The Infected Implant

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Heino Kienapfel, Klaus-Dieter Kühn
Springer Science & Business Media, Nov 21, 2009 - Medical - 139 pages
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Musculosketal infections are potentially devastating for the patient,

his family and the health care services, as they may lead to functional

impairment, long lasting disability, or even permanent handicap.

This problem may also have socioeconomic implications. Infection

commonly results in prolonged use of antibiotics, multiple operations,

complications, extended rehabilitation and long lasting followup

visits with additional costs for the health care provider.

This book covers contributions from international experts who came

together in Potsdam, Germany, at the invitation of Professor Heino

Kienapfel, MD PhD, of the Department of Special Orthopaedic

Surgery and Traumatology of the Centre of Joint Arthroplasty,

Auguste Viktoria Clinics Berlin.

The focus of this book is the state of the art of:

-Antimicrobial Resistances: Facts and Statistics

- Arthroplasty Registers in EU: Status and Development

- Microbiology in Arthroplasty

- Strategies in Antibiotic Treatment

- Spacer Management: Clinical Experiences and Requirements

- Biofilm Creation: Low Grade Infection

- Revision: Cemented vs. Cementless

- Revision: One-stage vs. Two-stage treatment

 

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Contents

The Importance of European Registers in Respect to Infections in Arthroplasty
1
Increasing Incidence of Infected THA in Norway Despite Improved Antibiotic Prophylaxis
3
Results
4
Discussion
5
References
6
Update from the Swedish Arthroplasty Registers with Special Reference to Infections
7
Results
9
Discussion
11
Results
75
Discussion
78
Literature
81
Treatment of an Infected Joint Prosthesis Difficult Challenge for an Orthopedist Surgeon
83
LowGrade Infection and Multiresistant GramPositive Cocci
85
Isolated Microorganisms
86
Biofilm
87
References
88

Status and Prospect of an European Arthroplasty Register EAR
13
Conclusion
15
The Infected Implant Microbiology and Clinical Strategies
17
Infection of Joint Prosthesis and Local Drug Delivery
19
Diagnosis and Therapy of Periprosthetic Infection
20
Local Antibiotic Delivery Systems
21
Prophylactic Measures Against Colonization and Development of Biofilm
24
References
25
Clinical Strategy for the Treatment of Deep Infection of Hip Arthroplasty
27
Single Antibiotic Therapy Chronic Suppressive Therapy
31
OneStage Exchange
33
TwoStage Exchange
34
Resection Arthroplasty
38
Conclusions
39
References
40
Infection after Total Knee Artroplasty Diagnosis Management Strategies and Outcomes
43
Materials and Methods
44
Discussion
55
Conclusion
57
Spacer Management in Periprosthetic Infections
60
NonArticulating Spacers
62
Articulating Spacers
64
Concerns
66
Advantages of Mobile Spacers
68
Conclusion
69
References
70
Observational Study of Bone Cement with Two Antibiotics in Revision Arthroplasty of Knee and Hip
73
Methods
74
Antibiotic Strategies in Septic Arthroplasties
90
Biofilm
92
Intracellular Bacteria
93
Future
95
Introduction Revision Cemented Versus Uncemented
97
Cemented revision THA
99
Discussion
100
Conclusion
102
References
103
Pro Uncemented Revision
105
Results
106
Discussion
108
Conclusion
110
References
111
The Infected Implant Revision One Stage Versus Two Stage Introduction To Crossfire Session
112
Septic Hip Prosthesis OneStage Revision
114
Reasons of a Choice
116
References
117
One Stage Revision Favourite Option?
119
Technique of OneStaged Revision Including PreOperative Precautions and Postoperative Nursery
121
Antimicrobial Agents in OneStaged Revision
124
Discussion
125
References
126
Advantages of TwoStage Revision Arthroplasty
127
Total Hip Replacement Deep Infection Management
129
Conclusion
132
Subject Index
135
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