PL EN


Preferencje help
Widoczny [Schowaj] Abstrakt
Liczba wyników
2015 | 64 | 2 |
Tytuł artykułu

Investigation of the actual causes of hip joint implant loosening classified as aseptic – analysis of microbiological culture results and levels of inflammatory markers

Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Loosening of the hip joint prosthesis is considered as one of the most significant postoperative complications in recent years. The laboratory diagnostic procedure used to differentiate periprosthetic infection from aseptic loosening is very difficult because of the biofilm which microorganisms form on the implant surface. The purpose of this research was to evaluate the level of concordance between clinical classification of implant loosening among 50 patients subjected to reimplantation procedure and laboratory investigation of PJI including microbiological culture results and the levels of inflammatory markers assessed in the patients’ synovial fluid samples, serum, and full blood. The synovial fluid was collected for leukocyte count, differential cell count, and culture on standard media. The levels of systemic inflammation markers such as the ESR and CRP concentration were determined in serum and full blood. Tissue samples were collected for microbiological studies. Components from endoprostheses were exposed to ultrasound in a process called sonication. Among the parameters measured in serum and full blood the levels of ESR and CRP were higher in the septic group of patients. Cytologic analysis of synovial fluid was in correlation with microbiologic identification. The most frequent isolated bacteria was Staphylococcus epidermidis. Culture results from materials such as synovial fluid, sonicate and tissues are crucial to establish the infectious aetiology of the loosening. Microscopic analysis of synovial fluid represents a simple, rapid and accurate method for differentiating PJI from aseptic failure. Sonication increases detection of the infectious process, and culture results are in correlation with the cytologic analysis of synovial fluid.
Słowa kluczowe
Wydawca
-
Rocznik
Tom
64
Numer
2
Opis fizyczny
p.129-135,ref.
Twórcy
  • Department of Medical Microbiology, Medical University, Lublin, Poland
  • Department of Medical Microbiology, Medical University, Lublin, Poland
  • Department of Medical Microbiology, Medical University, Lublin, Poland
autor
  • Department of Medical Microbiology, Medical University, Lublin, Poland
autor
  • Department of Orthopaedics and Traumatology, University of Warmia and Mazury, Olsztyn, Poland
  • Department of Orthopaedics and Traumatology, Medical University, Lublin, Poland
Bibliografia
  • Bauer T.W, J. Parvizi, N. Kobayashi and V. Krebs. 2006. Diagnosis of periprosthetic infection. J. Bone Joint Surg. 88A, 4: 869–882.
  • Bedair H., N. Ting, C. Jacovides, A. Saxena, M. Moric, J. Parvizi, and C. J. Della Valle. 2011. Diagnosis of early postoperative TKA infection using synovial fluid analysis. Clin. Orthop. Relat. Res. 469, 1: 34–40.
  • Berbari E., T. Mabry, G. Tsaras, M. Spangehl, P.J Erwin, M.H. Murad, J. Steckelberg and D.Osmon. 2010. Inflammatory blood laboratory levels as markers of prosthetic joint infection. J. Bone. Joint Surg. 92, 11: 2102–2109.
  • Chevillotte C.J., M.H Ali, R.T. Trousdale, D.R. Larson, R.E. Gullerud and D.J Berry. 2009. Inflammatory laboratory markers in periprosthetic hip fractures. J. Arthroplasty 24, 5: 722–727.
  • Cipriano C.A., N.M. Brown, A.M. Michael, M. Moric, S.M. Sporer and C.J. Della Valle. 2012. Serum and synovial fluid analysis for diagnosing chronic periprosthetic infection in patients with inflammatory arthritis. J. Bone Joint Surg. 94, 7: 594–600.
  • Courtney P. and M. Doherty. 2009. Joint aspiration and injection and synovial fluid analysis. Best Practice Res. Clin. Rheumatol. 23: 161–192.
  • Dougados M. 1996. Synovial fluid cell analysis. Baillieres Clin. Rheumatol. 10, 3: 519–534.
  • Górecki A., W. Marczyński and I. Babiak. 2008. Prophylaxis, identification and treatment of nonspecific infection of bones and joints. (in Polish.) Ortop. Traumatol. Reh. 4, 6, 10: 396–415.
  • Kumar V. and A. Sharma. 2010. Neutrophils: Cinderella of innate immune system. Int. Immunopharmacol.10: 1325–1334.
  • Leszczyńska-Gorzelak B. and E. Poniedziałek-Czajkowska. 2009. Inflammatory symptoms: immunological response, local and systemic symptoms, laboratory values. (in Polish). Zakażenia w położnictwie i ginekologii Chapter 4: 32–44.
  • Marculescu C.E. and J.R. Cantey. 2008. Polymicrobial prosthetic joint infections. Clin. Orthop. Relat. Res. 466, 6: 1397–1404.
  • Monsen T., E. Lövgren, M. Widerström and L. Wallinder. 2009. In vitro effect of ultrasound on bacteria and suggested protocol for sonication and diagnosis of prosthetic infections. J. Clin. Microbiol. 47, 8: 2496–2501.
  • Moran E., I. Byren and B.L. Atkins. 2010. The diagnosis and management of prosthetic joint infection. J. Antimicrob. Chemother. 65, 3: 45–54.
  • Parvizi J., B. Zmistowski, E.F. Berbari, T.W. Bauer, B.D. Springer, C.J. Della Valle, K.L. Garvin, M.A. Mont, M.D. Wongworawat and C.G. Zalavras. 2011. New definition for periprosthetic joint infection. J. Arthroplasty 26, 8: 1136–1138.
  • Piper K., M. Fernandez-Sampedro, K.E. Steckelberg, J.N. Mandrekar, M.J. Karau, J.M. Steckelberg, E.F. Berbari, D.R. Osmon, A.D. Hanssen, D.G. Lewallen, R.H. and others. 2010. C-reactive protein, erythrocyte sedimentation rate and orthopedic implant infection. PLoS ONE 5, 2: e9358.
  • Schinsky M.F., C.J. Della Valle, S.M. Sporer and W.G. Paprosky. 2008. Perioperative testing for joint infection In patients undergoing revision total hip arthroplasty. J. Bone Joint Surg. 90, 9: 1869–1975.
  • Shah K., A. Mohammed, S. Patil, A. McFadyen, and R.M.D. Meek. 2009. Circulating cytokines after hip and knee arthroplasty. Clin. Orthop. Relat. Res. 467, 4: 946–451.
  • Trampuz A. and W. Zimmerli. 2005. Prosthetic joint infections: update in diagnosis and treatment. Swiss Med. Wkly 135, 17–18: 243–251.
  • Trampuz A., K.E. Piper, M.J. Jacobson, A.D. Hanssen, K.K. Unni, D.R. Osmon, J.N. Mandrekar, F.R. Cockerill, J.M. Steckelberg, J.F. Greenleaf and others. 2007. Sonication of removed hip and knee prostheses for diagnosis of infection. N. Engl. J. Med. 16, 357, 7: 654–663.
  • Zimmerli W. 2006. Prosthetic-joint-associated infections. Best Pract. Res. Clin. Rheumatol. 20, 6: 1045–1063.
  • Zimmermann-Górska I., G. Białkowska-Puszczewicz and M. Puszczewicz. 1997. Analysis of synovial fluid (in Polish). Skrypt dla studentów Oddziału Analityki Medycznej, Poznań.
  • Zmistowski B., C.Restrepo, R. Huang, W.J. Hozack and J. Parvizi. 2012. Periprothetic joint infection diagnosis. A complete understanding of white blood cell count and differential. J. Arthroplasty 27, 9: 1589–1593.
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.agro-a7ad9180-088f-416b-8318-ae50e1d236d0
JavaScript jest wyłączony w Twojej przeglądarce internetowej. Włącz go, a następnie odśwież stronę, aby móc w pełni z niej korzystać.