Skip to main content
Top
Published in: Current Reviews in Musculoskeletal Medicine 3/2018

01-09-2018 | Prosthetic Joint Infection (S Nodzo and N Frisch, section editors)

Intraoperative Considerations for Treatment/Prevention of Prosthetic Joint Infection

Authors: Linda I. Suleiman, Daniel R. Mesko, Denis Nam

Published in: Current Reviews in Musculoskeletal Medicine | Issue 3/2018

Login to get access

Abstract

Purpose of Review

Innovative measures have recently been proposed to prevent periprosthetic joint infection following total hip and knee arthroplasty. We sought to review these recent innovations to determine the reported reduction in periprosthetic joint infection.

Recent Findings

The most recent literature demonstrates promising results in regard to hydrofiber dressings as an independent risk factor for primary prosthetic joint infection reduction, which in turn is also linked with cost savings. As our understanding of safe yet effective concentrations of antiseptic solutions develops, dilute betadine in particular has demonstrated encouraging efficacy which warrants continued investigation through controlled trials.

Summary

In summary, we found that the application of a hydrofiber dressing may prove beneficial in decreasing the risk of prosthetic joint infection following primary total hip and knee arthroplasty. The gold standard for an infection prevention protocol continues to be explored and optimized.
Literature
1.
go back to reference Kurtz SM, Lau E, Watson H, Schmier JK, Parvizi J. Economic burden of periprosthetic joint infection in the United States. J Arthroplast. 2012;27(8, Supplement):61–5.e1.CrossRef Kurtz SM, Lau E, Watson H, Schmier JK, Parvizi J. Economic burden of periprosthetic joint infection in the United States. J Arthroplast. 2012;27(8, Supplement):61–5.e1.CrossRef
2.
go back to reference Bozic KJ, Lau E, Kurtz S, Ong K, Berry DJ. Patient-related risk factors for postoperative mortality and periprosthetic joint infection in medicare patients undergoing TKA. Clin Orthop Relat Res. 2012;470(1):130–7.CrossRefPubMed Bozic KJ, Lau E, Kurtz S, Ong K, Berry DJ. Patient-related risk factors for postoperative mortality and periprosthetic joint infection in medicare patients undergoing TKA. Clin Orthop Relat Res. 2012;470(1):130–7.CrossRefPubMed
3.
go back to reference van Meurs SJ, Gawlitta D, Heemstra KA, Poolman RW, Vogely HC, Kruyt MC. Selection of an optimal antiseptic solution for intraoperative irrigation: an in vitro study. J Bone Joint Surg Am. 2014;96(4):285–91.CrossRefPubMed van Meurs SJ, Gawlitta D, Heemstra KA, Poolman RW, Vogely HC, Kruyt MC. Selection of an optimal antiseptic solution for intraoperative irrigation: an in vitro study. J Bone Joint Surg Am. 2014;96(4):285–91.CrossRefPubMed
4.
go back to reference Oduwole KO, Glynn AA, Molony DC, Murray D, Rowe S, Holland LM, et al. Anti-biofilm activity of sub-inhibitory povidone-iodine concentrations against Staphylococcus epidermidis and Staphylococcus aureus. J Orthop Res. 2010;28(9):1252–6.CrossRefPubMed Oduwole KO, Glynn AA, Molony DC, Murray D, Rowe S, Holland LM, et al. Anti-biofilm activity of sub-inhibitory povidone-iodine concentrations against Staphylococcus epidermidis and Staphylococcus aureus. J Orthop Res. 2010;28(9):1252–6.CrossRefPubMed
5.
go back to reference Rodeheaver G, Bellamy W, Kody M, Spatafora G, Fitton L, Leyden K, et al. Bactericidal activity and toxicity of iodine-containing solutions in wounds. Arch Surg. 1982;117(2):181–6.CrossRefPubMed Rodeheaver G, Bellamy W, Kody M, Spatafora G, Fitton L, Leyden K, et al. Bactericidal activity and toxicity of iodine-containing solutions in wounds. Arch Surg. 1982;117(2):181–6.CrossRefPubMed
6.
go back to reference Chundamala J, Wright JG. The efficacy and risks of using povidone-iodine irrigation to prevent surgical site infection: an evidence-based review. Can J Surg. 2007;50(6):473–81.PubMedPubMedCentral Chundamala J, Wright JG. The efficacy and risks of using povidone-iodine irrigation to prevent surgical site infection: an evidence-based review. Can J Surg. 2007;50(6):473–81.PubMedPubMedCentral
7.
go back to reference Sindelar WF, Mason GR. Efficacy of povidone-iodine irrigation in prevention of surgical wound infections. Surg Forum. 1977;28:48–51.PubMed Sindelar WF, Mason GR. Efficacy of povidone-iodine irrigation in prevention of surgical wound infections. Surg Forum. 1977;28:48–51.PubMed
8.
go back to reference Cheng M-T, Chang M-C, Wang S-T, Yu W-K, Liu C-L, Chen T-H. Efficacy of dilute betadine solution irrigation in the prevention of postoperative infection of spinal surgery. Spine. 2005;30(15):1689–93.CrossRefPubMed Cheng M-T, Chang M-C, Wang S-T, Yu W-K, Liu C-L, Chen T-H. Efficacy of dilute betadine solution irrigation in the prevention of postoperative infection of spinal surgery. Spine. 2005;30(15):1689–93.CrossRefPubMed
9.
go back to reference Chang F-Y, Chang M-C, Wang S-T, Yu W-K, Liu C-L, Chen T-H. Can povidone-iodine solution be used safely in a spinal surgery? Eur Spine J. 2006;15(6):1005–14.CrossRefPubMed Chang F-Y, Chang M-C, Wang S-T, Yu W-K, Liu C-L, Chen T-H. Can povidone-iodine solution be used safely in a spinal surgery? Eur Spine J. 2006;15(6):1005–14.CrossRefPubMed
10.
go back to reference Brown NM, Cipriano CA, Moric M, Sporer SM, Della Valle CJ. Dilute betadine lavage before closure for the prevention of acute postoperative deep periprosthetic joint infection. J Arthroplast. 2012;27(1):27–30.CrossRef Brown NM, Cipriano CA, Moric M, Sporer SM, Della Valle CJ. Dilute betadine lavage before closure for the prevention of acute postoperative deep periprosthetic joint infection. J Arthroplast. 2012;27(1):27–30.CrossRef
11.
go back to reference • Hofmann KJ, Hayden BL, Kong Q, Pevear ME, Cassidy C, Smith EL. Triple prophylaxis for the prevention of surgical site infections in total joint arthroplasty. Curr Orthop Pract. 2017;28(1):66. Reported a reduction in SSI from 2 to 0.7% ( p = 0.08), including PJI (1.4 to 0.2% ( p = 0.02)) following institution of a protocol of preop nasal mupericin, addition of vancomycin to preoperative antibiotics, and incorporating an intraoperative betadine irrigation in their total joint arthroplasty patients. CrossRef • Hofmann KJ, Hayden BL, Kong Q, Pevear ME, Cassidy C, Smith EL. Triple prophylaxis for the prevention of surgical site infections in total joint arthroplasty. Curr Orthop Pract. 2017;28(1):66. Reported a reduction in SSI from 2 to 0.7% ( p= 0.08), including PJI (1.4 to 0.2% ( p= 0.02)) following institution of a protocol of preop nasal mupericin, addition of vancomycin to preoperative antibiotics, and incorporating an intraoperative betadine irrigation in their total joint arthroplasty patients. CrossRef
12.
go back to reference Hidalgo E, Dominguez C. Mechanisms underlying chlorhexidine-induced cytotoxicity. Toxicol In Vitro. 2001;15(4–5):271–6.CrossRefPubMed Hidalgo E, Dominguez C. Mechanisms underlying chlorhexidine-induced cytotoxicity. Toxicol In Vitro. 2001;15(4–5):271–6.CrossRefPubMed
13.
go back to reference Lindgren KE, Pelt CE, Anderson MB, Peters CL, Spivak ES, Gililland JM. A chlorhexidine solution reduces aerobic organism growth in operative splash basins in a randomized controlled trial. J Arthroplast. 2018;33(1):211–5.CrossRef Lindgren KE, Pelt CE, Anderson MB, Peters CL, Spivak ES, Gililland JM. A chlorhexidine solution reduces aerobic organism growth in operative splash basins in a randomized controlled trial. J Arthroplast. 2018;33(1):211–5.CrossRef
14.
go back to reference Frisch NB, Kadri OM, Tenbrunsel T, Abdul-Hak A, Qatu M, Davis JJ. Intraoperative chlorhexidine irrigation to prevent infection in total hip and knee arthroplasty. Arthroplast Today. 2017;3(4):294–7.CrossRefPubMedPubMedCentral Frisch NB, Kadri OM, Tenbrunsel T, Abdul-Hak A, Qatu M, Davis JJ. Intraoperative chlorhexidine irrigation to prevent infection in total hip and knee arthroplasty. Arthroplast Today. 2017;3(4):294–7.CrossRefPubMedPubMedCentral
15.
go back to reference Larson E. Guideline for use of topical antimicrobial agents. Am J Infect Control. 1988;16(6):253–66.CrossRefPubMed Larson E. Guideline for use of topical antimicrobial agents. Am J Infect Control. 1988;16(6):253–66.CrossRefPubMed
16.
go back to reference Edmiston CE, Bruden B, Rucinski MC, Henen C, Graham MB, Lewis BL. Reducing the risk of surgical site infections: does chlorhexidine gluconate provide a risk reduction benefit? Am J Infect Control. 2013;41(5 Suppl):S49–55.CrossRefPubMed Edmiston CE, Bruden B, Rucinski MC, Henen C, Graham MB, Lewis BL. Reducing the risk of surgical site infections: does chlorhexidine gluconate provide a risk reduction benefit? Am J Infect Control. 2013;41(5 Suppl):S49–55.CrossRefPubMed
17.
go back to reference Smith DC, Maiman R, Schwechter EM, Kim SJ, Hirsh DM. Optimal irrigation and debridement of infected Total joint implants with chlorhexidine gluconate. J Arthroplast. 2015;30(10):1820–2.CrossRef Smith DC, Maiman R, Schwechter EM, Kim SJ, Hirsh DM. Optimal irrigation and debridement of infected Total joint implants with chlorhexidine gluconate. J Arthroplast. 2015;30(10):1820–2.CrossRef
18.
go back to reference Ruder JA, Springer BD. Treatment of periprosthetic joint infection using antimicrobials: dilute povidone-iodine lavage. J Bone Jt Infect. 2017;2(1):10–4.CrossRefPubMedPubMedCentral Ruder JA, Springer BD. Treatment of periprosthetic joint infection using antimicrobials: dilute povidone-iodine lavage. J Bone Jt Infect. 2017;2(1):10–4.CrossRefPubMedPubMedCentral
19.
go back to reference Campbell ST, Goodnough LH, Bennett CG, Giori NJ. Antiseptics commonly used in total joint arthroplasty interact and may form toxic products. J Arthroplasty. 2018;33(3):844–846. Campbell ST, Goodnough LH, Bennett CG, Giori NJ. Antiseptics commonly used in total joint arthroplasty interact and may form toxic products. J Arthroplasty. 2018;33(3):844–846.
20.
go back to reference Berg A, Fleischer S, Kuss O, Unverzagt S, Langer G. Timing of dressing removal in the healing of surgical wounds by primary intention: quantitative systematic review protocol. J Adv Nurs. 2012;68(2):264–70.CrossRefPubMed Berg A, Fleischer S, Kuss O, Unverzagt S, Langer G. Timing of dressing removal in the healing of surgical wounds by primary intention: quantitative systematic review protocol. J Adv Nurs. 2012;68(2):264–70.CrossRefPubMed
21.
go back to reference Galat DD, McGovern SC, Larson DR, Harrington JR, Hanssen AD, Clarke HD. Surgical treatment of early wound complications following primary total knee arthroplasty. J Bone Joint Surg Am. 2009;91(1):48–54.CrossRefPubMed Galat DD, McGovern SC, Larson DR, Harrington JR, Hanssen AD, Clarke HD. Surgical treatment of early wound complications following primary total knee arthroplasty. J Bone Joint Surg Am. 2009;91(1):48–54.CrossRefPubMed
22.
go back to reference Carroll K, Dowsey M, Choong P, Peel T. Risk factors for superficial wound complications in hip and knee arthroplasty. Clin Microbiol Infect. 2014;20(2):130–5.CrossRefPubMed Carroll K, Dowsey M, Choong P, Peel T. Risk factors for superficial wound complications in hip and knee arthroplasty. Clin Microbiol Infect. 2014;20(2):130–5.CrossRefPubMed
23.
go back to reference Kuo F-C, Chen B, Lee MS, Yen S-H, Wang J-W. AQUACEL® Ag surgical dressing reduces surgical site infection and improves patient satisfaction in minimally invasive total knee arthroplasty: a prospective, randomized, controlled study [Internet]. Biomed Res Int 2017 [cited 2017 Nov 19]. Available from: https://www.hindawi.com/journals/bmri/2017/1262108/ Kuo F-C, Chen B, Lee MS, Yen S-H, Wang J-W. AQUACEL® Ag surgical dressing reduces surgical site infection and improves patient satisfaction in minimally invasive total knee arthroplasty: a prospective, randomized, controlled study [Internet]. Biomed Res Int 2017 [cited 2017 Nov 19]. Available from: https://www.hindawi.com/journals/bmri/2017/1262108/
24.
go back to reference Jones SA, Bowler PG, Walker M, Parsons D. Controlling wound bioburden with a novel silver-containing hydrofiber dressing. Wound Repair Regen. 2004;12(3):288–94.CrossRefPubMed Jones SA, Bowler PG, Walker M, Parsons D. Controlling wound bioburden with a novel silver-containing hydrofiber dressing. Wound Repair Regen. 2004;12(3):288–94.CrossRefPubMed
25.
go back to reference Hurlow J. AQUACEL® Ag dressing with Hydrofiber® Technology. Adv Wound Care. 2012;1(2):104–7.CrossRef Hurlow J. AQUACEL® Ag dressing with Hydrofiber® Technology. Adv Wound Care. 2012;1(2):104–7.CrossRef
26.
go back to reference Langlois J, Zaoui A, Ozil C, Courpied J-P, Anract P, Hamadouche M. Randomized controlled trial of conventional versus modern surgical dressings following primary total hip and knee replacement. Int Orthop. 2015;39(7):1315–9.CrossRefPubMed Langlois J, Zaoui A, Ozil C, Courpied J-P, Anract P, Hamadouche M. Randomized controlled trial of conventional versus modern surgical dressings following primary total hip and knee replacement. Int Orthop. 2015;39(7):1315–9.CrossRefPubMed
27.
go back to reference Dobbelaere A, Schuermans N, Smet S, Van Der Straeten C, Victor J. Comparative study of innovative postoperative wound dressings after total knee arthroplasty. Acta Orthop Belg. 2015;81(3):454–61.PubMed Dobbelaere A, Schuermans N, Smet S, Van Der Straeten C, Victor J. Comparative study of innovative postoperative wound dressings after total knee arthroplasty. Acta Orthop Belg. 2015;81(3):454–61.PubMed
28.
go back to reference •• Springer BD, Beaver WB, Griffin WL, Mason JB, Odum SM. Role of Surgical Dressings in Total Joint Arthroplasty: A Randomized Controlled Trial. Am J Orthop (Belle Mead NJ). 2015;44(9):415–20. They found statistical significance in regard to less wound complications (10 vs 22%, p = 0.015) and blistering (0.7 vs 6%, p = 0.026) in the Aquacel Ag group compared to their control Primapore (Smith and Nephew). •• Springer BD, Beaver WB, Griffin WL, Mason JB, Odum SM. Role of Surgical Dressings in Total Joint Arthroplasty: A Randomized Controlled Trial. Am J Orthop (Belle Mead NJ). 2015;44(9):415–20. They found statistical significance in regard to less wound complications (10 vs 22%, p= 0.015) and blistering (0.7 vs 6%, p= 0.026) in the Aquacel Ag group compared to their control Primapore (Smith and Nephew).
29.
go back to reference •• Cai J, Karam JA, Parvizi J, Smith EB, Sharkey PF. Aquacel surgical dressing reduces the rate of acute PJI following total joint arthroplasty: a case–control study. J Arthroplast. 2014;29(6):1098–100. Decreased rate of prosthetic joint infection in the Aquacel group (0.44 vs 1.7%, p = 0.005). CrossRef •• Cai J, Karam JA, Parvizi J, Smith EB, Sharkey PF. Aquacel surgical dressing reduces the rate of acute PJI following total joint arthroplasty: a case–control study. J Arthroplast. 2014;29(6):1098–100. Decreased rate of prosthetic joint infection in the Aquacel group (0.44 vs 1.7%, p= 0.005). CrossRef
30.
go back to reference •• Grosso MJ, Berg A, LaRussa S, Murtaugh T, Trofa DP, Geller JA. Silver-impregnated occlusive dressing reduces rates of acute periprosthetic joint infection after total joint arthroplasty. J Arthroplast. 2017;32(3):929–32. Acute PJI within 3 months post arthroplasty, in which 605 Aquacel Ag dressings were compared to 568 sterile xeroform dressings. Similar to Cai et al., a significant lower incidence of PJI (0.33 vs 1.58%, p = 0.03) was again found in the Aquacel Ag group. CrossRef •• Grosso MJ, Berg A, LaRussa S, Murtaugh T, Trofa DP, Geller JA. Silver-impregnated occlusive dressing reduces rates of acute periprosthetic joint infection after total joint arthroplasty. J Arthroplast. 2017;32(3):929–32. Acute PJI within 3 months post arthroplasty, in which 605 Aquacel Ag dressings were compared to 568 sterile xeroform dressings. Similar to Cai et al., a significant lower incidence of PJI (0.33 vs 1.58%, p= 0.03) was again found in the Aquacel Ag group. CrossRef
31.
go back to reference Chowdhry M, Chen AF. Wound dressings for primary and revision total joint arthroplasty. Ann Transl Med. 2015;3(18):268.PubMedPubMedCentral Chowdhry M, Chen AF. Wound dressings for primary and revision total joint arthroplasty. Ann Transl Med. 2015;3(18):268.PubMedPubMedCentral
32.
go back to reference Sharma G, Lee SW, Atanacio O, Parvizi J, Kim TK. In search of the optimal wound dressing material following total hip and knee arthroplasty: a systematic review and meta-analysis. Int Orthop. 2017;41(7):1295–305.CrossRefPubMed Sharma G, Lee SW, Atanacio O, Parvizi J, Kim TK. In search of the optimal wound dressing material following total hip and knee arthroplasty: a systematic review and meta-analysis. Int Orthop. 2017;41(7):1295–305.CrossRefPubMed
34.
go back to reference Manoharan V, Grant AL, Harris AC, Hazratwala K, Wilkinson MPR, McEwen PJC. Closed incision negative pressure wound therapy vs conventional dry dressings after primary knee arthroplasty: a randomized controlled study. J Arthroplast. 2016;31(11):2487–94.CrossRef Manoharan V, Grant AL, Harris AC, Hazratwala K, Wilkinson MPR, McEwen PJC. Closed incision negative pressure wound therapy vs conventional dry dressings after primary knee arthroplasty: a randomized controlled study. J Arthroplast. 2016;31(11):2487–94.CrossRef
35.
go back to reference •• Cooper HJ, Bas MA. Closed-incision negative-pressure therapy versus antimicrobial dressings after revision hip and knee surgery: a comparative study. J Arthroplast. 2016;31(5):1047–52. Despite a group generally deemed higher risk in the NPWT, they were able to demonstrate statistically significant less wound complications (6.7 vs 26.9%, p = 0.024) and surgical site infections (3.3 vs 18.5%, p = 0.045). CrossRef •• Cooper HJ, Bas MA. Closed-incision negative-pressure therapy versus antimicrobial dressings after revision hip and knee surgery: a comparative study. J Arthroplast. 2016;31(5):1047–52. Despite a group generally deemed higher risk in the NPWT, they were able to demonstrate statistically significant less wound complications (6.7 vs 26.9%, p= 0.024) and surgical site infections (3.3 vs 18.5%, p= 0.045). CrossRef
36.
go back to reference Adámková M, Tymonová J, Zámecníková I, Kadlcík M, Klosová H. First experience with the use of vacuum assisted closure in the treatment of skin defects at the burn center. Acta Chir Plast. 2005;47(1):24–7.PubMed Adámková M, Tymonová J, Zámecníková I, Kadlcík M, Klosová H. First experience with the use of vacuum assisted closure in the treatment of skin defects at the burn center. Acta Chir Plast. 2005;47(1):24–7.PubMed
37.
go back to reference Scherer SS, Pietramaggiori G, Mathews JC, Prsa MJ, Huang S, Orgill DP. The mechanism of action of the vacuum-assisted closure device. Plast Reconstr Surg. 2008;122(3):786–97.CrossRefPubMed Scherer SS, Pietramaggiori G, Mathews JC, Prsa MJ, Huang S, Orgill DP. The mechanism of action of the vacuum-assisted closure device. Plast Reconstr Surg. 2008;122(3):786–97.CrossRefPubMed
38.
go back to reference Huang C, Leavitt T, Bayer LR, Orgill DP. Effect of negative pressure wound therapy on wound healing. Curr Probl Surg. 2014;51(7):301–31.CrossRefPubMed Huang C, Leavitt T, Bayer LR, Orgill DP. Effect of negative pressure wound therapy on wound healing. Curr Probl Surg. 2014;51(7):301–31.CrossRefPubMed
39.
go back to reference Wilkes RP, Kilpad DV, Zhao Y, Kazala R, McNulty A. Closed incision management with negative pressure wound therapy (CIM): biomechanics. Surg Innov. 2012;19(1):67–75.CrossRefPubMed Wilkes RP, Kilpad DV, Zhao Y, Kazala R, McNulty A. Closed incision management with negative pressure wound therapy (CIM): biomechanics. Surg Innov. 2012;19(1):67–75.CrossRefPubMed
40.
go back to reference • Shohat N, Parvizi J. Prevention of periprosthetic joint infection: examining the recent guidelines. J Arthroplast. 2017;32(7):2040–6. The WHO and the CDC support that there is evidence in favor of the use of NPWT in high-risk arthroplasty patients; however, this was graded as weak. CrossRef • Shohat N, Parvizi J. Prevention of periprosthetic joint infection: examining the recent guidelines. J Arthroplast. 2017;32(7):2040–6. The WHO and the CDC support that there is evidence in favor of the use of NPWT in high-risk arthroplasty patients; however, this was graded as weak. CrossRef
41.
go back to reference Willy C, Agarwal A, Andersen CA, Santis GD, Gabriel A, Grauhan O, et al. Closed incision negative pressure therapy: international multidisciplinary consensus recommendations. Int Wound J. 2017;14(2):385–98.CrossRefPubMed Willy C, Agarwal A, Andersen CA, Santis GD, Gabriel A, Grauhan O, et al. Closed incision negative pressure therapy: international multidisciplinary consensus recommendations. Int Wound J. 2017;14(2):385–98.CrossRefPubMed
42.
go back to reference Semsarzadeh NN, Tadisina KK, Maddox J, Chopra K, Singh DP. Closed incision negative-pressure therapy is associated with decreased surgical-site infections: a meta-analysis. Plast Reconstr Surg. 2015;136(3):592–602.CrossRefPubMed Semsarzadeh NN, Tadisina KK, Maddox J, Chopra K, Singh DP. Closed incision negative-pressure therapy is associated with decreased surgical-site infections: a meta-analysis. Plast Reconstr Surg. 2015;136(3):592–602.CrossRefPubMed
43.
go back to reference • Gillespie BM, Rickard CM, Thalib L, Kang E, Finigan T, Homer A, et al. Use of negative-pressure wound dressings to prevent surgical site complications after primary hip arthroplasty: a pilot RCT. Surg Innov. 2015;22(5):488–95. Non-significant reduction in SSIs (5.7% NPWT vs 8.6% control (hydrocolloid dressing), p = 0.65); however, they found that there was a statistically significant higher absolute number of any complications (68.5 vs 42.8% ( p = 0.04)) in the NPWT group. CrossRefPubMed • Gillespie BM, Rickard CM, Thalib L, Kang E, Finigan T, Homer A, et al. Use of negative-pressure wound dressings to prevent surgical site complications after primary hip arthroplasty: a pilot RCT. Surg Innov. 2015;22(5):488–95. Non-significant reduction in SSIs (5.7% NPWT vs 8.6% control (hydrocolloid dressing), p= 0.65); however, they found that there was a statistically significant higher absolute number of any complications (68.5 vs 42.8% ( p= 0.04)) in the NPWT group. CrossRefPubMed
44.
go back to reference Pauser J, Nordmeyer M, Biber R, Jantsch J, Kopschina C, Bail HJ, et al. Incisional negative pressure wound therapy after hemiarthroplasty for femoral neck fractures—reduction of wound complications. Int Wound J. 2016;13(5):663–7.CrossRefPubMed Pauser J, Nordmeyer M, Biber R, Jantsch J, Kopschina C, Bail HJ, et al. Incisional negative pressure wound therapy after hemiarthroplasty for femoral neck fractures—reduction of wound complications. Int Wound J. 2016;13(5):663–7.CrossRefPubMed
45.
go back to reference Karlakki SL, Hamad AK, Whittall C, Graham NM, Banerjee RD, Kuiper JH. Incisional negative pressure wound therapy dressings (iNPWTd) in routine primary hip and knee arthroplasties: a randomised controlled trial. Bone Joint Res. 2016;5(8):328–37.CrossRefPubMedPubMedCentral Karlakki SL, Hamad AK, Whittall C, Graham NM, Banerjee RD, Kuiper JH. Incisional negative pressure wound therapy dressings (iNPWTd) in routine primary hip and knee arthroplasties: a randomised controlled trial. Bone Joint Res. 2016;5(8):328–37.CrossRefPubMedPubMedCentral
46.
go back to reference Redfern RE, Cameron-Ruetz C, O’Drobinak SK, Chen JT, Beer KJ. Closed incision negative pressure therapy effects on postoperative infection and surgical site complication after total hip and knee arthroplasty. J Arthroplast. 2017;32(11):3333–9.CrossRef Redfern RE, Cameron-Ruetz C, O’Drobinak SK, Chen JT, Beer KJ. Closed incision negative pressure therapy effects on postoperative infection and surgical site complication after total hip and knee arthroplasty. J Arthroplast. 2017;32(11):3333–9.CrossRef
47.
go back to reference •• Cooper HJ, Roc GC, Bas MA, Berliner ZP, Hepinstall MS, Rodriguez JA, et al. Closed incision negative pressure therapy decreases complications after periprosthetic fracture surgery around the hip and knee. Injury. 2018;49(2):386–91. NPWT group had statistically reduced wound complications (4 vs 35%, p = 0.002), but also saw a decrease in deep prosthetic joint infections (0 vs 25%, p = 0.004) and reoperations related to wound issues (4 vs 25%, p = 0.021). •• Cooper HJ, Roc GC, Bas MA, Berliner ZP, Hepinstall MS, Rodriguez JA, et al. Closed incision negative pressure therapy decreases complications after periprosthetic fracture surgery around the hip and knee. Injury. 2018;49(2):386–91. NPWT group had statistically reduced wound complications (4 vs 35%, p= 0.002), but also saw a decrease in deep prosthetic joint infections (0 vs 25%, p= 0.004) and reoperations related to wound issues (4 vs 25%, p= 0.021).
48.
go back to reference Siqueira MB, Ramanathan D, Klika AK, Higuera CA, Barsoum WK. Role of negative pressure wound therapy in total hip and knee arthroplasty. World J Orthop. 2016;7(1):30–7.CrossRefPubMedPubMedCentral Siqueira MB, Ramanathan D, Klika AK, Higuera CA, Barsoum WK. Role of negative pressure wound therapy in total hip and knee arthroplasty. World J Orthop. 2016;7(1):30–7.CrossRefPubMedPubMedCentral
49.
go back to reference Randelli P, Evola FR, Cabitza P, Polli L, Denti M, Vaienti L. Prophylactic use of antibiotic-loaded bone cement in primary total knee replacement. Knee Surg Sports Traumatol Arthrosc. 2010;18(2):181–6.CrossRefPubMed Randelli P, Evola FR, Cabitza P, Polli L, Denti M, Vaienti L. Prophylactic use of antibiotic-loaded bone cement in primary total knee replacement. Knee Surg Sports Traumatol Arthrosc. 2010;18(2):181–6.CrossRefPubMed
50.
go back to reference Bourne RB. Prophylactic use of antibiotic bone cement: an emerging standard—in the affirmative. J Arthroplast. 2004;19(4 Suppl 1):69–72.CrossRef Bourne RB. Prophylactic use of antibiotic bone cement: an emerging standard—in the affirmative. J Arthroplast. 2004;19(4 Suppl 1):69–72.CrossRef
51.
go back to reference Malchau H, Herberts P, Ahnfelt L. Prognosis of total hip replacement in Sweden. Follow-up of 92,675 operations performed 1978-1990. Acta Orthop Scand. 1993;64(5):497–506.CrossRefPubMed Malchau H, Herberts P, Ahnfelt L. Prognosis of total hip replacement in Sweden. Follow-up of 92,675 operations performed 1978-1990. Acta Orthop Scand. 1993;64(5):497–506.CrossRefPubMed
52.
go back to reference Wilson NI. A survey, in Scotland, of measures to prevent infection following orthopaedic surgery. J Hosp Infect. 1987;9(3):235–42.CrossRefPubMed Wilson NI. A survey, in Scotland, of measures to prevent infection following orthopaedic surgery. J Hosp Infect. 1987;9(3):235–42.CrossRefPubMed
53.
go back to reference Jiranek WA, Hanssen AD, Greenwald AS. Antibiotic-loaded bone cement for infection prophylaxis in total joint replacement. J Bone Joint Surg Am. 2006;88(11):2487–500.CrossRefPubMed Jiranek WA, Hanssen AD, Greenwald AS. Antibiotic-loaded bone cement for infection prophylaxis in total joint replacement. J Bone Joint Surg Am. 2006;88(11):2487–500.CrossRefPubMed
54.
go back to reference Chiu F-Y, Chen C-M, Lin C-FJ, Lo W-H. Cefuroxime-impregnated cement in primary total knee arthroplasty: a prospective, randomized study of three hundred and forty knees. J Bone Joint Surg Am. 2002;84-A(5):759–62.CrossRefPubMed Chiu F-Y, Chen C-M, Lin C-FJ, Lo W-H. Cefuroxime-impregnated cement in primary total knee arthroplasty: a prospective, randomized study of three hundred and forty knees. J Bone Joint Surg Am. 2002;84-A(5):759–62.CrossRefPubMed
55.
go back to reference Parvizi J, Saleh KJ, Ragland PS, Pour AE, Mont MA. Efficacy of antibiotic-impregnated cement in total hip replacement. Acta Orthop. 2008;79(3):335–41.CrossRefPubMed Parvizi J, Saleh KJ, Ragland PS, Pour AE, Mont MA. Efficacy of antibiotic-impregnated cement in total hip replacement. Acta Orthop. 2008;79(3):335–41.CrossRefPubMed
56.
go back to reference Gutowski CJ, Zmistowski BM, Clyde CT, Parvizi J. The economics of using prophylactic antibiotic-loaded bone cement in total knee replacement. Bone Joint J. 2014;96-B(1):65–9.CrossRefPubMed Gutowski CJ, Zmistowski BM, Clyde CT, Parvizi J. The economics of using prophylactic antibiotic-loaded bone cement in total knee replacement. Bone Joint J. 2014;96-B(1):65–9.CrossRefPubMed
57.
go back to reference •• Sanz-Ruiz P, Matas-Diez JA, Sanchez-Somolinos M, Villanueva-Martinez M, Vaquero-Martín J. Is the commercial antibiotic-loaded bone cement useful in prophylaxis and cost saving after knee and hip joint arthroplasty? The transatlantic paradox. J Arthroplast. 2017;32(4):1095–9. Largest recent publication with the routine use of ALBC in primary hip and knee arthroplasty. They found a 57% overall decrease in PJI ( p = 0.001) with the use of ALBC. CrossRef •• Sanz-Ruiz P, Matas-Diez JA, Sanchez-Somolinos M, Villanueva-Martinez M, Vaquero-Martín J. Is the commercial antibiotic-loaded bone cement useful in prophylaxis and cost saving after knee and hip joint arthroplasty? The transatlantic paradox. J Arthroplast. 2017;32(4):1095–9. Largest recent publication with the routine use of ALBC in primary hip and knee arthroplasty. They found a 57% overall decrease in PJI ( p= 0.001) with the use of ALBC. CrossRef
58.
go back to reference Namba RS, Chen Y, Paxton EW, Slipchenko T, Fithian DC. Outcomes of routine use of antibiotic-loaded cement in primary total knee arthroplasty. J Arthroplast. 2009;24(6 Suppl):44–7.CrossRef Namba RS, Chen Y, Paxton EW, Slipchenko T, Fithian DC. Outcomes of routine use of antibiotic-loaded cement in primary total knee arthroplasty. J Arthroplast. 2009;24(6 Suppl):44–7.CrossRef
59.
go back to reference McQueen M, Littlejohn A, Hughes SP. A comparison of systemic cefuroxime and cefuroxime loaded bone cement in the prevention of early infection after total joint replacement. Int Orthop. 1987;11(3):241–3.CrossRefPubMed McQueen M, Littlejohn A, Hughes SP. A comparison of systemic cefuroxime and cefuroxime loaded bone cement in the prevention of early infection after total joint replacement. Int Orthop. 1987;11(3):241–3.CrossRefPubMed
60.
go back to reference Josefsson G, Kolmert L. Prophylaxis with systematic antibiotics versus gentamicin bone cement in total hip arthroplasty. A ten-year survey of 1,688 hips. Clin Orthop. 1993;(292):210–4. Josefsson G, Kolmert L. Prophylaxis with systematic antibiotics versus gentamicin bone cement in total hip arthroplasty. A ten-year survey of 1,688 hips. Clin Orthop. 1993;(292):210–4.
61.
go back to reference Qadir R, Sidhu S, Ochsner JL, Meyer MS, Chimento GF. Risk stratified usage of antibiotic-loaded bone cement for primary total knee arthroplasty: short term infection outcomes with a standardized cement protocol. J Arthroplast. 2014;29(8):1622–4.CrossRef Qadir R, Sidhu S, Ochsner JL, Meyer MS, Chimento GF. Risk stratified usage of antibiotic-loaded bone cement for primary total knee arthroplasty: short term infection outcomes with a standardized cement protocol. J Arthroplast. 2014;29(8):1622–4.CrossRef
62.
go back to reference McKee MD, Li-Bland EA, Wild LM, Schemitsch EH. A prospective, randomized clinical trial comparing an antibiotic-impregnated bioabsorbable bone substitute with standard antibiotic-impregnated cement beads in the treatment of chronic osteomyelitis and infected nonunion. J Orthop Trauma. 2010;24(8):483–90.CrossRefPubMed McKee MD, Li-Bland EA, Wild LM, Schemitsch EH. A prospective, randomized clinical trial comparing an antibiotic-impregnated bioabsorbable bone substitute with standard antibiotic-impregnated cement beads in the treatment of chronic osteomyelitis and infected nonunion. J Orthop Trauma. 2010;24(8):483–90.CrossRefPubMed
63.
go back to reference Oga M, Sugioka Y, Hobgood CD, Gristina AG, Myrvik QN. Surgical biomaterials and differential colonization by Staphylococcus epidermidis. Biomaterials. 1988;9(3):285–9.CrossRefPubMed Oga M, Sugioka Y, Hobgood CD, Gristina AG, Myrvik QN. Surgical biomaterials and differential colonization by Staphylococcus epidermidis. Biomaterials. 1988;9(3):285–9.CrossRefPubMed
64.
go back to reference Howlin RP, Brayford MJ, Webb JS, Cooper JJ, Aiken SS, Stoodley P. Antibiotic-loaded synthetic calcium sulfate beads for prevention of bacterial colonization and biofilm formation in periprosthetic infections. Antimicrob Agents Chemother. 2015;59(1):111–20.CrossRefPubMed Howlin RP, Brayford MJ, Webb JS, Cooper JJ, Aiken SS, Stoodley P. Antibiotic-loaded synthetic calcium sulfate beads for prevention of bacterial colonization and biofilm formation in periprosthetic infections. Antimicrob Agents Chemother. 2015;59(1):111–20.CrossRefPubMed
65.
go back to reference McPherson E, Facs M, Matthew Dipane BA, Sherif Sherif MD. Dissolvable antibiotic beads in treatment of periprosthetic joint infection and revision arthroplasty—the use of synthetic pure calcium sulfate (Stimulan®) Impregnated with vancomycin & tobramycin. Reconstr Rev [Internet]. 2013 [cited 2018 Mar 4];3(1). Available from: https://www.reconstructivereview.org/ojs/index.php/rr/article/view/27 . McPherson E, Facs M, Matthew Dipane BA, Sherif Sherif MD. Dissolvable antibiotic beads in treatment of periprosthetic joint infection and revision arthroplasty—the use of synthetic pure calcium sulfate (Stimulan®) Impregnated with vancomycin & tobramycin. Reconstr Rev [Internet]. 2013 [cited 2018 Mar 4];3(1). Available from: https://www.reconstructivereview.org/ojs/index.php/rr/article/view/27 .
66.
go back to reference Sanicola SM, Albert SF. The in vitro elution characteristics of vancomycin and tobramycin from calcium sulfate beads. J Foot Ankle Surg. 2005;44(2):121–4.CrossRefPubMed Sanicola SM, Albert SF. The in vitro elution characteristics of vancomycin and tobramycin from calcium sulfate beads. J Foot Ankle Surg. 2005;44(2):121–4.CrossRefPubMed
67.
go back to reference •• Flierl MA, Culp BM, Okroj KT, Springer BD, Levine BR, Della Valle CJ. Poor outcomes of irrigation and debridement in acute periprosthetic joint infection with antibiotic-impregnated calcium sulfate beads. J Arthroplast. 2017;32(8):2505–7. In this series of 33 patients treated with irrigation and debridement with the addition of antibiotic impregnated calcium sulfate beads, 16 patients failed and went on to a two-stage exchange or chronic antibiotic suppression. CrossRef •• Flierl MA, Culp BM, Okroj KT, Springer BD, Levine BR, Della Valle CJ. Poor outcomes of irrigation and debridement in acute periprosthetic joint infection with antibiotic-impregnated calcium sulfate beads. J Arthroplast. 2017;32(8):2505–7. In this series of 33 patients treated with irrigation and debridement with the addition of antibiotic impregnated calcium sulfate beads, 16 patients failed and went on to a two-stage exchange or chronic antibiotic suppression. CrossRef
68.
go back to reference Kallala R, Haddad FS. Hypercalcaemia following the use of antibiotic-eluting absorbable calcium sulphate beads in revision arthroplasty for infection. Bone Joint J. 2015;97-B(9):1237–41.CrossRefPubMed Kallala R, Haddad FS. Hypercalcaemia following the use of antibiotic-eluting absorbable calcium sulphate beads in revision arthroplasty for infection. Bone Joint J. 2015;97-B(9):1237–41.CrossRefPubMed
Metadata
Title
Intraoperative Considerations for Treatment/Prevention of Prosthetic Joint Infection
Authors
Linda I. Suleiman
Daniel R. Mesko
Denis Nam
Publication date
01-09-2018
Publisher
Springer US
Published in
Current Reviews in Musculoskeletal Medicine / Issue 3/2018
Electronic ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-018-9502-3

Other articles of this Issue 3/2018

Current Reviews in Musculoskeletal Medicine 3/2018 Go to the issue

Prosthetic Joint Infection (S Nodzo and N Frisch, section editors)

Two-Stage Revision Arthroplasty for the Treatment of Prosthetic Joint Infection

PCL Update (K Jones and M Alaia, section editors)

Graft Considerations in Posterior Cruciate Ligament Reconstruction