Journal of Bone and Joint Infection最新文献

{"title":"<i>Corrigendum to</i> \"Assessment of risk factors for early-onset deep surgical site infection following primary total hip arthroplasty for osteoarthritis\" published in J. Bone Joint Infect., 6, 443-450, 2021.","authors":"Jonathan Bourget-Murray,&nbsp;Rohit Bansal,&nbsp;Alexandra Soroceanu,&nbsp;Sophie Piroozfar,&nbsp;Pam Railton,&nbsp;Kelly Johnston,&nbsp;Andrew Johnson,&nbsp;James Powell","doi":"10.5194/jbji-7-151-2022","DOIUrl":"https://doi.org/10.5194/jbji-7-151-2022","url":null,"abstract":"<jats:p>\u0000 </jats:p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":" ","pages":"151-153"},"PeriodicalIF":0.0,"publicationDate":"2022-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9284413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40630295","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":"Prosthetic joint infections caused by <i>Mycobacterium avium</i> complex: a series of five cases.","authors":"Katharine Dobos,&nbsp;Gina A Suh,&nbsp;Aaron J Tande,&nbsp;Shanthi Kappagoda","doi":"10.5194/jbji-7-137-2022","DOIUrl":"https://doi.org/10.5194/jbji-7-137-2022","url":null,"abstract":"<p><p>Prosthetic joint infection (PJI) due to <i>Mycobacterium avium</i> complex (MAC) is a rare entity. There is limited guidance on management strategies and outcomes. In this paper, we describe the demographics, comorbidities, and clinical course of five patients at two academic institutions, constituting the largest series described to date.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":" ","pages":"137-141"},"PeriodicalIF":0.0,"publicationDate":"2022-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9284414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40630296","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":"Osteocutaneous-flap-related osteomyelitis following mandibular reconstruction: a cohort study of an emerging and complex bone infection.","authors":"Clément Javaux,&nbsp;Clémentine Daveau,&nbsp;Clotilde Bettinger,&nbsp;Mathieu Daurade,&nbsp;Céline Dupieux-Chabert,&nbsp;Fabien Craighero,&nbsp;Carine Fuchsmann,&nbsp;Philippe Céruse,&nbsp;Arnaud Gleizal,&nbsp;Nicolas Sigaux,&nbsp;Tristan Ferry,&nbsp;Florent Valour,&nbsp;The Lyon Bji Study Group","doi":"10.5194/jbji-7-127-2022","DOIUrl":"https://doi.org/10.5194/jbji-7-127-2022","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Osteocutaneous flap (OCF) mandible reconstruction is at high risk for surgical site infection. This study aimed to describe diagnosis, management, and outcome of OCF-related osteomyelitis. All patients managed at our institution for an OCF-related osteomyelitis following mandible reconstruction were included in a retrospective cohort study (2012-2019). Microbiology was described according to gold-standard surgical samples, considering all virulent pathogens, and potential contaminants if present on at least two samples. Determinants of treatment failure were assessed by logistic regression and Kaplan-Meier curve analysis. The 48 included patients (median age 60.5 (IQR, 52.4-66.6) years) benefited from OCF mandible reconstruction mostly for carcinoma ( &lt;math&gt;&lt;mrow&gt;&lt;mi&gt;n&lt;/mi&gt; &lt;mo&gt;=&lt;/mo&gt; &lt;mn&gt;27&lt;/mn&gt; &lt;mo&gt;/&lt;/mo&gt; &lt;mn&gt;48&lt;/mn&gt;&lt;/mrow&gt; &lt;/math&gt; ; 56.3 %) or osteoradionecrosis ( &lt;math&gt;&lt;mrow&gt;&lt;mi&gt;n&lt;/mi&gt; &lt;mo&gt;=&lt;/mo&gt; &lt;mn&gt;12&lt;/mn&gt; &lt;mo&gt;/&lt;/mo&gt; &lt;mn&gt;48&lt;/mn&gt;&lt;/mrow&gt; &lt;/math&gt; ; 25.0 %). OCF-related osteomyelitis was mostly early ( &lt;math&gt;&lt;mrow&gt;&lt;mo&gt;≤&lt;/mo&gt; &lt;mn&gt;3&lt;/mn&gt;&lt;/mrow&gt; &lt;/math&gt; months post-surgery; &lt;math&gt;&lt;mrow&gt;&lt;mi&gt;n&lt;/mi&gt; &lt;mo&gt;=&lt;/mo&gt; &lt;mn&gt;43&lt;/mn&gt; &lt;mo&gt;/&lt;/mo&gt; &lt;mn&gt;48&lt;/mn&gt;&lt;/mrow&gt; &lt;/math&gt; ; 89.6 %), presenting with local inflammation ( &lt;math&gt;&lt;mrow&gt;&lt;mi&gt;n&lt;/mi&gt; &lt;mo&gt;=&lt;/mo&gt; &lt;mn&gt;28&lt;/mn&gt; &lt;mo&gt;/&lt;/mo&gt; &lt;mn&gt;47&lt;/mn&gt;&lt;/mrow&gt; &lt;/math&gt; ; 59.6 %), nonunion (wound dehiscence) or sinus tract ( &lt;math&gt;&lt;mrow&gt;&lt;mi&gt;n&lt;/mi&gt; &lt;mo&gt;=&lt;/mo&gt; &lt;mn&gt;28&lt;/mn&gt; &lt;mo&gt;/&lt;/mo&gt; &lt;mn&gt;47&lt;/mn&gt;&lt;/mrow&gt; &lt;/math&gt; ; 59.6 %), and/or bone or device exposure ( &lt;math&gt;&lt;mrow&gt;&lt;mi&gt;n&lt;/mi&gt; &lt;mo&gt;=&lt;/mo&gt; &lt;mn&gt;21&lt;/mn&gt; &lt;mo&gt;/&lt;/mo&gt; &lt;mn&gt;47&lt;/mn&gt;&lt;/mrow&gt; &lt;/math&gt; ; 44.7 %). Main implicated pathogens were Enterobacteriaceae ( &lt;math&gt;&lt;mrow&gt;&lt;mi&gt;n&lt;/mi&gt; &lt;mo&gt;=&lt;/mo&gt; &lt;mn&gt;25&lt;/mn&gt; &lt;mo&gt;/&lt;/mo&gt; &lt;mn&gt;41&lt;/mn&gt;&lt;/mrow&gt; &lt;/math&gt; ; 61.0 %), streptococci ( &lt;math&gt;&lt;mrow&gt;&lt;mi&gt;n&lt;/mi&gt; &lt;mo&gt;=&lt;/mo&gt; &lt;mn&gt;22&lt;/mn&gt; &lt;mo&gt;/&lt;/mo&gt; &lt;mn&gt;41&lt;/mn&gt;&lt;/mrow&gt; &lt;/math&gt; ; 53.7 %), &lt;i&gt;Staphylococcus aureus&lt;/i&gt; ( &lt;math&gt;&lt;mrow&gt;&lt;mi&gt;n&lt;/mi&gt; &lt;mo&gt;=&lt;/mo&gt; &lt;mn&gt;10&lt;/mn&gt; &lt;mo&gt;/&lt;/mo&gt; &lt;mn&gt;41&lt;/mn&gt;&lt;/mrow&gt; &lt;/math&gt; ; 24.4 %), enterococci ( &lt;math&gt;&lt;mrow&gt;&lt;mi&gt;n&lt;/mi&gt; &lt;mo&gt;=&lt;/mo&gt; &lt;mn&gt;9&lt;/mn&gt; &lt;mo&gt;/&lt;/mo&gt; &lt;mn&gt;41&lt;/mn&gt;&lt;/mrow&gt; &lt;/math&gt; ; 22.0 %), non-fermenting Gram-negative bacilli ( &lt;math&gt;&lt;mrow&gt;&lt;mi&gt;n&lt;/mi&gt; &lt;mo&gt;=&lt;/mo&gt; &lt;mn&gt;8&lt;/mn&gt; &lt;mo&gt;/&lt;/mo&gt; &lt;mn&gt;41&lt;/mn&gt;&lt;/mrow&gt; &lt;/math&gt; ; 19.5 %), and anaerobes ( &lt;math&gt;&lt;mrow&gt;&lt;mi&gt;n&lt;/mi&gt; &lt;mo&gt;=&lt;/mo&gt; &lt;mn&gt;8&lt;/mn&gt; &lt;mo&gt;/&lt;/mo&gt; &lt;mn&gt;41&lt;/mn&gt;&lt;/mrow&gt; &lt;/math&gt; ; 19.5 %). Thirty-nine patients (81.3 %) benefited from surgery, consisting of debridement with implant retention (DAIR) in &lt;math&gt;&lt;mrow&gt;&lt;mn&gt;25&lt;/mn&gt; &lt;mo&gt;/&lt;/mo&gt; &lt;mn&gt;39&lt;/mn&gt;&lt;/mrow&gt; &lt;/math&gt; (64.1 %) cases, associated with 93 (IQR, 64-128) days of antimicrobial therapy. After a follow-up of 18 (IQR, 11-31) months, &lt;math&gt;&lt;mrow&gt;&lt;mn&gt;24&lt;/mn&gt; &lt;mo&gt;/&lt;/mo&gt; &lt;mn&gt;48&lt;/mn&gt;&lt;/mrow&gt; &lt;/math&gt; (50.0 %) treatment failures were observed. Determinants of treatment outcomes were DAIR (OR, 3.333; 95 % CI, 1.020-10.898) and an early infectious disease specialist referral (OR, 0.236 if &lt;math&gt;&lt;mrow&gt;&lt;mo&gt;≤&lt;/mo&gt; &lt;mn&gt;2&lt;/mn&gt;&lt;/mrow&gt; &lt;/math&gt;  weeks; 95 % CI, 0.062-0.933). OCF-related osteomyelitis following mandibul","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":" ","pages":"127-136"},"PeriodicalIF":0.0,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9285487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40618470","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}

{"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}