1.

Record Nr.

UNINA9910523710903321

Titolo

Infection in knee replacement / / edited by Umile Giuseppe Longo [and four others]

Pubbl/distr/stampa

Cham, Switzerland : , : Springer, , [2022]

©2022

ISBN

3-030-81553-6

Descrizione fisica

1 online resource (358 pages)

Disciplina

617.5820592

Soggetti

Sports medicine

Orthopedics

Lingua di pubblicazione

Inglese

Formato

Materiale a stampa

Livello bibliografico

Monografia

Nota di bibliografia

Includes bibliographical references.

Nota di contenuto

Intro -- Foreword -- References -- Foreword -- Preface -- Contents -- Part I: Introduction -- 1: Epidemiology and Socioeconomic Impact of Infections in Knee Replacement -- 1.1  Introduction -- 1.2  Epidemiology and Socioeconomic Burden of PJIs in TKA -- 1.3  The Psychological Impact of PJIs -- 1.4  Conclusion -- References -- 2: Etiology and Pathogenesis of Knee Replacement Infections -- 2.1  Introduction -- 2.2  The Different Ways to Infect a Prosthetic Joint -- 2.2.1  Direct Inoculation During Invasive Procedures -- 2.2.2  Inoculation by Contiguous Spread -- 2.2.3  Inoculation by Hematogenous Spread -- 2.3  Epidemiology -- 2.3.1  Knee vs. Hip Location -- 2.3.2  Antimicrobial Resistance -- 2.3.3  Time to PJI-Onset -- 2.3.4  Main Pathogens Involved -- 2.4  The Pathophysiology of Chronic PJI -- 2.4.1  Biofilm in TKA Infection -- 2.4.2  Attachment -- 2.4.3  Accumulation/Maturation -- 2.4.4  Detachment/Dispersal -- 2.4.5  Bacterial Interactions with Bone Cells -- 2.5  Conclusion -- References -- Part II: Biomaterials in Artificial Joint Replacements -- 3: The Role of the Surface on Bacteria-Implant Interactions -- 3.1  Introduction -- 3.2  Mechanism of Implant Biofilm Formation -- 3.3  Mechanisms of Antibiotic Resistance in Biofilms -- 3.4  Microbiology of Periprosthetic Infection (PJI) -- 3.5  Methods for the Detection of Biofilms -- 3.6  The Treatment of PJI Biofilm After TKA -- 3.7  Conclusions -- References -- 4: In-Vitro and In-Vivo Models



for the Study of Prosthetic Joint Infections -- 4.1  In-Vitro Models of PJI -- 4.1.1  Bacterial Adherence -- 4.1.2  Biofilm -- 4.1.3  Antimicrobial Efficacy -- 4.1.4  Modelling for Risk Factors -- 4.1.5  Limitations -- 4.2  In-Vivo Models of PJI -- 4.2.1  Animal Characteristics -- 4.2.2  Prosthetic Designs -- 4.2.3  Gram-Positive Models -- 4.2.4  Gram-Negative Models -- 4.2.5  Biofilm Formation.

4.2.6  Immune Reactions -- 4.2.7  Limitations -- 4.3  Conclusion -- References -- Part III: Clinical Manifestation -- 5: General and Local Symptoms of Infection in Knee Replacement -- 5.1  Introduction -- 5.2  General Consideration -- 5.3  Clinical Examination -- 5.4  Presenting Symptoms and Clinical Assessment -- 5.5  Wound Complications -- 5.6  Conclusions -- References -- Part IV: Diagnosis -- 6: Laboratory Diagnosis of Periprosthetic Joint Infections -- 6.1  Introduction -- 6.2  Peripheral Blood Tests -- 6.2.1  Erythrocyte Sedimentation Rate and C-Reactive Protein -- 6.2.2  d-Dimer -- 6.2.3  Fibrinogen -- 6.2.4  Interleukin-6 -- 6.2.5  Procalcitonin -- 6.2.6  Novel Serological Markers -- 6.3  Synovial Fluid Analysis -- 6.3.1  White Blood Cell Count and Polymorphonuclear Neutrophil Percentage -- 6.3.2  Leukocyte Esterase -- 6.3.3  Alpha-Defensin -- 6.3.4  Synovial CRP -- 6.3.5  Novel Synovial Fluid Markers -- 6.4  Frozen Section Histopathology -- 6.5  Microorganism Identification -- 6.5.1  Synovial Fluid Cultures -- 6.5.2  Intraoperative Tissue Cultures -- 6.5.3  Sonication Fluid Cultures -- 6.5.4  Culture-Negative Infections -- 6.5.5  Antibiotics and Culture Yield -- 6.5.6  Molecular Tests -- 6.6  Conclusion -- References -- 7: Microbiological Diagnosis of Knee Prosthesis Infections -- 7.1  Introduction -- 7.2  Types of Samples -- 7.2.1  Preoperative Samples -- 7.2.2  Peri-operative Samples -- 7.3  Bacteriological Analysis -- 7.3.1  Microscopic Examination -- 7.3.2  Culture -- 7.4  Molecular Biology -- 7.5  Interpretation -- References -- 8: Molecular Analysis and Histological Evaluation -- 8.1  Introduction -- 8.2  Molecular Analysis -- 8.2.1  PCR -- 8.2.2  NGS -- 8.2.3  Histological Evaluation -- 8.3  Conclusions -- References -- 9: Imaging -- 9.1  Introduction -- 9.2  Ultrasound (US) -- 9.3  Radiography -- 9.4  Resonance Imaging.

9.5  Computerized Tomography Imaging -- 9.6  Single-Photon Emission Computed Tomography with Computerized Tomography (SPECT/CT) -- 9.7  Bone Scintigraphy/Three-Phase Bone Scan -- 9.8  Gallium-67 Citrate Scintigraphy -- 9.9  Indium-111 Leukocyte Scan -- 9.10  Dual-Isotope Imaging with In-111-Labelled Leukocytes and Tc-99m Sulphur Colloid Bone Marrow Scan -- 9.11  Labelled Leukocyte Scintigraphy with Antigranulocyte Antibody -- 9.12  Positron Emission Tomography with 18F-Fluorodeoxyglucose (18F-FDG/PET) -- 9.13  Conclusion -- References -- 10: Definition of Periprosthetic Joint Infection -- 10.1  Algorithm for Diagnosis -- Bibliography -- 11: Differential Diagnosis of Periprosthetic Joint Infection -- 11.1  Introduction -- 11.2  Serum Negative Infections -- 11.3  Culture Negative and Slow Growing Organism Infections -- 11.3.1  Inflammatory Arthritis -- 11.3.2  Crystalline Deposit Diseases -- 11.3.3  Hemarthrosis -- 11.3.4  Metal Allergy -- 11.4  Conclusion -- References -- Part V: Treatment of Knee Replacement Infections -- 12: Systemic Antibiotic Therapy -- 12.1  Introduction -- 12.2  Principles and Timing -- 12.3  Debridement, Antibiotics, and Implant Retention (Dair) -- 12.4  One-Stage Exchange -- 12.5  Two-Stage Exchange -- 12.6  Empiric Therapy -- 12.7  Focused Therapy -- 12.7.1  Staphylococcus spp. -- 12.7.2  Streptococcus spp. -- 12.7.3  Enterococcus spp. -- 12.7.4  Gram-Negative Bacteria -- 12.7.5  Anaerobic Bacteria -- 12.7.6  Fungi -- 12.8  Suppressive Therapy -- 12.9  Conclusion -- References -- 13: Local Delivery of Antibiotic



and Antiseptic -- 13.1  Introduction -- 13.2  Antiseptic Intraoperative Lavage -- 13.2.1  Povidone-Iodine Intraoperative Lavage -- 13.2.2  Chlorhexidine Intraoperative Lavage -- 13.3  Antibiotic Local Delivery -- 13.3.1  Antibiotic Powder -- 13.3.2  Nonabsorbable Polymethylmethacrylate (PMMA) Beads.

13.3.3  Absorbable Calcium Sulfate Beads -- 13.4  Coated Implant -- 13.4.1  Silver-Coated Implant -- 13.4.2  Iodine-Coated Implant -- 13.4.3  DAC® Hydrogel Coated Implant -- 13.5  Conclusions -- References -- 14: Surgical Approaches -- 14.1  Introduction -- 14.2  Skin Incisions -- 14.3  Medial Parapatellar Approach -- 14.4  Insall's Modification to Medial Parapatellar Approach -- 14.5  Lateral Approach -- 14.6  Techniques for Exposure of Difficult TKA -- 14.6.1  Rectus Snip -- 14.6.2  V-Y Quadricepsplasty -- 14.6.3  Tibial Tubercle Osteotomy -- 14.6.4  Femoral Peel -- 14.6.5  Medial Epicondylar Osteotomy -- 14.7  Conclusion -- References -- 15: DAIR (Debridement, Antibiotics, and Implant Retention) for the Treatment of Periprosthetic Joint Infection of Knee -- 15.1  Introduction -- 15.2  Preoperative Considerations -- 15.2.1  Definition of PJI and Classification -- 15.2.2  Treatment Algorithm -- 15.2.3  Patients Selection for DAIR -- 15.3  Intraoperative Considerations -- 15.3.1  Surgical Technique -- 15.3.2  Irrigation Protocol -- 15.3.3  Modular Component Exchange -- 15.3.4  Local Antibiotics Administration -- 15.4  Postoperative Consideration -- 15.4.1  Postoperative Antibiotics Regimen -- 15.4.2  Factors Associated with Outcomes of Dair -- References -- 16: One-Stage Exchange Arthroplasty of the Infected Knee -- 16.1  Introduction -- 16.2  Indications for One-Stage Exchange Arthroplasty -- 16.3  Endo-Klinik Diagnostic Protocol -- 16.4  Surgical Technique -- 16.4.1  Preoperative Planning and Surgical Approach -- 16.4.2  Radical Debridement and Removal of All Hardware Materials -- 16.4.3  Re-Implantation -- 16.4.4  Postoperative Course -- 16.5  Clinical Results -- 16.6  Conclusions -- References -- 17: Two-Stage Revision Arthroplasty for Periprosthetic Knee Infection -- 17.1  Introduction -- 17.2  History -- 17.3  Timing for Reimplantation.

17.4  Non-Articulating Vs. Articulating Spacers -- 17.5  Local Antibiotics -- 17.6  Systemic Antimicrobial Therapy -- 17.7  Surgical Tips and Tricks -- 17.8  Cement Spacer Exchange -- 17.9  Cement Spacer Irrigation and Debridement -- 17.10  Infected Bilateral Knee Arthroplasties -- 17.11  Conclusion -- References -- 18: The Use of Static Spacers in Periprosthetic Knee Infections -- 18.1  Introduction -- 18.2  General Spacer Properties -- 18.2.1  Mechanical Properties -- 18.2.2  Anti-Microbial Properties -- 18.2.3  Two Types of Cement Spacer -- 18.3  Indications for a Static Spacer in TKA Infections -- 18.4  Surgical Technique -- 18.5  Results and Complications of Static Spacers (Table 18.1) -- 18.5.1  Rate of Infection Eradication -- 18.5.2  Range of Motion -- 18.5.3  Knee Society Score (KSS) and Hospital for Special Surgery Knee Score (HSS) -- 18.5.4  Rate of Surgical Soft Tissue Release -- 18.5.5  Complications -- 18.6  Conclusion -- References -- 19: Dynamic (Mobile) Spacers in Infected Total Knee Arthroplasty -- 19.1  Introduction -- 19.2  Types and Properties of Dynamic Spacers -- 19.3  Advantages of Dynamic Spacers -- 19.4  Contraindication of Dynamic Spacers -- 19.5  Antibiotic Properties of Dynamic Spacers -- 19.6  Interim Period Length and Mobilization with Dynamic Spacers -- 19.6.1  Length of the Interim -- 19.6.2  Mobility During the Interim -- 19.7  Complications Related to the Use of Dynamic Spacers -- 19.8  Conclusion -- References -- 20: Knee Arthrodesis -- 20.1  Introduction -- 20.2  Indications and Contraindications for Arthrodesis -- 20.3  Limitations of Knee Arthrodesis -- 20.4  Principles of Knee Arthrodesis -- 20.4.1  Host Optimisation -- 20.4.2  Knee Fusion



Position -- 20.4.3  One-Stage Versus Two-Stage Arthrodesis -- 20.5  Techniques for Arthrodesis -- 20.5.1  External Fixator -- 20.5.2  Fusion Nail.

20.5.3  Combined Surgical Techniques.