The Journal of Bone and Joint Surgery (American). 2009;91:142-149.
doi:10.2106/JBJS.I.00574
© 2009 The Journal of Bone and Joint Surgery, Inc.
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Microbiological, Clinical, and Surgical Features of Fungal Prosthetic Joint Infections: A Multi-Institutional Experience

Khalid Azzam, MD1, Javad Parvizi, MD, FRCS1, Donald Jungkind, PhD, Diplomate (ABMM)2, Arlen Hanssen, MD3, Thomas Fehring, MD4, Bryan Springer, MD4, Kevin Bozic, MD5, Craig Della Valle, MD6, Luis Pulido, MD3 and Robert Barrack, MD7

1 Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, Rothman Institute, 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107. E-mail address for J. Parvizi: parvj@aol.com
2 Department of Pathology and Microbiology, Thomas Jefferson University Hospital, 207 Pavilion Building, 11th and Walnut Street, Philadelphia, PA 19107
3 Department of Orthopedic Surgery, Mayo Clinic and Mayo Foundation, 200 First Street S.W., Rochester, MN 55905
4 OrthoCarolina, 1915 Randolph Road, Charlotte, NC 28207
5 Department of Orthopaedic Surgery, University of California, San Francisco, 500 Parnassus Avenue, MU 320W, San Francisco, CA 94143-0728
6 Department of Orthopaedic Surgery, Rush University Medical Center, 1725 West Harrison Street, Suite 1063, Chicago, IL 60612
7 Department of Orthopaedic Surgery, Washington University School of Medicine, One Barnes-Jewish Hospital Plaza, 11300 West Pavilion, St. Louis, MO 63110

The first 150 words of the full text of this article appear below.


   Introduction
 
Periprosthetic joint infection is one of the most dreaded and complex complications of total joint arthroplasty. Periprosthetic joint infection is now the major cause of failure following total knee arthroplasty1 and the third most common cause of failure following total hip arthroplasty2. It is estimated that the prevalence of periprosthetic joint infection may be on the rise3. A wide variety of pathogens are known to cause periprosthetic joint infection, with the majority of infections being caused by gram-positive bacteria, especially staphylococcal species4,5. The treatment of a confirmed periprosthetic joint infection often includes the need for surgical intervention, and two-stage exchange arthroplasty is the most common mode of surgical treatment in North America. Two-stage exchange arthroplasty relies on removal of all foreign material and insertion of an antibiotic-impregnated cement spacer for the purpose of delivering high doses of antibiotics locally in the interval of time between the resection . . . [Full Text of this Article]


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