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PJI: Prosthetic Joint Infection

Keywords: Hip and knee arthroplasty, periprosthetic joint infection, debridement and irrigation, prosthesis survival.

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Loosening of the hip joint prostheses.

The aim of our study was to evaluate the effectiveness of debridement, antibiotics, irrigation and retention (DAIR) in patients who developed a periprosthetic joint infection (PJI) after primary hip or knee arthroplasty in two community hospitals in the Netherlands. We retrospectively collected data in two hospitals in the Netherlands on all episodes of PJI after primary hip (THA) and knee arthroplasty (TKA) from 1998-2012. In 109 of 8234 THA (1.32%) and 65 of 5752 TKA (1.13%) a PJI developed. DAIR was used as treatment in 84 patients after THA (77.1%) and 56 patients after TKA (86.2%). 34 Patients only received antibiotics or were immediately revised. After 1 year follow-up, prosthesis retention was achieved in 81 THA patients (74.3%) and 48 TKA patients (73.8%). Acute infections showed a better survival compared to late infections (84.0% vs 46.6% respectively; p In conclusion, debridement, antibiotics and irrigation in acute PJI may lead to retention of the prosthesis in a majority of cases. Large patient cohort studies can provide data on PJI outcome, complementing National Registries which have limited detail.

Demographic data of 174 patients with a deep prosthetic joint infection after THA or TKA.

The classification system of the American Academy of Orthopaedic Surgeons (AAOS) of acetabular and femoral deficiencies in total hip replacement [-].

Prosthetic Joint Infection - Recon - Orthobullets

Keywords: hip joint infection, early infection, late infection, low-grade infection

13. Shanmugasundaram S, Ricciardi BF, Briggs TWR, Sussmann PS, Bostrom MP. Evaluation and management of periprosthetic joint infection - an international, multicenter study. 2014;10:36-44

14. Klouche S, Lhotellier L, Mamoudy P. Infected total hip arthroplasty treated by an irrigation-debridement/component retention protocol. A prospective study in a 12-case series with minimum 2 years' follow-up. 2011;97:134-138

Prosthetic joint infection: Treatment - UpToDate

Keywords: prosthetic joint infection, antibiotic suppressive therapy, side effects

41. Durbhakula SM, Czajka J, Fuchs MD, Uhl RL. Spacer endoprosthesis for the treatment of infected total hip arthroplasty. 2004;19:760-7

40. Haddad FS, Masri BA, Garbuz DS, Duncan CP. The treatment of the infected hip replacement, the complex case. 1999;369:144-156

4. Haddad FS, Bridgens A. Infection following hip replacement: solution options.  2008;31(9):907-8
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  • Preventing Joint Replacement Infection - OrthoInfo - …

    In this review article, the current status about classification of hip joint infections is presented.

  • Painful Infection at the Site of Hip Prosthesis: CT Imaging

    extraction and analysis of synovic fluid from the hip capsule) that could detect the presence of an infection.

  • [Infection of a hip prosthesis after dry needling]. - IDN

    1. Hanssen AD, Osmon DR. Evaluation of a staging system for infected hip arthroplasty. 2002;403:16-22

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Right hip arthroplasty infection;

Outcome of antibiotic suppressive therapy (n=21) subdivided in several parameters; the affected joint (A), the indication for the prosthesis / underlying condition (B), the type of prosthesis (C) and the causative pathogen / micro-organism for the prosthetic joint infection (PJI) (D). The definition of successful treatment and failed treatment is descripted in the text.

Prosthetic Joint Infection: Diagnosis and Management

Infection of a hip replacement can occur at any time after surgery, sometimes many years after surgery. The risk, however, is higher in the first few weeks following a surgical procedure. A sudden change in the pain around a hip that has otherwise been recovering normally should be investigated. The challenge in this situation is that many of the laboratory studies will not be helpful in sorting out normal healing from a low-grade infection. Superficial wound infections are typically identified by a dramatic change in the appearance of the incision, but a deep infection around the joint itself can be hard to prove without some interventional study.

Infection After Total Joint Replacement Surgery - Verywell

Nevertheless, as a cause leading to revision hip replacement, infection is the third most common. In several studies which assess the causes of primary hip replacement failure, infection of the joint is the most challenging and potentially devastating cause with 15% of all revision hip replacement procedures being done for this reason [3]. If an artificial joint becomes infected, the pain is typically more constant than with a loose, but non-infected joint, but symptoms greatly vary with the type of infecting organism. Along with pain, symptoms include a stiffening of the joint, making movement quite difficult. On rare occasion, a prosthetic joint infection can make the patient systemically ill with fever, chills, weight loss, and lethargy.

{Peri-prosthetic infection PJI} - Osteomyelitis

8. Berry DJ, Chandler HP, Reilly DT. The use of bone allografts in two-stage reconstruction after failure of hip replacement due to infection. 1991;73A:1460-1468

Infection in hip replacement symptoms - What Doctors …

In sorting out persistent pain around the hip, infection is a distinct but uncommon diagnosis reported to occur in less than 1% of all total hips ever getting infected in most studies of this issue. Fortunately, there are many other causes for pain around the hip joint other than infection, but infection always remains a diagnosis that must be considered in dealing with painful hip replacements.

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