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Periprosthetic Joint Infection: Diagnosis and Treatment
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Periprosthetic Joint Infection: Diagnosis and Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: closed (31 December 2022) | Viewed by 4076

Special Issue Editors

Prof. Dr. Carsten Perka

E-Mail Website
Guest Editor
Center for Musculoskeletal Surgery, Charité - University Medicine Berlin, Berlin, Germany
Interests: arthroplasty; periprosthetic joint infection; adult hip reconstruction; adult knee reconstruction; patient reported outcome; joint register
Prof. Dr. Tobias Winkler

E-Mail Website
Guest Editor
Center for Musculoskeletal Surgery, Berlin Institute of Health Center for Regenerative Therapies & Julius Wolff Institute, Charité - University Medicine Berlin, Berlin, Germany
Interests: arthroplasty; periprosthetic joint infection; regenerative orthopaedics; orthobiologics; digital orthopaedics; advanced therapies
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Despite multiple efforts, periprosthetic joint infections remain one of the most devastating complications in arthroplasty surgery. However, modern diagnostic and therapeutical approaches manage to get a better and in-depth understanding of both the mechanisms of treatment success and also their failures. The aim of this Special Issue is to highlight these approaches and to offer interested readers knowledge and solutions for PJI management. Next to the presentation of algorithms which are vital for treatment successes, a focus of the Special Issue will also be the reporting and evaluation of new methods identified in basic research and, if advanced, translated to patient care.

Prof. Dr. Carsten Perka
Prof. Dr. Tobias Winkler
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • periprosthetic joint infection
  • PJI
  • arthroplasty
  • adult reconstruction
  • one-stage revision
  • two-stage exchange
  • infection

Published Papers (2 papers)

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Research

11 pages, 1106 KiB  
Article
Inhaled Corticosteroids, Vitamin K Antagonists and Amlodipine Were Associated with an Increased Risk of Acute Periprosthetic Joint Infection in Patients with Total Hip Arthroplasty: A Retrospective Case–Cohort Study
by Maarten M. Bruin, Ruud L. M. Deijkers, Michaël P. A. Bus, Erika P. M. van Elzakker, Roos Bazuin, Rob G. Nelissen and Bart G. Pijls
J. Clin. Med. 2022, 11(7), 1842; https://doi.org/10.3390/jcm11071842 - 26 Mar 2022
Cited by 3 | Viewed by 1741
Abstract
The perioperative use of certain medication may influence the risk of developing a periprosthetic joint infection (PJI). Inhaled corticosteroids (ICSs) and cardiovascular drugs are widely used against pulmonary and cardiovascular diseases. While oral corticosteroids and anticoagulants have been shown to increase the risk [...] Read more.
The perioperative use of certain medication may influence the risk of developing a periprosthetic joint infection (PJI). Inhaled corticosteroids (ICSs) and cardiovascular drugs are widely used against pulmonary and cardiovascular diseases. While oral corticosteroids and anticoagulants have been shown to increase the risk of developing PJI, this is not clear for ICSs. In contrast, some cardiovascular drugs, such as amlodipine, nifedipine and statins, have been documented to show an antimicrobial effect, suggesting a synergistic effect with antibiotics in the treatment of (multi-resistant) microorganisms. We performed a case–cohort study to assess the association between the occurrence of PJI after THA and the use of inhaled corticosteroids, anticoagulants, or previously mentioned cardiovascular agents. In a cohort of 5512 primary THAs, we identified 75 patients with a PJI (1.4%), and randomly selected 302 controls. A weighted Cox proportional hazard regression model was used for the study design and to adjust for potential confounders (age, sex, smoking, and cardiovascular/pulmonary disease). We found ICS use (HR 2.6 [95% CI 1.1–5.9]), vitamin K antagonist use (HR 5.3 [95% CI 2.5–11]), and amlodipine use (HR 3.1 [95% CI 1.4–6.9]) to be associated with an increased risk of developing PJI after THA. The effect remained after correction for the mentioned possible confounders. The underlying diseases for which the medications are prescribed could also play a role in the mentioned association; we believe, however, that the usages of ICSs, vitamin K antagonists and amlodipine appear to be potential modifiable risk factors for PJI, and therefore have to be questioned during preoperative screening and consultation. Full article
(This article belongs to the Special Issue Periprosthetic Joint Infection: Diagnosis and Treatment)
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12 pages, 1315 KiB  
Article
Failure Analysis in Multiple TKA Revisions—Periprosthetic Infections Remain Surgeons’ Nemesis
by Stephanie Kirschbaum, Sarah Erhart, Carsten Perka, Robert Hube and Kathi Thiele
J. Clin. Med. 2022, 11(2), 376; https://doi.org/10.3390/jcm11020376 - 13 Jan 2022
Cited by 9 | Viewed by 1362
Abstract
Background: The aim of this study was to categorize reasons for failure and to analyze the survivorship of multiple total knee arthroplasty (TKA) revisions. Methods: The study retrospectively evaluated all multiple TKA revisions performed between 2005 and 2015 at the authors’ institutions. Sixty-three [...] Read more.
Background: The aim of this study was to categorize reasons for failure and to analyze the survivorship of multiple total knee arthroplasty (TKA) revisions. Methods: The study retrospectively evaluated all multiple TKA revisions performed between 2005 and 2015 at the authors’ institutions. Sixty-three patients (35 female, 28 male, age 64 ± 10 years, follow-up 55 ± 36 months) underwent a total of 157 re-revision TKA surgeries (range 2–5). The revision indications were divided up into main diagnoses. Survivorship was evaluated by mixed model analysis. Results: The main overall reason for re-revision was periprosthetic joint infection (PJI) (48%), followed by instability (12%), polyethylene wear (11%), malpositioning (8%), and aseptic loosening (8%). Survivorship shortened with an increasing number of revision surgeries (p = 0.003). While PJI was in 38% of all cases, the reason for the first revision, incidence increased constantly with the number of revisions (48% at second revision, 55% at third revision, 86% at fourth revision, and 100% at fifth revision, p = 0.022). If periprosthetic infection caused the first revision, patients showed an average of two more septic revisions at follow-up than patients with an aseptic first revision indication (p < 0.001). In 36% of cases, the reason for follow-up surgery in case of periprosthetic infection was again PJI. Conclusion: The probability of survival of the implanted knee arthroplasty is significantly reduced with each subsequent revision. Periprosthetic infection is the main cause of multiple revisions. Full article
(This article belongs to the Special Issue Periprosthetic Joint Infection: Diagnosis and Treatment)
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