Infection News

Modifiable patient factors, such as BMI, vitamin D levels and diabetes, can be optimized preoperatively to reduce the risk of infection and other postoperative complications. However, sometimes patient risk factors — and how to modify them — are not as clear cut.

The next EFORT webinar is approaching and it is focused on adverse reaction to implant materials. It is organized by the EFORT Basic Research Education Group, which is independent of any commercial educational support and will take place Monday 21 January 2019 from 19:00 to 20:30 CET.

Preoperative medical optimization of patients is an approach orthopedic surgeons can use to reduce postoperative complications and improve the overall safety of procedures they perform.

The final consensus documents that resulted from the International Consensus Meeting on Musculoskeletal Infection, which was held July 25-27, 2018, in Philadelphia, are now available at the meeting’s website, which is ICMPhilly.com, and via the ICMPhilly app, according to Javad Parvizi, MD, FRCS, of Philadelphia, who co-chaired the meeting with Thorsten Gehrke, MD, of Hamburg, Germany.

Denis Nam, MD, MSc, discussed some strategies to diagnose a periprosthetic infection following total joint arthroplasty, including newer tests that have been introduced, at the American Association of Hip and Knee Surgeons Annual Meeting.

Each year, one of the most important components of the EFORT Congress is the presence of an outstanding orthopaedic surgeon with international reputation who contributes to our scientific program by giving the Erwin Morscher Honorary Lecture. This plenary session is scheduled for Thursday, 6 June 2019, just before the lunch break, to gather the biggest audience of all the scientific sessions. This year, EFORT is pleased to welcome Javad Parvizi, MD, FRCS, a native of Azerbaijan, Iran, who is currently practicing at Rothman Orthopaedic Institute in Philadelphia, United States. Parvizi will share with the orthopaedics and trauma community his broad knowledge on handling musculoskeletal infections via a presentation on the evolution of periprosthetic joint infection (PJI) diagnosis and treatment used in recent years.

ORLANDO, Fla. — Use of vancomycin powder compared with the standard of care reduced the rate of gram-positive surgical site infections in patients with tibial plateau or pilon fractures, according to a presenter at the Orthopaedic Trauma Association Annual Meeting.

As infection remains the most devastating cause of failure and reoperation after total knee arthroplasty, antibiotic-loaded cement has been recommended for prophylaxis, but its efficacy and cost-effectiveness remain controversial. The Norwegian Arthroplasty Registry reported a decreased rate of infection with antibiotic-loaded cement (ABLC) in 22,700 THAs. Recent systematic reviews of its efficacy showed conflicting results, possibly due to the relatively low overall incidence of infection. ABLC is available as premixed commercial preparations or the surgeon may manually add a heat-stable antibiotic. At our institution, premixed ABLC costs about $140 more than plain cement per package, but vancomycin, tobramycin or cefuroxime powder can be added manually to it at a lower cost. One analysis suggested ABLC may decrease the costs of revision surgery by $200. Another study reported that manually mixed ABLC was more cost-effective than premixed preparations, but the price reported in the study for the premixed cement was three-times higher than it is at our institution. American Academy of Orthopaedic Surgeons clinical guidelines suggest ABLC should be used only for “high-risk” patients in cases of revision, prior joint infection or chronic immunosuppression. The senior author also uses ABLC in patients with multiple medical comorbidities associated with a higher risk of infection. Since most THAs now performed in the United States use cementless fixation, additional studies of the efficacy and cost-effectiveness of both surgeon-mixed and premixed ABLC in TKA are warranted before its routine use is recommended.

Musculoskeletal and infection professionals from 98 countries convened July 25-27, 2018 at the International Consensus Meeting on Musculoskeletal Infection in Philadelphia to discuss how to improve the prevention and treatment of musculoskeletal infections. Of the topics presented, delegates strongly debated whether antibiotic-loaded bone cement should be used in primary total joint arthroplasty to prevent periprosthetic joint infection.

CHICAGO — At the American Shoulder and Elbow Surgeons Open Symposium, Eric T. Ricchetti, MD, presented recommended standardized protocols for obtaining intraoperative tissue specimens, tissue culture technique and new diagnostic criteria for infection of the shoulder.