Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
7.3
4.3
Journals
Antibiotics
Special Issues
Antibiotics in Orthopedic Infections, 2nd Volume
share announcement

Antibiotics in Orthopedic Infections, 2nd Volume

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotics Use and Antimicrobial Stewardship".

Deadline for manuscript submissions: closed (31 March 2024) | Viewed by 16714

Special Issue Editors

Prof. Dr. Sascha Gravius

E-Mail Website
Guest Editor
Department of Orthopaedic and Trauma Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1–3, 68167 Mannheim, Germany
Interests: primary and revision joint arthroplasty of hip and knee; diagnostics and therapy of bone and joint infections; antibiotic resistance
Dr. Ali Darwich

E-Mail Website
Guest Editor
Department of Orthopaedic and Trauma Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1–3, 68167 Mannheim, Germany
Interests: primary and revision joint arthroplasty of hip and knee; diagnostics and therapy of bone and joint infections; antibiotic resistance

Special Issue Information

Dear Colleagues,

Despite the great interest and attention given to orthopedic especially periprosthetic and implant-associated infections, including improvements in the diagnosis and therapy algorithms, as well as the advances in preventive measures and perioperative preparations, orthopedic infections remain a considerable challenge and deserve our undivided attention. In this context, various diagnostic tools have been developed and suggested to allow the early detection of pathogens, especially low virulence microorganisms, as well as diverse therapeutic protocols and surgical techniques—particularly in cases of extensive antibiotic resistance. In addition, the role of biofilms, particularly in the context of periprosthetic infections as well as systemic and local antibiotics, remains essential to reach satisfactory outcomes.

This Special Issue of Antibiotics deals with these topics. The Issue welcomes original research papers, short communications, reviews, case reports, and perspectives.

Potential topics for this Special Issue include but are not limited to:

  • Diagnostic methods in orthopedic infections;
  • Role of local antibiotics in orthopedic infections;
  • Systemic antibiotic therapy in bone and joint infections;
  • Resistant pathogens in orthopedic infections;
  • Biofilms in orthopedic infections;
  • Periprosthetic and implant-associated infections.

Prof. Dr. Sascha Gravius
Dr. Ali Darwich
Guest Editors

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. Antibiotics is an international peer-reviewed open access monthly 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 2900 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

  • orthopedic infections
  • antibiotic resistance
  • bone and joint infection

Benefits of Publishing in a Special Issue

  • Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
  • Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
  • Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
  • External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
  • e-Book format: Special Issues with more than 10 articles can be published as dedicated e-books, ensuring wide and rapid dissemination.

Further information on MDPI's Special Issue polices can be found here.

Published Papers (9 papers)

Download All Papers
Order results
Result details
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:

Research

Jump to: Review, Other

11 pages, 4973 KiB  
Article
Mouldable Collagen–Tricalciumphosphate Is a Safe Carrier for Local Antibiotics—Short-Term Results in Revision Hip Arthroplasty
by Yannik Hanusrichter, Carsten Gebert, Sven Frieler, Burkhard Moellenbeck, Marcel Dudda, Martin Wessling and Christoph Theil
Antibiotics 2024, 13(6), 510; https://doi.org/10.3390/antibiotics13060510 - 30 May 2024
Viewed by 1158
Abstract
Background: Improving local antibiotic delivery is a promising approach to improve infection control and potentially shorten systemic treatment in periprosthetic joint infection (PJI). This study investigates the use of an antibiotic-loaded, mouldable collagen–tricalciumphosphate composite in treatment of hip PJI. Methods: 124 application cases [...] Read more.
Background: Improving local antibiotic delivery is a promising approach to improve infection control and potentially shorten systemic treatment in periprosthetic joint infection (PJI). This study investigates the use of an antibiotic-loaded, mouldable collagen–tricalciumphosphate composite in treatment of hip PJI. Methods: 124 application cases in 79 patients were included from a referral centre; systemic adverse infects, local complications, and infection control were analysed. Results: In most cases, either vancomycin or meropenem were used. Pathogens were previously known in 82 (66%) cases with polymicrobial infection in 20 (25%) patients. There were no cases of hypercalcaemia. Acute kidney injure was present in 14 (11%) cases. Chronic kidney failure persisted in two cases. During a mean follow-up of 12 (SD 9.3; range 3–35) months, implant survival was achieved in 73 (92%) patients; revision due to PJI was performed in 19 cases. Conclusion: Mouldable collagen–tricalciumphosphate composite bone substitute as a local antibiotic carrier in revision hip arthroplasty appears to be a valid option for local antibiotic delivery without systemic complications. Implant survival of 92% supports the hypothesis that local antibiotic therapy is an important component in the treatment of PJI. Full article
(This article belongs to the Special Issue Antibiotics in Orthopedic Infections, 2nd Volume)
►▼ Show Figures

Figure 1

14 pages, 1154 KiB  
Article
Early-Outcome Differences between Acute and Chronic Periprosthetic Joint Infections—A Retrospective Single-Center Study
by Yasmin Youssef, Elisabeth Roschke, Nadine Dietze, Anna-Judith Dahse, Iris F. Chaberny, Donald Ranft, Christina Pempe, Szymon Goralski, Mohamed Ghanem, Regine Kluge, Christoph Lübbert, Arne C. Rodloff and Andreas Roth
Antibiotics 2024, 13(3), 198; https://doi.org/10.3390/antibiotics13030198 - 20 Feb 2024
Cited by 1 | Viewed by 2253
Abstract
Periprosthetic joint infections (PJI) are serious complications after arthroplasty, associated with high morbidity, mortality, and complex treatment processes. The outcomes of different PJI entities are largely unknown. The aim of this study was to access the early outcomes of different PJI entities. A [...] Read more.
Periprosthetic joint infections (PJI) are serious complications after arthroplasty, associated with high morbidity, mortality, and complex treatment processes. The outcomes of different PJI entities are largely unknown. The aim of this study was to access the early outcomes of different PJI entities. A retrospective, single-center study was conducted. The characteristics and outcomes of patients with PJI treated between 2018 and 2019 were evaluated 12 months after the completion of treatment. Primary endpoints were mortality, relapse free survival (RFS) and postoperative complications (kidney failure, sepsis, admission to ICU). A total of 115 cases were included [19.1% early (EI), 33.0% acute late (ALI), and 47.8% chronic infections (CI)]. Patients with ALI were older (p = 0.023), had higher ASA scores (p = 0.031), preoperative CRP concentrations (p = 0.011), incidence of kidney failure (p = 0.002) and sepsis (p = 0.026). They also tended towards higher in-house mortality (ALI 21.1%, 13.6% EI, 5.5% CI) and admission to ICU (ALI 50.0%, 22.7% EI, 30.9% CI). At 12 months, 15.4% of patients with EI had a relapse, compared to 38.1% in ALI and 36.4% in CI. There are differences in patient characteristics and early outcomes between PJI entities. Patients with EI have better early clinical outcomes. Patients with ALI require special attention during follow-up because they have higher occurrences of relapses and postoperative complications than patients with EI and CI. Full article
(This article belongs to the Special Issue Antibiotics in Orthopedic Infections, 2nd Volume)
►▼ Show Figures

Figure 1

10 pages, 581 KiB  
Article
Two-Stage Revision Arthroplasty for Resistant Gram-Positive Periprosthetic Joint Infections Using an Oral Linezolid-Based Antibiotic Regime
by Lars Gründer, Sebastian Bockholt, Georg Gosheger, Martin Schulze, Jan Schwarze, Jan Pützler, Burkhard Moellenbeck and Christoph Theil
Antibiotics 2023, 12(8), 1235; https://doi.org/10.3390/antibiotics12081235 - 26 Jul 2023
Cited by 1 | Viewed by 1417
Abstract
Background: Increasing antibiotic resistance has been reported as an issue in the systemic treatment of periprosthetic joint infection (PJI). Linezolid offers the advantages of high oral bioavailability and little resistance; however, efficacy in the treatment of PJI varies considerably, and studies reporting consistent [...] Read more.
Background: Increasing antibiotic resistance has been reported as an issue in the systemic treatment of periprosthetic joint infection (PJI). Linezolid offers the advantages of high oral bioavailability and little resistance; however, efficacy in the treatment of PJI varies considerably, and studies reporting consistent surgical treatment are scarce. Methods: This is a retrospective, single-center analysis of two-stage revisions performed between 2008 and 2017. We identified 111 patients who met the inclusion criteria. Oral linezolid was given for 28 days following 14 days of intravenous tailored antibiotics in resistant gram-positive PJI. A total of 64% of the patients had methicillin-resistant coagulase-negative staphylococci. The median follow-up was 43 (interquartile range (IQR) 30–57) months. Results: 22% (24/111) of the patients underwent surgery for subsequent infection. The 5-year infection-free survival probability was 77% (95% confidence interval (CI) 69–85). A total of 5% of the patients (6/111) had the same organism at the time of reinfection. The patients with infections caused by other organisms than Coagulase-negative staphylococci tended to have a worse reinfection-free survivorship at five years (70% vs. 81%, p = 0.09). Furthermore, the patients with obesity tended to have reduced reinfection-free survivorship at five years (69% vs. 84%, p = 0.08). Overall, 5% (6/111) of the patients had blood count abnormalities with no treatment discontinuations. Conclusion: Two-stage revision arthroplasty with systemic oral linezolid treatment for resistant gram-positive PJI results in an infection control of 77% at the mid-term. Full article
(This article belongs to the Special Issue Antibiotics in Orthopedic Infections, 2nd Volume)
►▼ Show Figures

Figure 1

9 pages, 254 KiB  
Article
Total Knee Arthroplasty in Unrecognized Septic Arthritis—A Descriptive Case Series Study
by Florian Hubert Sax and Bernd Fink
Antibiotics 2023, 12(7), 1153; https://doi.org/10.3390/antibiotics12071153 - 6 Jul 2023
Cited by 1 | Viewed by 1459
Abstract
Background: Synovitis, like that associated with chronic bacterial arthritis, is a very rare finding during the implantation of knee endoprostheses. In such cases, we fix the knee prostheses with cement containing two antibiotics and carry out a course of systemic antibiotic administration. The [...] Read more.
Background: Synovitis, like that associated with chronic bacterial arthritis, is a very rare finding during the implantation of knee endoprostheses. In such cases, we fix the knee prostheses with cement containing two antibiotics and carry out a course of systemic antibiotic administration. The aim was to analyze these cases for incidence, detection of bacteria, risk factors, and outcome. Methods: Out of 7534 knee replacements between January 2013 and December 2020, 25 cases were suspected during the surgical procedure to have suffered from bacterial arthritis and were treated accordingly. Total synovectomy was carried out, whereby five intraoperative synovial samples were examined bacteriologically, and the complete synovitis was analyzed histologically. The mean follow-up was 65.3 ± 27.1 (24–85) months. Results: In nine cases (0.12%), the diagnosis of bacterial arthritis was made histologically and by clinical chemistry (elevated CRP), and in two of these cases, pathogen verification was performed. Eight of these nine patients had previously had injections or surgery associated with the corresponding knee joint or had an underlying immunomodulatory disease. None of the patients developed a periprosthetic infection at a later stage. Conclusion: With an incidence of 0.12%, it is rare to unexpectedly detect bacterial synovitis during surgery. Total synovectomy, use of bone cement with two antibiotics, and immediate systemic antibiotic therapy seem to keep the risk of periprosthetic infection low. Full article
(This article belongs to the Special Issue Antibiotics in Orthopedic Infections, 2nd Volume)
12 pages, 251 KiB  
Article
Is Vancomycin More Effective than Taurolidine? Comparative Analysis of Their Preventive Effect against Spinal Infection in 1000 Patients with Spinal Fusion
by Dong-Chan Eun, Kyung-Soo Suk, Hak-Sun Kim, Ji-Won Kwon, Seong-Hwan Moon, Yong-Ho Lee and Byung-Ho Lee
Antibiotics 2022, 11(10), 1388; https://doi.org/10.3390/antibiotics11101388 - 11 Oct 2022
Cited by 5 | Viewed by 1842
Abstract
This study aimed to examine the effect of taurolidine irrigation on preventing surgical site infection by comparing the spinal infection rate after spinal fusion surgery using vancomycin powder application and taurolidine irrigation. Of 1081 participants, 369 underwent taurolidine irrigation, 221 underwent vancomycin powder [...] Read more.
This study aimed to examine the effect of taurolidine irrigation on preventing surgical site infection by comparing the spinal infection rate after spinal fusion surgery using vancomycin powder application and taurolidine irrigation. Of 1081 participants, 369 underwent taurolidine irrigation, 221 underwent vancomycin powder application, and 491 were controls. Of the 20 surgical site infections (1.85%), 14 occurred in the control group (2.85%), 5 in the vancomycin group (2.26%), and 1 (0.27%) in the taurolidine group. Among the various variables, age at the time of surgery, smoking, surgical site, and hemovac removal time were significant in the univariate logistic regression. The final result was derived after variable selection using the stepwise method. In the univariate model, the odds ratios were 0.09 and 0.79 in each of the vancomycin and taurolidine groups compared to that of the control group. In the multivariate model, the odds ratios were 0.09 and 0.83 in each of the vancomycin and taurolidine groups compared to that of the control group. The preventive effect of vancomycin powder application was not statistically significant. However, the vancomycin group showed a less effective tendency than the taurolidine group. Taurolidine irrigation may be a good substitute for the vancomycin powder application. Full article
(This article belongs to the Special Issue Antibiotics in Orthopedic Infections, 2nd Volume)
11 pages, 1963 KiB  
Article
Diagnostic Value of CRP and Serum WBC Count during Septic Two-Stage Revision of Total Hip Arthroplasties
by Moritz Mederake, Ulf K. Hofmann, Sebastian Benda, Philipp Schuster and Bernd Fink
Antibiotics 2022, 11(8), 1098; https://doi.org/10.3390/antibiotics11081098 - 12 Aug 2022
Cited by 6 | Viewed by 1882
Abstract
The diagnostic value of C-reactive protein (CRP) and the serum white blood cell (WBC) count is still barely defined for decision making during septic two-stage revision surgery of hip arthroplasty. We, therefore, compared these values between stages as well as between the groups [...] Read more.
The diagnostic value of C-reactive protein (CRP) and the serum white blood cell (WBC) count is still barely defined for decision making during septic two-stage revision surgery of hip arthroplasty. We, therefore, compared these values between stages as well as between the groups without and with reinfection in 117 patients. A total of 106 patients were reinfection-free (91%). The median follow-up was 51 months. With a ΔCRP of −10 mg/L and a ΔWBC count of −1000/µL, a significant decrease between stages (p = 0.001) could be observed. When comparing the CRP and WBC count values between groups, however, no significant difference was found at stage one, stage two and even the difference between these two time points (reinfection-free ΔCRP of −11 mg/L and ΔWBC count of −1000/µL vs. reinfection ΔCRP of −5 mg/L (p = 0.131) and ΔWBC count of −1100/µL) (p = 0.424). The diagnostic value was poor for the calculated parameters (area under the curve (AUC) 0.5–0.6). The courses of the mean CRP values of both groups were similar. We conclude that the CRP and WBC count are not helpful to guide the decision making in individual cases. Full article
(This article belongs to the Special Issue Antibiotics in Orthopedic Infections, 2nd Volume)
►▼ Show Figures

Figure 1

Review

Jump to: Research, Other

12 pages, 804 KiB  
Review
Antifungal-Loaded Acrylic Bone Cement in the Treatment of Periprosthetic Hip and Knee Joint Infections: A Review
by Konstantinos Anagnostakos, Sören L. Becker and Ismail Sahan
Antibiotics 2022, 11(7), 879; https://doi.org/10.3390/antibiotics11070879 - 30 Jun 2022
Cited by 12 | Viewed by 2491
Abstract
Little is known about the clinical use of antifungal-loaded acrylic bone cement in the treatment of periprosthetic hip and knee joint infections (PJIs). Hence, we performed a literature search using PubMed/MEDLINE from inception until December 2021. Search terms were “cement” in combination with [...] Read more.
Little is known about the clinical use of antifungal-loaded acrylic bone cement in the treatment of periprosthetic hip and knee joint infections (PJIs). Hence, we performed a literature search using PubMed/MEDLINE from inception until December 2021. Search terms were “cement” in combination with 13 antifungal agents. A total of 10 published reports were identified, which described 11 patients and 12 joints in which antifungal-loaded cement was employed. All studies were case reports or case series, and no randomized controlled trials were identified. In 6 of 11 patients, predisposing comorbidities regarding the emergence of a fungal PJI were present. The majority of the studies reported on infections caused by Candida species. In six cases (seven joints), the cement was solely impregnated with an antifungal, but no antibiotic agent (amphotericin B, voriconazole, and fluconazole). In the other five joints, the cement was impregnated with both antibiotic(s) and antifungals. Great discrepancies were seen regarding the exact loading dose. Four studies investigated the local elution of antifungal agents in the early postoperative period and observed a local release of antifungals in vivo. We conclude that there is a paucity of data pertaining to the clinical use of antifungal-loaded bone cement, and no studies have assessed the clinical efficacy of such procedures. Future studies are urgently required to evaluate this use of antifungals in PJI. Full article
(This article belongs to the Special Issue Antibiotics in Orthopedic Infections, 2nd Volume)
►▼ Show Figures

Figure 1

Other

Jump to: Research, Review

16 pages, 2250 KiB  
Systematic Review
One- vs. Two-Stage Revision for Periprosthetic Shoulder Infections: A Systematic Review and Meta-Analysis
by Mohamad Bdeir, Aimée Lerchl, Svetlana Hetjens, Andreas Schilder, Sascha Gravius, Tobias Baumgärtner and Ali Darwich
Antibiotics 2024, 13(5), 440; https://doi.org/10.3390/antibiotics13050440 - 14 May 2024
Cited by 1 | Viewed by 1488
Abstract
Periprosthetic shoulder infection (PSI) remains a challenging complication after shoulder arthroplasty. Therapeutic options include one- or two-stage revision, irrigation and debridement, and resection arthroplasty. With our systematic review and meta-analysis, we aimed to compare one- and two-stage revisions for periprosthetic shoulder joint infections [...] Read more.
Periprosthetic shoulder infection (PSI) remains a challenging complication after shoulder arthroplasty. Therapeutic options include one- or two-stage revision, irrigation and debridement, and resection arthroplasty. With our systematic review and meta-analysis, we aimed to compare one- and two-stage revisions for periprosthetic shoulder joint infections and determine the most appropriate therapeutic procedure. We performed an extensive literature search in PubMed, Ovid Medline, Cochrane Library, Web of Science, and CINAHL and filtered out all relevant studies. The meta-analysis was performed using the random-effects model, heterogeneity was analyzed using I2, and publication bias was assessed using the Egger’s test. A total of 8 studies with one-stage revisions, 36 studies with two-stage revisions, and 12 studies with both one-stage and two-stage revisions were included. According to the random-effects model, the reinfection rate for the entirety of the studies was 12.3% (95% Cl: 9.6–15.3), with a low-to-moderate heterogeneity of I2 = 47.72%. The reinfection rate of the one-stage revisions was 10.9%, which was significantly lower than the reinfection rate of the two-stage revisions, which was 12.93% (p = 0.0062). The one-stage revision rate was significantly lower with 1.16 vs. 2.25 revisions in the two-stage revision group (p < 0.0001). The postoperative functional outcome in one-stage-revised patients was comparable but not statistically significant (p = 0.1523). In one- and two-stage revisions, most infections were caused by Cutibacterium acnes. In summary, our systematic review and meta-analysis show the superiority of single-stage revision regarding reinfection and revision rates in periprosthetic shoulder joint infection. Full article
(This article belongs to the Special Issue Antibiotics in Orthopedic Infections, 2nd Volume)
►▼ Show Figures

Figure 1

19 pages, 2835 KiB  
Systematic Review
Cemented versus Cementless Stem Fixation in Revision Total Knee Arthroplasty: A Systematic Review and Meta-Analysis
by Ali Darwich, Andrea Jovanovic, Franz-Joseph Dally, Asseel Abd El Hai, Tobias Baumgärtner, Elio Assaf, Sascha Gravius, Svetlana Hetjens and Mohamad Bdeir
Antibiotics 2023, 12(11), 1633; https://doi.org/10.3390/antibiotics12111633 - 17 Nov 2023
Cited by 2 | Viewed by 1882
Abstract
The number of revision knee arthroplasties (rTKA) is growing significantly as is the use of intramedullary stems for optimized stability. The choice of the most appropriate stem fixation method is still controversial. The purpose of this meta-analysis is to compare cemented versus cementless [...] Read more.
The number of revision knee arthroplasties (rTKA) is growing significantly as is the use of intramedullary stems for optimized stability. The choice of the most appropriate stem fixation method is still controversial. The purpose of this meta-analysis is to compare cemented versus cementless stem fixation in rTKA. Publications with patients undergoing rTKA with a follow-up > 24 months were systemically reviewed. Extracted parameters included total revision and failure rates for any reason, incidence of aseptic loosening, periprosthetic infection, and radiolucent lines, as well as the clinical outcome. A statistical regression analysis was then performed on all extracted clinical and radiological outcome data. A total of 35 publications met the inclusion criteria and were included and analyzed. Overall, 14/35 publications compared cementless versus cemented stem fixation, whereas 21/35 publications investigated only one stem fixation method. There were no significant differences in revision (p = 0.2613) or failure rates (p = 0.3559) and no differences in the incidence of aseptic loosening (p = 0.3999) or periprosthetic infection (p = 0.1010). The incidence of radiolucent lines was significantly higher in patients with cemented stems (26.2% versus 18.6%, p < 0.0001). However, no differences in clinical outcomes were observed. No superiority of a specific stem fixation method in rTKA was found. Rates of revision or failure for any reason as well as incidence of aseptic loosening and periprosthetic infection in cemented versus cementless stem fixation showed no significant difference. A higher incidence of radiolucent lines was observed in cemented stem fixation; however, no effect was observed on the clinical outcome. Full article
(This article belongs to the Special Issue Antibiotics in Orthopedic Infections, 2nd Volume)
►▼ Show Figures

Figure 1

Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying articles 1-9
Back to TopTop