Abstract:
PURPOSE:Prosthetic joint infections (PJI) are a serious and challenging complication after total joint arthroplasty. According to the literature, most PJI are monomicrobial infections caused by gram-positive cocci. The number of polymicrobial PJI might be underrepresented in the literature and only limited data are available regarding the outcome of polymicrobial PJI. Our hypothesis was that polymicrobial PJI are associated with a reduced cure rate compared with monomicrobial PJI. METHODS:Routine clinical data were collected and analysed retrospectively as anonymised, aggregated data. A total of 77 consecutive patients with 77 confirmed PJI and proven infectious organism of the hip and knee joint treated within a two-stage exchange concept and a follow-up ≥ two years were investigated. Detection of the infectious organism was based on multiple microbiological cultures taken intra-operatively. Superficial wound swabs or swabs from sinus tracts were not taken into account. Data were grouped into polymicrobial and monomicrobial PJI. The main outcome variable was "definitively free of infection after two years" as published. Second, we considered several variables as potential confounders or as risk factors. RESULTS:A total of 42 men and 35 women with 46 infected total hip arthroplasties and 31 infected total knee arthroplasties were evaluated. In 37 (46.6 %) of our 77 patients a polymicrobial PJI could be detected. We found a significant association between polymicrobial PJI and the outcome parameter definitively free of infection after two years with an odds ratio (OR) of 0.3 [95 % confidence interval (CI) 0.1-1.0]. The rate of patients graded as definitively free of infection after two years was 67.6 % for polymicrobial infections vs. 87.5 % for monomicrobial infections. The American Society of Anesthesiologists (ASA) score (OR 0.4, 95 % CI 0.2-1.0, p = 0.062) was identified as a borderline significant covariable. CONCLUSIONS:Our data suggest that polymicrobial PJI might be underrepresented in the current literature. Additionally, the presence of multiple infectious organisms is associated with a reduced rate after two years with 67.6 vs 87.5 % for monomicrobial infections. Special attention and extra care should be considered for these patients.
journal_name
Int Orthopjournal_title
International orthopaedicsauthors
Wimmer MD,Friedrich MJ,Randau TM,Ploeger MM,Schmolders J,Strauss AA,Hischebeth GT,Pennekamp PH,Vavken P,Gravius Sdoi
10.1007/s00264-015-2871-ysubject
Has Abstractpub_date
2016-07-01 00:00:00pages
1367-73issue
7eissn
0341-2695issn
1432-5195pii
10.1007/s00264-015-2871-yjournal_volume
40pub_type
杂志文章abstract::Results of two methods, conventional open reduction-internal plating and minimally invasive plating osteosynthesis (MIPO), in the treatment of mid-distal humeral shaft fractures were compared. Thirty-three patients were retrospectively analysed and divided into two groups. Group A (n = 17) patients were treated by MIP...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-009-0753-x
更新日期:2010-02-01 00:00:00
abstract::A retrospective review of complications with the gamma nail has been carried out in 152 patients with stable and unstable pertrochanteric fractures. Operative complications occurred in 10 patients. Screws penetrated the femoral neck in 3, immediate varus was associated with a short screw in 2, diaphyseal fractures occ...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s002640050026
更新日期:1996-01-01 00:00:00
abstract::Twenty-eight arthrodeses of the wrist were carried out for various indications using an ulnar graft. The results were evaluated and it was found that the obliquely resected lower end of the ulna gave a longer graft for better fusion between the distal end of radius and the base of the 3rd metacarpal. There was no inst...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/BF00180131
更新日期:1990-01-01 00:00:00
abstract::This study included 15 patients with humeral shaft fractures who had no clinical, radiological or bone scan signs of healing after eight months. The patients were followed for a mean of 35.8 months. No patient was lost to follow-up. Anterior plating of humeral shaft nonunion via an anterior approach was performed usin...
journal_title:International orthopaedics
pub_type: 临床试验,杂志文章
doi:10.1007/s00264-009-0863-5
更新日期:2010-10-01 00:00:00
abstract::The measure of radiographic pelvic and spinal parameters for sagittal balance analysis has gained importance in reconstructive surgery of the spine and particularly in degenerative spinal diseases (DSD). Fusion in the lumbar spine may result in loss of lumbar lordosis (LL), with possible compensatory mechanisms: decre...
journal_title:International orthopaedics
pub_type: 杂志文章,评审
doi:10.1007/s00264-014-2516-6
更新日期:2015-01-01 00:00:00
abstract:PURPOSE:Several studies have reported a risk of dislocation in obese patients after total hip arthroplasty. In this study, we evaluated the interaction between obesity and dislocation by kinematic analysis using a navigation system. METHODS:The intraoperative range of motion (ROM) and postoperative impingement-free RO...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-012-1701-8
更新日期:2012-12-01 00:00:00
abstract::We compared the incidence of anterior thigh pain retrospectively following primary uncemented total hip replacement in 70 patients (78 hips) with osteoarthritis. In one group (38 hips), an Endoplus porous-coated, canal-filling prosthesis was inserted through an anterolateral approach. In the other group (40 hips), a F...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-005-0642-x
更新日期:2005-06-01 00:00:00
abstract::This paper reports the long term results of 3 patients with lumbosacral spondyloptosis who were treated by closed reduction, followed by 6 to 12 weeks plaster cast immobilisation, posterior fusion and finally anterior fusion after a further 3 to 6 months. The follow up was from 7.5 to 10.5 years. Spondyloptosis was di...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/BF00180118
更新日期:1990-01-01 00:00:00
abstract::A Grosse-Kempf nail was used with a Scan femoral hip prosthesis to manage a patient who sustained a pathological fracture of the neck of the femur after the previous introduction of the interlocking nail for a similar fracture of the lower end of the femur. ...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/BF00178764
更新日期:1990-01-01 00:00:00
abstract::Incorporation of massive cortical bone allografts in the human is slow and remains incomplete. Late biopsies of implanted allografts or histological studies of explanted allografts always show the partial substitution of necrotic bone by new bone from the host. The aim of the present study was to evaluate the value of...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/BF00183550
更新日期:1993-01-01 00:00:00
abstract::Between 1993 and 1998, 49 consecutive patients with impending or complete pathological fractures of the femur due to metastatic bone disease were treated with intramedullary nailing. Twenty-four were treated with a long Gamma nail and 32 with an AO nail with a cephalomedullary spiral blade. Both implants gave a good f...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s002640000114
更新日期:2000-01-01 00:00:00
abstract::The purpose of this study was to evaluate the effects of partial and full weightbearing after cementless total hip arthroplasty over a two year follow-up period. Fifty-nine women and 41 men (average age 61 years) received an uncemented Spotorno stem and were randomised into a full and a partial weightbearing group. No...
journal_title:International orthopaedics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00264-010-1089-2
更新日期:2011-08-01 00:00:00
abstract:PURPOSE:In reconstruction of congenital hip dislocation by total hip arthroplasty (THA), positioning of the acetabular component in the true acetabulum is sometimes accompanied by shortening of the femur. Shortening of the femur is of importance for minimising risk of damaging neurovascular structures due to excessive ...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-011-1293-8
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Controversies regarding the treatment of advanced tuberculosis of the knee still exist. We retrospectively investigated protocols of total knee arthroplasty (TKA) and their efficacy in patients with advanced tuberculosis. METHODS:Nine TKAs associated with advanced tuberculosis were performed at our institut...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-015-3050-x
更新日期:2016-07-01 00:00:00
abstract:PURPOSE:This study describes a case series of 15 patients with radial head fractures who underwent radial head excision using an arthroscopic technique. METHODS:Over a four year period, 15 patients (average age 49.6 years) who had sustained a radial head or radial neck fracture underwent an arthroscopic excision of th...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-012-1667-6
更新日期:2012-12-01 00:00:00
abstract:PURPOSE:While as many as 50% of revision shoulder arthroplasties are culture positive, a consistent, clinically useful definition of a "periprosthetic shoulder infection" is lacking. We conducted a systematic review of the published literature with respect to (1) the definition of a "periprosthetic shoulder infection",...
journal_title:International orthopaedics
pub_type: 杂志文章,评审
doi:10.1007/s00264-017-3421-6
更新日期:2017-04-01 00:00:00
abstract:PURPOSE:There remains controversy as to whether computer-navigated total knee replacement (TKR) improves the overall prosthesis alignment and patient function. The aim of this study was to determine whether computer-assisted total knee arthroplasty provides superior prosthesis positioning when compared to a conventiona...
journal_title:International orthopaedics
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00264-013-1996-0
更新日期:2014-02-01 00:00:00
abstract::We applied four published classifications for assessment of heterotopic ossification after total hip arthroplasty (Arcq, Brooker, DeLee and Della Valle [1, 2, 5, 6]. The average incidence of heterotopic ossification varied from 19.8% to 27.7%. The inter-observer reliability of the various classifications was determine...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-004-0603-9
更新日期:2005-06-01 00:00:00
abstract:PURPOSE:Pain in and around the metatarsal heads, the metatarsal phalangeal joints and the surrounding soft tissues is called metatarsalgia. Non-operative treatment of metatarsalgia includes foot orthoses. Foot orthoses may be classified as standard or custom-made. A systematic review was carried out to determine whethe...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-018-3817-y
更新日期:2018-08-01 00:00:00
abstract::Thirty-two patients, who had frozen shoulders which had not improved with physiotherapy, were treated by manipulation under general anaesthesia or by steroid injection and hydraulic distension under local anaesthesia. Distension is recommended as it is easy to carry out and gave better results than manipulation. ...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/BF00181697
更新日期:1993-11-01 00:00:00
abstract::First metatarsophalangeal joint replacement is an alternative surgical procedure to arthrodesis in the treatment of moderate-to-severe hallux rigidus. However, few studies have been published about functional outcome after joint reconstructive procedures for hallux rigidus. The purpose of this study was to assess clin...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-009-0935-6
更新日期:2010-10-01 00:00:00
abstract:PURPOSE:Short-stem hip arthroplasty preserves femoral bone stock which includes the femoral neck. This implies that the stem has to follow the anatomy of the femoral neck. Therefore, it has been questioned whether biomechanical reconstruction of the hip can be safely achieved with SHA. METHODS:Biomechanical reconstruc...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-011-1477-2
更新日期:2012-07-01 00:00:00
abstract:PURPOSE:Although diabetes mellitus (DM) has an adverse effect on complication rates in orthopaedic surgery, neither the effect of DM nor the association between haemoglobin A1C (HbA1C) and outcomes after shoulder arthroplasty (SA) has been studied. METHODS:A retrospective review of 406 SAs (70 HAs, 188 total shoulder ...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-018-3874-2
更新日期:2018-08-01 00:00:00
abstract:PURPOSE:We report our experience analysing the risk of fracture amongst allografts in limb-preserving surgery for bone tumours. METHODS:We retrospectively reviewed our experience with bone allograft and its major complications when used for limb -preserving operations for bone tumours. Forty-one structural allografts ...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-015-2980-7
更新日期:2015-11-01 00:00:00
abstract::In 53 patients with a mean age of 38 (17-73) years, 71 high tibial osteotomies were performed. Twenty-three patients had no radiological signs of osteoarthrosis (Ahlbäck grade 0), whereas 26 patients had primary and 22 patients secondary osteoarthritis. Follow-up was 10.5 (5.8-16.6) years. The patients without radiolo...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s002640100244
更新日期:2001-01-01 00:00:00
abstract::Between 1991 and 1998, we treated 72 patients with fusion of the lumbar spine using posterior pedicle screw fixation followed by anterior retroperitoneal insertion of a titanium cage filled with autogenous bone graft. All patients had chronic low back pain after failed conservative treatment. We were able to review 54...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-004-0577-7
更新日期:2004-10-01 00:00:00
abstract::Synovial fluid from a loose prosthesis may act as a vehicle for factors that regulate bone turnover. The effect of such synovial fluid on osteoblasts has been studied. Synovial fluid obtained from patients who underwent revision hip arthroplasty because of aseptic prosthesis loosening was studied regarding the effect ...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-008-0533-z
更新日期:2009-06-01 00:00:00
abstract::Hyperostosis of the spine, Forestier's disease, is a rare, but well defined entity which results from silent, extensive paraspinal calcification. It has been regarded as an asymptomatic ankylosis requiring no medical or surgical treatment. Two patients with Forestier's disease are presented who show severe stenosis of...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/BF00267561
更新日期:1983-01-01 00:00:00
abstract:PURPOSE:Recently, endoprosthesis reconstruction has been used for scapular malignant tumours. Our aim is to present and evaluate the clinical indications, peri-operative technique, and mid-term clinical results. METHODS:Scapular hemiarthroplasty after total scapulectomy has been performed in 15 patients between 2011 a...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-017-3429-y
更新日期:2017-05-01 00:00:00
abstract::The aim of this investigation was to examine the effect of short-term immobilization on subchondral cortical and trabecular bone tissue in the rat tibia and to determine whether there was any difference when the knee was immobilized in extension or flexion. Thirty-six male rats were used in this study, and in 18 the k...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/BF00266984
更新日期:1988-01-01 00:00:00