl":"https://doi.org/10.5194/jbji-8-19-2023","url":null,"abstract":"<p><p><b>Introduction</b>: biomaterials combined with antibiotics are routinely used for the management of bone infections. After eluting high concentrations of antibiotics during the first week, sub-inhibitory concentrations of antibiotics may lead to late repopulation of recalcitrant bacteria. Recent studies have shown that systemically given antibiotics like tetracycline and rifampicin (RIF) could seek and bind to locally implanted hydroxyapatite (HA). The aim of this in vivo study was to test if systemically administered rifampicin could replenish HA-based biomaterials with or without prior antibiotic loading to protect the material from late bacterial repopulation. <b>Methods</b>: in vivo accretion of systemically administered RIF to three different types of HA-based materials was tested. In group 1, nano (n)- and micro (m)-sized HA particles were used, while group 2 consisted of a calcium sulfate <math><mo>/</mo></math> hydroxyapatite (CaS <math><mo>/</mo></math> HA) biomaterial without preloaded antibiotics gentamycin (GEN) or vancomycin (VAN), and in group 3, the CaS <math><mo>/</mo></math> HA material contained GEN (CaS <math><mo>/</mo></math> HA <math><mo>+</mo></math> GEN) or VAN (CaS <math><mo>/</mo></math> HA <math><mo>+</mo></math> VAN). The above materials were implanted in an abdominal muscle pouch model in rats, and at 7 d post-surgery, the animals were assigned to a control group (i.e., no systemic antibiotic) and a test group (i.e., animals receiving one single intraperitoneal injection of RIF each day (4 mg per rat) for 3 consecutive days). Twenty-four hours after the third injection, the animals were sacrificed and the implanted pellets were retrieved and tested against <i>Staphylococcus aureus</i> ATCC 25923 in an agar diffusion assay. After overnight incubation, the zone of inhibition (ZOI) around the pellets were measured. <b>Results</b>: in the control group, <math><mrow><mn>2</mn> <mo>/</mo> <mn>6</mn></mrow> </math> CaS <math><mo>/</mo></math> HA <math><mo>+</mo></math> GEN pellets had a ZOI, while all other harvested pellets had no ZOI. No pellets from animals in test group 1 had a ZOI. In test group 2, <math><mrow><mn>10</mn> <mo>/</mo> <mn>10</mn></mrow> </math> CaS <math><mo>/</mo></math> HA pellets showed a ZOI. In test group 3, <math><mrow><mn>5</mn> <mo>/</mo> <mn>6</mn></mrow> </math> CaS <math><mo>/</mo></math> HA <math><mo>+</mo></math> GEN and <math><mrow><mn>4</mn> <mo>/</mo> <mn>6</mn></mrow> </math> CaS <math><mo>/</mo></math> HA <math><mo>+</mo></math> VAN pellets showed a ZOI. <b>Conclusions</b>: in this proof-of-concept study, we have shown that a locally implanted biphasic CaS <math><mo>/</mo></math> HA carrier after 1 week can be loaded by systemic RIF administration and exert an antibacterial effect. Further in vivo infection models are necessary to validate our findings.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"8 1","pages":"19-28"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9850244/pdf/jbji-8-19.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10659342","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":"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":"Implant surface modifications as a prevention method for periprosthetic joint infection caused by <i>Staphylococcus aureus</i>: a systematic review and meta-analysis.","authors":"Krisna Yuarno Phatama,&nbsp;Respati Suryanto Dradjat,&nbsp;Edi Mustamsir,&nbsp;Dwi Yuni Nurhidayati,&nbsp;Dewi Santosaningsih,&nbsp;Dwikora Novembri Utomo,&nbsp;Mohamad Hidayat","doi":"10.5194/jbji-7-231-2022","DOIUrl":"https://doi.org/10.5194/jbji-7-231-2022","url":null,"abstract":"<p><p><b>Background</b>: Periprosthetic joint infection is the most common infection due to joint replacement. It has been reported that, over a 5-year time span, 3.7 % of cases occurred annually. This statistic has increased to 6.86 % over 16 years. Thus, an effective method is required to reduce these complications. Several strategies such as coating methods with various materials, such as antibiotics, silver, and iodine, have been reported. However, the best preventive strategy is still undetermined. Therefore, this systematic review aims to evaluate the outcome of coating methods on joint arthroplasty as a treatment or preventive management for infection complications. <b>Methods</b>: Eligible articles were systematically searched from multiple electronic databases (PubMed, Cochrane library, and ScienceDirect) up to 2 June 2022. Based on the criterion inclusion, eight articles were selected for this study. The Newcastle-Ottawa scale (NOS) was used to assess the quality of the study, and the meta-analysis test was conducted with Review Manager 5.4. <b>Results</b>: The quality of the articles in this study is in the range of moderate to good. It was found that the application of modified antibiotic coatings significantly reduced the occurrence of periprosthetic joint infection (PJI) ( <math><mi>p</mi></math> 0.03), and silver coating could not significantly ( <math><mi>p</mi></math> 0.47) prevent the occurrence of PJI. However, according to the whole aspect of coating modification, the use of antibiotics, silver, and iodine can minimize the occurrence of PJI ( <math><mi>p</mi></math>   <math><mrow><mi><</mi> <mn>0.0001</mn></mrow> </math> ). <b>Conclusion</b>: Coating methods using antibiotics are an effective method that could significantly prevent the occurrence of PJI. On the other hand, coating with non-antibiotic materials such as silver could not significantly prevent the incidence of PJI.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":" ","pages":"231-239"},"PeriodicalIF":0.0,"publicationDate":"2022-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9677338/pdf/jbji-7-231.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40491862","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":"A desirability of outcome ranking (DOOR) for periprosthetic joint infection - a Delphi analysis.","authors":"Brenton P Johns,&nbsp;David C Dewar,&nbsp;Mark R Loewenthal,&nbsp;Laurens A Manning,&nbsp;Amit Atrey,&nbsp;Nipun Atri,&nbsp;David G Campbell,&nbsp;Michael Dunbar,&nbsp;Christopher Kandel,&nbsp;Amir Khoshbin,&nbsp;Christopher W Jones,&nbsp;Jaime Lora-Tamayo,&nbsp;Catherine McDougall,&nbsp;Dirk Jan F Moojen,&nbsp;Jonathan Mulford,&nbsp;David L Paterson,&nbsp;Trisha Peel,&nbsp;Michael Solomon,&nbsp;Simon W Young,&nbsp;Joshua S Davis","doi":"10.5194/jbji-7-221-2022","DOIUrl":"https://doi.org/10.5194/jbji-7-221-2022","url":null,"abstract":"<p><p><b>Background</b>: Treatment outcomes in studies on prosthetic joint infection are generally assessed using a dichotomous outcome relating to treatment success or failure. These outcome measures neither include patient-centred outcome measures including joint function and quality of life, nor do they account for adverse effects of treatment. A desirability of outcome ranking (DOOR) measure can include these factors and has previously been proposed and validated for other serious infections. We aimed to develop a novel DOOR for prosthetic joint infections (PJIs). <b>Methods</b>: The Delphi method was used to develop a DOOR for PJI research. An international working group of 18 clinicians (orthopaedic surgeons and infectious disease specialists) completed the Delphi process. The final DOOR comprised the dimensions established to be most important by consensus with <math><mrow><mi>></mi> <mn>75</mn></mrow> </math>  % of participant agreement. <b>Results</b>: The consensus DOOR comprised four main dimensions. The primary dimension was patient-reported joint function. The secondary dimensions were infection cure and mortality. The final dimension of quality of life was selected as a tie-breaker. <b>Discussion</b>: A desirability of outcome ranking for periprosthetic joint infection has been proposed. It focuses on patient-centric outcome measures of joint function, cure and quality of life. This DOOR provides a multidimensional assessment to comprehensively rank outcomes when comparing treatments for prosthetic joint infection.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":" ","pages":"221-229"},"PeriodicalIF":0.0,"publicationDate":"2022-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9677339/pdf/jbji-7-221.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40491863","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}