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Periprosthetic Joint Infection With Fungal Pathogens.
Brown, Timothy S; Petis, Stephen M; Osmon, Douglas R; Mabry, Tad M; Berry, Daniel J; Hanssen, Arlen D; Abdel, Matthew P.
Afiliación
  • Brown TS; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
  • Petis SM; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
  • Osmon DR; Department of Internal Medicine, Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota.
  • Mabry TM; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
  • Berry DJ; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
  • Hanssen AD; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
  • Abdel MP; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
J Arthroplasty ; 33(8): 2605-2612, 2018 08.
Article en En | MEDLINE | ID: mdl-29636249
ABSTRACT

BACKGROUND:

Although there is abundant information about bacterial periprosthetic joint infections (PJIs), there is a notable paucity of information about fungal PJIs. The goals of this study are to describe the patient demographics, diagnostic findings, and treatment results of fungal PJIs after total joint arthroplasty.

METHODS:

We identified 31 fungal PJIs (13 total hip arthroplasties and 18 total knee arthroplasties) in 31 patients treated between 1996 and 2014. This represented 0.9% of the 3525 PJIs treated at our institution during this time period. Candida species accounted for 81% of infections. The mean patient age at diagnosis of fungal PJI was 68 years. Mean follow-up after initiation of treatment was 4 years.

RESULTS:

In the total hip arthroplasty cohort, survivorship free from all-cause revision or implant removal was 44% at 2 years. Survivorship free from reinfection was 38% at 2 years. Mean Harris hip score was 27 at final follow-up.In the total knee arthroplasty cohort, survivorship free from all-cause revision was 70% at 2 years. Survivorship free from reinfection was 76% at 2 years. Mean Knee Society scores were 36 at final follow-up.

CONCLUSION:

Fungal PJIs are rare (0.9% of diagnosed PJIs). Survivorship free of all-cause revision or implant removal was very low in the hip group (44% at 2 years), but slightly better in the knee group (70% at 2 years). Moreover, clinical outcomes were poor with high perioperative complication rates. Improved treatment regimens are needed for this unsolved clinical problem.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Infecciones Relacionadas con Prótesis / Artroplastia de Reemplazo de Cadera / Artroplastia de Reemplazo de Rodilla / Micosis Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Arthroplasty Asunto de la revista: ORTOPEDIA Año: 2018 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Infecciones Relacionadas con Prótesis / Artroplastia de Reemplazo de Cadera / Artroplastia de Reemplazo de Rodilla / Micosis Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Arthroplasty Asunto de la revista: ORTOPEDIA Año: 2018 Tipo del documento: Article