Infection News

NEW ORLEANS — At the American Academy of Orthopaedic Surgeons Annual Meeting, Robert A. Sershon, MD, spoke about a study which looked at acute, traumatic, wound dehiscence in patients who underwent primary or revision total knee arthroplasty.

Among patients with periprosthetic joint infection, use of high-dose antibiotic-loaded cement spacers yielded elevated systemic antibiotic concentrations for at least 8 weeks after placement, posing a risk of systemic toxicity, according to results.

KOLOA, Hawaii – At Orthopedics Today Hawaii 2018, Robert D’Ambrosia, MD, spoke about prophylaxis for VTE.

Next-generation sequencing, in combination with culture collection, may help identify causative organisms in culture-negative periprosthetic joint infections, according to results published in The Journal of Bone and Joint Surgery.

A single preoperative dose of IV cefazolin did not reduce the risk of surgical site infection within 30 days following removal of orthopedic implants used for treatment of fractures below the knee compared with saline, according to results published in JAMA.

In a contemporary series, investigators found irrigation, debridement and component retention for hip infection had a high rate of success, especially among patients considered McPherson systemic grade A hosts.

Risk factors for mortality after surgery, including use of ventilation, oxygen support and wound infections, are more prevalent in black children than in white children and pose a significantly greater risk of death, according to research published in Pediatrics.

Results from a recently published study demonstrated MRSA-colonized patients who underwent total hip arthroplasty or total knee arthroplasty had a significantly increased risk of surgical site infection compared with non-MRSA carriers.

With an increasing number of total knee arthroplasty and total hip arthroplasty procedures being performed in the United States, the rate of failure has also increased. In its annual report, the American Joint Replacement Registry listed infection as a leading cause of TKA and THA revisions from 2012 to 2016. Research has also shown failures due to periprosthetic joint infection are expected to increase at an annual rate of between 38,000 cases and 270,000 cases by the year 2030.

The administration of vancomycin powder into orthopedic surgical wounds has been well described in the setting of posterior spinal fusion. With the clinical evidence demonstrating that this is a successful prophylactic measure in spine patients, there has been interest in adopting this practice in hip and knee replacement surgery. There is currently a dearth of literature on this practice for total joint replacement. There is evidence that local administration of vancomycin achieves high levels of the antibiotic in the hip and knee joint with likely bactericidal properties, without excessive serum levels of the medication. This may translate to lower PJI rates. However, there are a number of unknowns which preclude recommending the widespread adoption of this practice for total joint replacement.