Archives of Orthopaedic and Trauma Surgery, Journal Year: 2024, Volume and Issue: 145(1)
Published: Dec. 24, 2024
Language: Английский
Infection and Drug Resistance, Journal Year: 2025, Volume and Issue: Volume 18, P. 533 - 542
Published: Jan. 1, 2025
Diagnosing chronic periprosthetic joint infection (PJI) is challenging. Synovial fluid interleukin-10 (SF IL-10), an anti-inflammatory cytokine produced by leukocytes, plays a pivotal role in inflammation and regulation. However, limited research has explored the diagnostic potential of SF IL-10 PJI patients. The study aimed to investigate relationship between incidence PIJ, evaluate its reliability. We analyzed data from 137 patients who underwent revision surgery for aseptic loosening or 2017 2019 our hospital. diagnoses followed 2013 International Consensus Meeting criteria. measured serum ESR, CRP, PMN%, WBC levels, using logistic regression receiver operating characteristic (ROC) curves associations accuracy. Demographic showed no significant differences. levels differed significantly groups. Logistic indicated strong association (OR = 1.11, 95% CI 1.05~1.17, p < 0.001). At cut-off 10.305 pg/mL, had area under ROC curve (AUC) 0.891, with 92.16% sensitivity 77.91% specificity. Adding traditional models improved risk prediction (net reclassification improvement [NRI]: 0.167 [0.023 ~ 0.312]; integrated discrimination [IDI]: 0.160 [0.096 0.224]). Higher were associated patients, incorporating into model enhanced predictive value these
Language: Английский
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Biofilm, Journal Year: 2025, Volume and Issue: 9, P. 100264 - 100264
Published: Feb. 20, 2025
Biofilms are bacterial communities surrounded by a polymeric matrix that can form on implanted materials and biotic surfaces, resulting in chronic infection is recalcitrant to immune- antibiotic-mediated clearance. Therefore, biofilm infections present substantial clinical challenge, as treatment often involves additional surgical interventions remove the nidus, prolonged antimicrobial therapy clear residual bacteria, considerable risk of failure or recurrence. These factors, combined with progressive increases resistance, highlight need for alternative therapeutic strategies circumvent undue morbidity, mortality, resource strain healthcare system from infections. One promising option reprogramming dysfunctional immune responses elicited biofilm. Here, we review literature describing focus targets ripe translation. This represents complex dynamic context-dependent host-pathogen interactions differ across models, microenvironments, individuals. Nevertheless, consistencies among these variables exist, which could facilitate development immune-based future
Language: Английский
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Pharmaceutics, Journal Year: 2025, Volume and Issue: 17(4), P. 519 - 519
Published: April 15, 2025
Background/Objectives: Bone infection is one of the most prevalent complications in orthopedic surgery. This pathology mostly due to bacterial pathogens, among which S. aureus stands out. The formation a biofilm makes systemic treatment with antibiotics ineffective. Herein we propose nanosystem composed mesoporous bioactive glass nanoparticles (MBGN) loaded levofloxacin and functionalized N-acetylcysteine (NAC), aiming offer an alternative current treatments. These would present antibacterial activity able disintegrate regenerate peri-implantar osseous tissue. Methods: MBGN composition 82.5 SiO2—17.5 CaO have been synthesized, levofloxacin, NAC (MBGN-L-NAC). antimicrobial against mature biofilms bioactivity evaluated, as well its biocompatibility ability promote murine pre-osteoblastic MC3T3-E1 differentiation. Results: MBGNs exhibited high surface areas radial mesoporosity, allowing up 23.1% (% w/w) loading. was covalently bound keeping mucolytic thiol group, SH, available. combination enhances by disrupting integrity. biocompatible pre-osteoblasts, enhanced their differentiation towards osteoblast phenotype, promoted bio-mimetic mineralization under vitro conditions. MBGN-L-NAC induced greater osteogenic response osteoprogenitor cells through increased alkaline phosphatase expression, mineralization, stimulation pre-osteoblast nodule formation. Conclusions: exhibits more efficient disaggregation exerted NAC, also contributes enhance osteoinductive properties MBGNs, providing potential conventional strategies for management bone infections.
Language: Английский
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Journal of Experimental Orthopaedics, Journal Year: 2025, Volume and Issue: 12(2)
Published: April 1, 2025
Abstract Purpose Periprosthetic joint infections (PJI) are among the most feared complications of reconstruction. Unfortunately, traditional cultures often fail to identify aetiological agents PJI. Molecular diagnostics can overcome limitations standard synovial fluid culture by utilising information from DNA/RNA samples microbial species. The authors conducted a scoping review evaluate current state regarding use molecular in decision‐making process for surgical treatment PJI and create flowchart based on diagnostics. Methods A was provide an overview literature diagnostic techniques detecting perioperative population considered included patients undergoing total hip or knee arthroplasty replacement, with focus methods within period. database search encompassed PubMed, Embase, Scopus Cochrane Library. Results Seventy‐five articles were after preliminary 1315 records. Each article assigned one four categories fulfil purpose this review: (1) Polymerase chain reaction (PCR) related studies: n = 18; (2) Next‐Generation‐Sequencing (NGS) 40; (3) comparative studies, including systematic reviews meta‐analyses, between different methodologies: 7; (4) general nucleic acid‐based strategies detect PJIs: 10. Conclusions This confirmed that becoming extremely valuable tools treatment. Culture‐based still represent gold microorganism identification, but our showed culture, 2025, could be integrated newer strategies. Level Evidence I.
Language: Английский
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Diagnostics, Journal Year: 2024, Volume and Issue: 14(22), P. 2502 - 2502
Published: Nov. 8, 2024
The reactive enlargement of external iliac lymph nodes and increased blood flow in the infected region are commonly observed lower limb infections. We aimed to differentiate between aseptic loosening periprosthetic joint infection (PJI) after replacement surgery by quantifying number enlarged using bone scintigraphy monitor flow.
Language: Английский
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Infection and Drug Resistance, Journal Year: 2024, Volume and Issue: Volume 17, P. 5605 - 5617
Published: Dec. 1, 2024
Periprosthetic joint infection (PJI) is a severe complication following replacement surgery, and there current lack of rapid, accurate, non-invasive diagnostic methods. This study aims to assess the effectiveness using dual-energy computed tomography (DECT) quantify maximum long short axes external iliac lymph nodes (LNs) as tool for PJI. In this prospective controlled study, 112 patients undergoing total hip or knee revision surgery were enrolled. All underwent preoperative DECT scanning measure LNs on affected side. The value node size PJI was assessed receiver operating characteristic curves. AUC (Area Under Curve) quantifies method's ability distinguish between positive negative outcomes in study. A closer 1.0 indicates better discriminatory performance. Compared erythrocyte sedimentation rate Curve (AUC) = 0.834), percentage polymorphonuclear leukocytes (AUC 0.621), C-reactive protein 0.765), axis =0.895) 0.858) differentiated from aseptic failure. For diagnosing PJI, threshold 20.5 mm, with sensitivity 84.21% specificity 87.84%. axis, 8.5 89.47% 82.43%. Combining enhanced accuracy Measuring an effective approach aiding differentiation failure surgery.
Language: Английский
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Prosthesis, Journal Year: 2024, Volume and Issue: 6(5), P. 1240 - 1258
Published: Oct. 16, 2024
Background/Objectives: Periprosthetic joint infection (PJI) is one of the most common complications after replacement. Two-stage revision remains standard care in chronic infections. The aim this systematic review was to investigate outcomes, complications, and eradication rates two-stage surgery treat PJI shoulder, elbow, hip, knee. Methods: A total 36 studies were included. Patient demographics, follow-up, visual analog scale (VAS) for pain, Constant–Murley score (CMS) Harris Hip Score (HHS) Knee Society (KSS) knee, range motion (ROM), number types rate recorded. Results: 2484 patients identified, whom 145, 29, 1269, 1041 underwent knee infections, respectively. overall mean follow-up 5.7 ± 4.5 years. time re-implantation 20.8 21.3 weeks. causative bacteria Cutibacterium acnes (32.7%) Methicillin-Sensitive Staphylococcus aureus (44.4%) coagulase negative (CNS) (31.3% 23%) hip infection, preoperative VAS 6.7 2.3, while, postoperatively, 2.7 (p < 0.001). 2059 out (82.9%) experienced eradication. Conclusions: an effective procedure with 83%. significant recovery functionality a decrease residual pain can be achieved surgery. Aseptic loosening re-infection shoulder Death high
Language: Английский
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Frontiers in Microbiology, Journal Year: 2024, Volume and Issue: 15
Published: Dec. 20, 2024
Postoperative infections in artificial joints provide considerable difficulties the field of orthopedics, especially after joint replacement procedures. These rank among most severe postoperative consequences, frequently leading to treatment ineffectiveness and reduced quality life for surgery patients. Consequently, it is crucial acquire knowledge about worldwide research trends this area order educate clinical practices improve therapeutic techniques. This work exploits bibliometric analysis investigate present state, developing patterns, main areas focus on infection.
Language: Английский
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Archives of Orthopaedic and Trauma Surgery, Journal Year: 2024, Volume and Issue: 145(1)
Published: Dec. 24, 2024
Language: Английский
Citations
0