ABSTRACT
Dear Editor, in recent years there has been an increase in the number of new cases of cancer. This increase, in part, is closely related to the increase in average life expectancy, as well as more accurate diagnostic techniques and well-defined screening programs. [...].
Subject(s)
COVID-19 , Health Promotion , Men's Health , Prostatic Neoplasms/prevention & control , Testicular Neoplasms/prevention & control , Foundations , Humans , MaleABSTRACT
To study the prevalence of Staphylococcus aureus carriage and the impact of preoperatively treating carriers in prosthetic joint infection (PJI), a prospective randomized trial was organized. From January 2010 to December 2012, 1028 of 1305 total joint arthroplasties performed were screened, and selected carriers underwent preoperative decolonization. We observed a 22.2% (228/1028) S aureus colonization rate and only 0.8% methicillin-resistant S aureus. Prosthetic joint infection rate was higher, albeit not significantly, in S aureus carriers than among noncarriers-3.9% (9/228) vs 2.0% (16/800). Treated and untreated carriers showed no significant differences-3.4% (3/89) vs 4.3% (6/139). Most of the 14 S aureus PJI occurred in noncarriers suggesting a lack of causal relation between nasal and PJI S aureus. No clear benefit in screening/decolonizing carriers before total joint arthroplasty could be demonstrated.
Subject(s)
Arthroplasty, Replacement, Hip/methods , Arthroplasty, Replacement, Knee/methods , Methicillin-Resistant Staphylococcus aureus , Staphylococcal Infections/diagnosis , Staphylococcal Infections/prevention & control , Staphylococcus aureus , Surgical Wound Infection/prevention & control , Adult , Aged , Aged, 80 and over , Arthroplasty/adverse effects , Female , Humans , Male , Methicillin Resistance , Middle Aged , Prevalence , Prospective Studies , Risk Factors , Young AdultABSTRACT
Periprosthetic joint infection is a devastating complication after total joint replacement. Prevention is mandatory and systemic antibiotic prophylaxis is nowadays a recognized cornerstone. Further addition of local antibiotics eluting from bone cement is a real possibility but its routine use is controversial. Pros and cons of its routine use in primary and revision total joint arthroplasty will be discussed. Cement spacers carrying high doses of antibiotic(s) are currently accepted during two-stage treatment of infected prosthetic joints. Several issues such as alternatives to classic antibiotics, optimal dosages and others will also be explored.
Subject(s)
Anti-Bacterial Agents/pharmacology , Arthroplasty, Replacement/methods , Bone Cements , Prosthesis-Related Infections/prevention & control , HumansABSTRACT
Periprosthetic joint infection is a frequent complication after total hip replacement. Two-stage exchange with the use of a temporary cement spacer is commonplace. Several complications are possible with its use. In addition to infection persistence, mechanical complications such as dislocation or fractures are among the most common. Several risk factors can and should be addressed during first stage or spacer implantation surgery in order to minimize complications. Technical aspects as well as practical tips and pearls to overcome common nuisances such as spacer instability or femoral and acetabular bone loss will be discussed.
