Chapter
Chapter 1: Prevention of joint infections
1.2 Preoperative considerations
1.2.1 Preoperative patient selection and risk factors for infection
1.2.2 Nonmodifiable comorbidities
1.2.3 Modifiable comorbidities
1.2.3.1 Active pyogenic infections
1.2.3.2 Colonization with Staphylococcus aureus
1.2.3.3 Hyperglycemia and diabetes
1.2.3.5 Immunosuppression and autoimmune/rheumatologic disease
1.2.3.6 Human immunodeficiency virus (HIV)
1.2.3.7 Obesity and malnutrition
1.2.3.8 Integumentary alterations
1.2.3.9 Tobacco, Ethanol, and intravenous drug use
1.2.3.10 Preoperative urinary screening and management of bacteriuria
1.3 Prevention of infection in the perioperative period
1.3.1 Body cleansing at home in anticipation of surgery
1.3.2 Preoperative hair management
1.3.3 Perioperative antibiotics
1.3.4 Surgical skin preparation
1.3.5 Antibiotic-loaded bone cement (ALBC) prophylaxis in primary and revision arthroplasty
1.3.6 The role of laminar air flow and body suits in operating rooms during arthroplasty
1.4 Prevention of infection after arthroplasty
1.4.1 Early postoperative period
1.4.1.2 Cellulitis and superficial wound infection
1.4.1.3 Postoperative fever
1.4.2 Late considerations
1.5 Conclusions and future trends
Chapter 2: Biofilm formation and the biological response
2.2.1.1 Biofilm-associated protein (Bap)
2.2.1.2 Outer membrane vesicles (OMVs)
2.2.1.3 Bacterial nucleoid-binding proteins
2.3 Resistance to antimicrobial agents
2.3.1 Delayed penetration of the antimicrobial agent
2.3.2 Altered growth rate of biofilm organisms
2.4 Host response against biofilm
2.4.1 How biofilm evades host' defenses
2.5 Clinical significance of biofilm
2.6 Therapeutic strategies against biofilm
2.6.1 Biofilm matrix-degrading enzymes
2.6.2 Ultrasonic treatment
2.6.4 Quorum sensing inhibitors
2.6.5 Silver nanoparticles
Chapter 3: Biomaterials in treatment of orthopedic infections
3.1 Orthopedic implant-related infections
3.2.1 Local antibiotic delivery
3.2.2 Bone defect filling
3.2.3 Materials for local antimicrobial treatment
3.2.3.2 Ceramics, composites, and bioactive glasses
3.3 Latest clinical evidence treatment osteomyelitis
3.3.2 Antibiotic-loaded bone graft substitutes (ceramics)
Chapter 4: S53P4 bioactive glass
4.2.4 Bone proliferation in a BAG graft layer
4.3 Antibacterial effects
4.4 Effect on angiogenesis
4.5 Current clinical applications
Chapter 5: Experimental models in orthopedic infection research
5.2 Prostheses, osteosynthesis, and infection
5.4 Infection development and prevention
5.5 Experimental models for orthopedic infections
5.6 Scoring of orthopedic infections in experimental models—(semi) systemic parameters
5.7 Scoring of orthopedic infections in experimental models—imaging and histology
Part Two: Types of periprosthetic joint infections
Chapter 6: Periprosthetic infection in the hip joint
6.5.1 History and clinical examination
6.5.2 Laboratory blood tests
6.5.3 Joint aspiration (synovial fluid tests)
6.5.4 Radiological investigations
6.5.5 Intraoperative tissue specimens
6.6 Other new diagnostic tools
6.6.3 Fluorescence in situ hybridization
6.6.4 Sonication of explanted prosthesis
6.7.1 Multidisciplinary team working
6.7.2 Preoperative planning and decision making
6.7.3 Debridement and implant retention (with or without exchange of mobile parts)
6.7.4 Single-stage revision (direct exchange)
6.7.5 Two-stage revision and implantation of a cement spacer
6.7.6 Long-term suppressive antibiotics
6.7.7 Salvage procedures (amputation/arthrodesis/excisional arthroplasty-girdlestones procedures)
6.8 Management of periprosthetic fracture in the presence of chronic PJI
6.9 The eradication of biofilm: Goals for the future
Chapter 7: Infection in total knee arthroplasty
7.1 Total knee arthroplasty today
7.2 Infection risks and prevention
7.2.1 Antibiotic prophylaxis in TKA
7.3.1 Acute hematogenous infections of a TKA
7.4 Chronic TKA infection
7.5 Management of the infected TKA
7.7.1 Postoperative course of antibiotics after first stage in two-stage revision
7.7.2 Second stage in the two-stage revision
Chapter 8: Periprosthetic infection in shoulder and elbow joints
8.2 Clinical presentation
8.3.3 Propionibacterium acnes
8.4 Treatment and outcomes—Shoulder
8.5 Treatment and outcomes—Elbow
8.6 Conclusion and future directions
Part Three: Managing and treating periprosthetic joint infections
Chapter 9: Practice and guidelines for treating periprosthetic joint infections: Single- and two-stage revision
9.2 Patient preparation, implant removal, and surgical debridement
9.2.1 One-stage technique
9.2.2 Two-stage technique
9.2.3 Indications and patient information
9.4 Conclusions and future trends
Chapter 10: PMMA beads and spacers for local antibiotic administration
10.2 Rationale and pharmacokinetics of antibiotic-loaded PMMA
10.4.1 Static vs mobile spacer in the knee [ 20–23 ]
Chapter 11: Pathogen-directed antibiotic therapy
11.2 Cultures and diagnosis
11.3 Prophylaxis and empirical therapy
11.4 The pathogens in PJI
11.5.1 General principles
11.5.2 Resistance induction and combination therapy
11.5.3 Duration of treatment and tolerability of antibiotics
11.5.4 Intravenous to oral switch
11.5.5 Suppressive antibiotic therapy
11.5.6 Clinical monitoring of patients receiving long-term antibiotic therapy
11.6 Pathogen-directed choice
11.6.1 Staphylococcus aureus (MSSA (methicillin-sensitive S. aureus .) and MRSA)
11.6.2 Coagulase-negative Staphylococci (CoNS)
11.6.3 Enterococci: Enterococcus faecalis and Enterococcus faecium
11.6.5 Gram-negative bacilli
11.6.6 Anaerobic microorganisms
11.6.7 Polymicrobial infections
11.6.9 Other microorganisms
11.7 Conclusion and areas for further research
Chapter 12: Imaging of prosthetic joint infections
12.2 Conventional imaging
12.2.3 Computed tomography and magnetic resonance imaging
12.3.2 Gallium scintigraphy
12.3.3 Leukocyte scintigraphy
12.3.4 Antigranulocyte scintigraphy
12.3.5 Fluorodeoxyglucose positron emission tomography
12.4 Imaging in the assessment of PJI
12.4.1 Hybrid imaging and new infection-specific agents
12.4.2 Multimodality diagnostic work-up of PJI
Management of Periprosthetic Joint Infections (PJIs)
( Woodhead Publishing Series in Biomaterials )
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