Navigation Links
A new definition for periprosthetic joint infection
Date:11/4/2011

(PHILADELPHIA) A rise in periprosthetic joint infection (PJI) rates has the orthopedic community moving to develop it's first-ever agreed upon definition and diagnostic criteria to help better treat patients.

The proposed criteria, published in the November issue of Clinical Orthopaedics and Related Research, was developed by a Musculoskeletal Infection Society working group led by Javad Parvizi, M.D., director of Research at the Rothman Institute at Jefferson. The group analyzed available research, much of which was conducted at Jefferson, to develop the new definition and criteria.

"Our aim was to develop a "gold standard" definition to serve as a roadmap for diagnosing patients with suspected PJI that could be universally adopted by the industry," said Dr. Parvizi.

PJI occurs in a replacement joint and is often found deep inside the joint prosthesis. It has become a major concern for the orthopedic community as antibiotic-resistance organisms have increased the prevalence of post-surgical periprosthetic infections. Deep periprosthetic joint infection is currently the most common indication for revision of total knee arthroplasty and the third most frequent indication for revision of total hip arthroplasty. The criteria will also be published in the December issue of the Journal of Arthroplasty.

The group's recommendations include sterile sampling of the periprosthetic tissue or fluid for the presence of virulent organisms, such as Staphylococcus aureus (S. aureus), the culprit in staph infections; and testing the blood serum surrounding the joint for elevated levels of known biomarkers for systemic inflammation and infection, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). They recommend certain considerations as the level of serum markers is affected by age, sex and medical comorbidities.

Aspiration and supplementary testing of the synovial fluid, the viscous liquid that lubricates the joints and feeds the cartilage is suggested to look for elevated white blood cell counts, specifically the percentage of neutrophils (PMN%), plentiful in infected bone marrow.

The appearance of joint during surgery, presence or absence of a sinus tract, and the result of histological analysis of tissue obtained during surgery (frozen section) are also recommended to consider in diagnosing PJI.

"Patients with PJI could suffer unintended consequences if their infection is not identified and treated hastily," said Dr. Parvizi. "Without an industry-wide definition, research, diagnosis and treatment cannot be uniform."

Numerous other Jefferson research studies are underway that will help fine-tune the recommendations in the future.

Recent research conducted by Parvizi et. al. tested levels of C-reactive protein (CRP) in the synovial fluid of septic patients. Their findings showed significantly elevated levels of CRP, with levels of 46.27 mg/L in the synovial fluid of septic patients compared to 1.64 mg/L in aseptic patients. The initial findings of this study have been published in Clinical Orthopeadics and Related Research and won the Mark Coventry Award for basic science research at the 2011 American Knee Society annual meeting in July and the Clinical Research Award from the American Association of Hip and Knee Surgeons (AAHKS). It will be presented at a podium presentation on Saturday, November 5th at the AAHKS annual meeting in Dallas.

"It's important to get to the root of the cause of PJI so that we can begin to get ahead of it at Jefferson and across the industry and turn the tide," said Dr. Parvizi. "Using this definition, we will now be more confident in our diagnosis and be able to provide appropriate treatment for patients."

To date their criteria has been evaluated and endorsed by the Knee Society, the Hip Society, the Infectious Disease Society of North America (IDSNA), the American Association of Orthopedic Surgeons (AAOS) and the CDC.


'/>"/>

Contact: Lee-Ann Landis
leeann.landis@jefferson.edu
215-459-2092
Thomas Jefferson University
Source:Eurekalert

Related medicine news :

1. 1 person of 1,900 met AHAs definition of ideal heart health, says University of Pittsburgh study
2. Society of Interventional Radiology advances global definition of specialty, benefits patients
3. IU study finds no consensus in definitions of had sex
4. Longview Therapy Center, PLLC, Unveils Its Definition Of Hope
5. Race Tied to Risk for Arthritis in Large Joints
6. Joint preservation in osteoarthritis
7. More African-Americans burdened by osteoarthritis in multiple large joints
8. FDA and NIH announce joint study on tobacco use and risk perceptions
9. Radiation boost for artificial joints
10. Lawson scientist presents joint pain treatment 2.0
11. Vitamin D relieves joint, muscle pain for breast cancer patients
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:8/17/2017)... ... August 17, 2017 , ... Inc. Magazine Unveils 36th Annual List ... with Three-Year Sales Growth of 3,004.8% , NEW YORK, August 16, 2017 – Inc. ... most prestigious ranking of the nation's fastest-growing private companies. The list represents a unique ...
(Date:8/17/2017)... ... ... Momkus McCluskey Roberts LLC recently announced it was naming attorney ... firm’s Commercial Litigation and Employment Law groups. , Ms. Parks joined Momkus McCluskey ... employment litigation, commercial litigation and business disputes. Her experience includes all aspects of litigation ...
(Date:8/17/2017)... Yorba Linda, Ca (PRWEB) , ... August 17, 2017 , ... ... centrifuges are useful tools in the laboratory that we can no longer do without. ... to prolong the lifetime of your device. , In this webinar, attendees will learn ...
(Date:8/17/2017)... Yorba Linda, Ca (PRWEB) , ... August 17, 2017 , ... ... by the FDA to the biopharmaceutical industry in 2016 cited deficiencies in data integrity. ... their 21 CFR Part 11 ruling. , Presented as part of the ...
(Date:8/16/2017)... ... , ... Summer days spent with family are priceless. Since August is Family ... enjoying the season of sunshine. Add trying something new to this summer’s bucket list. ... on the fun. , Try Something New , Choose an activity ...
Breaking Medicine News(10 mins):
(Date:8/7/2017)... , Aug. 7, 2017  Endo International plc (NASDAQ: ... agreements to resolve virtually all known U.S. mesh product ... to resolve the known remaining U.S. claims at reasonable ... beginning in the fourth quarter of 2017 and continuing ... its second quarter 2017 results, the Company intends to ...
(Date:8/3/2017)... , Aug. 3, 2017  Opioid addiction and ... driving up healthcare costs and threatening outcomes, were problems ... supply and IVD industry that support them, met this ... market researcher said that drugs of abuse, procalcitonin and ... sessions at the organization,s 69th meeting in ...
(Date:8/2/2017)... Aug. 2, 2017  Life Flight Network and PeaceHealth Oregon ... improves patient care and operational efficiency for patients at hospitals ... , Cottage Grove , and ... PeaceHealth and Life Flight Network work collaboratively to move patients ... or when a time sensitive emergency exists. ...
Breaking Medicine Technology: