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Challenges and Opportunities for Prosthetic Joint Infection: Prevention, Diagnosis and...
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Challenges and Opportunities for Prosthetic Joint Infection: Prevention, Diagnosis and Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: closed (31 March 2024) | Viewed by 3240

Special Issue Editor

Dr. Lorenzo Drago

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Guest Editor
Department of Biochemical Sciences for Health, University of Milan, Milan, Italy
Interests: microbiota and probiotics; prosthetic and joint infections; biofilm implant related infections; osteomyelitis; diagnosis for bone-joint infections; antimicrobials and antimicrobial devices
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Prosthetic joint infections are a major challenge in postoperative orthopedics. Despite ongoing optimization in diagnosis and treatment, infection remains a continuing concern. In the face of the continued increase in joint replacement surgery, the appropriate use of preoperative diagnostic tools, intraoperative and postoperative antibiotic use, and the optimization of aseptic technique are critical. Therefore, we are using this journal as a platform to reach a wide audience.

We hope that this Special Issue will reach a broad audience. We welcome scholars in related fields to submit prospective, retrospective, and review studies to discuss the challenges and opportunities in the prevention, diagnosis, and treatment of prosthetic joint infection.

We look forward to having you share your latest experiences in these areas with us. We hope that our work will have a positive impact on the development of effective strategies to improve the quality of life for this group of patients.

Prof. Dr. Lorenzo Drago
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • prosthetic joint infection
  • periprosthetic infection
  • arthroplasty
  • prevention
  • diagnosis
  • treatment

Published Papers (3 papers)

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Research

11 pages, 2067 KiB  
Article
A New Method for Assessing Patients’ Obesity-Associated Infection Risk Using X-rays in Hip Arthroplasties
by Sebastian Breden, Florian Hinterwimmer, Simone Beischl, Sarah Consalvo, Alexandra S. Gersing, Ulrich Lenze, Rüdiger von Eisenhart-Rothe and Carolin Knebel
J. Clin. Med. 2023, 12(23), 7277; https://doi.org/10.3390/jcm12237277 - 24 Nov 2023
Viewed by 579
Abstract
Overweight patients have higher complication rates during and after surgical procedures. In total hip arthroplasty (THA), postoperative infection is a major complication. In this study, we show that the patient’s body mass index (BMI) can be approximated by a newly developed grading system [...] Read more.
Overweight patients have higher complication rates during and after surgical procedures. In total hip arthroplasty (THA), postoperative infection is a major complication. In this study, we show that the patient’s body mass index (BMI) can be approximated by a newly developed grading system using preoperative X-rays. Furthermore, we show that a higher score and BMI result in a higher risk of infection. For this retrospective study, 635 patients undergoing THA or revision surgeries in 2018 and 2019 were included. The preoperatively acquired X-rays of the pelvis were analyzed using a four-stage grading system. The infection rate was compared to our score and the patients’ BMI. The mean BMI (95% confidence) of all patients graded as grade 0 was 25.16 (24.83; 25.50) kg/m2, for grade 1, it was 30.31 (29.52; 31.09) kg/m2, for grade 2, it was 35.06 (33.59; 36.54) kg/m2, and it was 45.03 (39.65; 50.41) kg/m2 for grade 3. The risk of infection was 4% in patients with normal radiographs, rising from 7% in patients graded as 1 up to 18% in each of the highest categories. This study shows that we were able to create a semi-quantitative grading tool for the abdominal contour displayed on X-rays of the pelvis in order to estimate the patients’ BMI and therefore the infection rate. A higher abdominal contour grade showed higher infection rates at follow-up. Full article
(This article belongs to the Special Issue Challenges and Opportunities for Prosthetic Joint Infection: Prevention, Diagnosis and Treatment)
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0 pages, 1884 KiB  
Article
Silver-Coated Distal Femur Megaprosthesis in Chronic Infections with Severe Bone Loss: A Multicentre Case Series
by Michele Fiore, Andrea Sambri, Lorenzo Morante, Marta Bortoli, Stefania Claudia Parisi, Francesco Panzavolta, Domenico Alesi, Elisabetta Neri, Maria Pia Neri, Sara Tedeschi, Eleonora Zamparini, Luca Cevolani, Davide Maria Donati, Pierluigi Viale, Domenico Andrea Campanacci, Stefano Zaffagnini and Massimiliano De Paolis
J. Clin. Med. 2023, 12(20), 6679; https://doi.org/10.3390/jcm12206679 - 23 Oct 2023
Cited by 1 | Viewed by 1220
Abstract
Periprosthetic joint infections (PJI) and fracture-related infections (FRI) of the distal femur (DF) may result in massive bone defects. Treatment options include articulated silver-coated (SC) megaprosthesis (MP) in the context of a two-stage protocol. However, there is limited evidence in the literature on [...] Read more.
Periprosthetic joint infections (PJI) and fracture-related infections (FRI) of the distal femur (DF) may result in massive bone defects. Treatment options include articulated silver-coated (SC) megaprosthesis (MP) in the context of a two-stage protocol. However, there is limited evidence in the literature on this topic. A retrospective review of the prospectively maintained databases of three Institutions was performed. Forty-five patients were included. The mean follow-up time was 43 ± 17.1 months. Eight (17.8%) patients had a recurrent infection. The estimated recurrence-free survival rate was 91.1% (93.5% PJI vs. 85.7% FRI) 2 years following MP implantation, and 75.7% (83.2% PJI vs. 64.3% FRI; p = 0.253) after 5 years. No statistically relevant difference was found according to the initial diagnosis (PJI vs. FRI). Among possible risk factors, only resection length was found to significantly worsen the outcomes in terms of infection control (p = 0.031). A total of eight complications not related to infection were found after reimplantation, but only five of them required further surgery. Above-the-knee amputation was performed in two cases (4.4%), both for reinfection. Articulated DF SC MP in a two-stage protocol is a safe and effective treatment for chronic knee infection with severe bone loss. Full article
(This article belongs to the Special Issue Challenges and Opportunities for Prosthetic Joint Infection: Prevention, Diagnosis and Treatment)
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11 pages, 371 KiB  
Article
Are ChatGPT’s Free-Text Responses on Periprosthetic Joint Infections of the Hip and Knee Reliable and Useful?
by Alexander Draschl, Georg Hauer, Stefan Franz Fischerauer, Angelika Kogler, Lukas Leitner, Dimosthenis Andreou, Andreas Leithner and Patrick Sadoghi
J. Clin. Med. 2023, 12(20), 6655; https://doi.org/10.3390/jcm12206655 - 20 Oct 2023
Cited by 1 | Viewed by 1189
Abstract
Background: This study aimed to evaluate ChatGPT’s performance on questions about periprosthetic joint infections (PJI) of the hip and knee. Methods: Twenty-seven questions from the 2018 International Consensus Meeting on Musculoskeletal Infection were selected for response generation. The free-text responses were evaluated by [...] Read more.
Background: This study aimed to evaluate ChatGPT’s performance on questions about periprosthetic joint infections (PJI) of the hip and knee. Methods: Twenty-seven questions from the 2018 International Consensus Meeting on Musculoskeletal Infection were selected for response generation. The free-text responses were evaluated by three orthopedic surgeons using a five-point Likert scale. Inter-rater reliability (IRR) was assessed via Fleiss’ kappa (FK). Results: Overall, near-perfect IRR was found for disagreement on the presence of factual errors (FK: 0.880, 95% CI [0.724, 1.035], p < 0.001) and agreement on information completeness (FK: 0.848, 95% CI [0.699, 0.996], p < 0.001). Substantial IRR was observed for disagreement on misleading information (FK: 0.743, 95% CI [0.601, 0.886], p < 0.001) and agreement on suitability for patients (FK: 0.627, 95% CI [0.478, 0.776], p < 0.001). Moderate IRR was observed for agreement on “up-to-dateness” (FK: 0.584, 95% CI [0.434, 0.734], p < 0.001) and suitability for orthopedic surgeons (FK: 0.505, 95% CI [0.383, 0.628], p < 0.001). Question- and subtopic-specific analysis revealed diverse IRR levels ranging from near-perfect to poor. Conclusions: ChatGPT’s free-text responses to complex orthopedic questions were predominantly reliable and useful for orthopedic surgeons and patients. Given variations in performance by question and subtopic, consulting additional sources and exercising careful interpretation should be emphasized for reliable medical decision-making. Full article
(This article belongs to the Special Issue Challenges and Opportunities for Prosthetic Joint Infection: Prevention, Diagnosis and Treatment)
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