Periprosthetic Joint Infection After Hip and Knee Arthroplasty: A Review for Emergency Care Providers Tyler A. Luthringer, BA, Yale A. Fillingham, MD,

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Presentation transcript:

Periprosthetic Joint Infection After Hip and Knee Arthroplasty: A Review for Emergency Care Providers Tyler A. Luthringer, BA, Yale A. Fillingham, MD, Kamil Okroj, BA, Edward J. Ward, MD, MPH, Craig Della Valle, MD Annals of Emergency Medicine Volume 68, Issue 3, Pages 324-334 (September 2016) DOI: 10.1016/j.annemergmed.2016.03.004 Copyright © 2016 American College of Emergency Physicians Terms and Conditions

Figure 1 Communicating sinus tract status post–total knee arthroplasty. Annals of Emergency Medicine 2016 68, 324-334DOI: (10.1016/j.annemergmed.2016.03.004) Copyright © 2016 American College of Emergency Physicians Terms and Conditions

Figure 2 Risk factors for periprosthetic joint infection. Annals of Emergency Medicine 2016 68, 324-334DOI: (10.1016/j.annemergmed.2016.03.004) Copyright © 2016 American College of Emergency Physicians Terms and Conditions

Figure 3 Adaptation of the Musculoskeletal Infection Society definition of periprosthetic joint infection.19,20 Annals of Emergency Medicine 2016 68, 324-334DOI: (10.1016/j.annemergmed.2016.03.004) Copyright © 2016 American College of Emergency Physicians Terms and Conditions

Figure 4 Highlights of the American Academy of Orthopedic Surgeons guidelines for management of periprosthetic joint infection.∗12,22 Annals of Emergency Medicine 2016 68, 324-334DOI: (10.1016/j.annemergmed.2016.03.004) Copyright © 2016 American College of Emergency Physicians Terms and Conditions

Figure 5 A, Suggested materials for basic aspiration procedure. B, Palpation and marking of the superolateral corner of the patella. C, Preparation of the skin at the aspiration site. D, Aspiration of the knee joint through the superolateral portal. Annals of Emergency Medicine 2016 68, 324-334DOI: (10.1016/j.annemergmed.2016.03.004) Copyright © 2016 American College of Emergency Physicians Terms and Conditions

Figure 6 Fluoroscopy-guided aspiration of a prosthetic hip joint. Annals of Emergency Medicine 2016 68, 324-334DOI: (10.1016/j.annemergmed.2016.03.004) Copyright © 2016 American College of Emergency Physicians Terms and Conditions

Figure 7 Plain anteroposterior radiograph of bilateral knee replacements and left-sided PJI. Bone resorption or osteolysis is evident on the left side underneath the tibial tray and at the medial portion of the femoral component. Right side is a normal comparison. Annals of Emergency Medicine 2016 68, 324-334DOI: (10.1016/j.annemergmed.2016.03.004) Copyright © 2016 American College of Emergency Physicians Terms and Conditions