Arthroplasty Complications Clinical Trial
Official title:
Antibiotic Elution Profile and Outcomes in the Treatment of Prosthetic Joint Infections of the Knee
Patients presenting with prosthetic joint infections of a total knee replacement who are treated with an antibiotic spacer will be observed prospectively for their response to treatment and antibiotic elution profiles will be measured post-operatively utilizing mass spectrometry from synovial fluid acquired as part of standard of care in the management of prosthetic joint infection. Secondary outcomes including post-operative complications, re-operation rates, and re-admission rates will also be compared.
Status | Recruiting |
Enrollment | 10 |
Est. completion date | December 31, 2026 |
Est. primary completion date | December 31, 2024 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Patients planned for treatment of a total knee arthroplasty prosthetic joint infection - Patients greater than 18 years of age - Patients able to provide informed consent Exclusion Criteria: - Prior history of ipsilateral or contralateral prosthetic joint infection warranting operative management - Patients less than 18 years of age - Patients unable to provide informed consent. |
Country | Name | City | State |
---|---|---|---|
United States | UPMC Shadyside | Pittsburgh | Pennsylvania |
Lead Sponsor | Collaborator |
---|---|
University of Pittsburgh |
United States,
Anagnostakos K, Wilmes P, Schmitt E, Kelm J. Elution of gentamicin and vancomycin from polymethylmethacrylate beads and hip spacers in vivo. Acta Orthop. 2009 Apr;80(2):193-7. doi: 10.3109/17453670902884700. — View Citation
Chen AF, Parvizi J. Antibiotic-loaded bone cement and periprosthetic joint infection. J Long Term Eff Med Implants. 2014;24(2-3):89-97. doi: 10.1615/jlongtermeffmedimplants.2013010238. — View Citation
Slane J, Gietman B, Squire M. Antibiotic elution from acrylic bone cement loaded with high doses of tobramycin and vancomycin. J Orthop Res. 2018 Apr;36(4):1078-1085. doi: 10.1002/jor.23722. Epub 2017 Sep 20. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Intra-articular Antibiotic Elution Profile | Antibiotic concentration will be quantified utilizing mass spectrometry from intra-articular synovial fluid obtained from post-operative drain and knee aspirations performed for re-implantation evaluation. | Post-operative day 2 and during 2nd stage re-implantation evaluation (around 10 weeks according to standard of care) | |
Secondary | Drain Output | Measured volume of output from post-operative drain will be quantified every 12 hours | Each 12 hours period until removal of the drain up to 5 days postoperatively based on drain output less than 30cc in 12 hours. | |
Secondary | Wound Healing Complications | Any issues with wound healing including closure, occurrence of infection, high drainage, or hematoma formation will be among wound healing complications which are measured. | up to 6 months following surgery | |
Secondary | Re-operation Rates | Rates of return to operating room will be quantified over course of 30 days and 90 days. | 30 days and 90 days post-operatively. | |
Secondary | Re-admission Rates | Rates of re-admission will be quantified over course of 30 days and 90 days. | 30 days and 90 days post-operatively. | |
Secondary | Pain Scores | Pain scores utilizing visual analog scale from 0 to 10 will be quantified during post-operative course. | Daily on postop day 0 until postop day 5, 3 weeks, 6 weeks and 10 weeks, 6 months postoperatively. | |
Secondary | Second Stage Re-implantation Rates | Rates of successful second stage re-implantation will be quantified during the post-operative course. | Through study completion up to 1 year | |
Secondary | Knee aspiration cell count | Knee aspiration with number of white cells less than 1300 | 3 weeks, 6 weeks and 10 weeks - 6 months postoperatively. | |
Secondary | Knee aspiration culture | Knee aspiration without evidence of bacteria on bacterial culture | 3 weeks, 6 weeks and 10 weeks - 6 months postoperatively. | |
Secondary | C-reactive protein assessment | C-reactive protein normalization (less than 1mg/dl) | baseline, 10 weeks to 6 months posteroperatively | |
Secondary | ESR assessment | Erythrocyte sedimentation rate normalization (less than 20 mm/hr) | baseline, 10 weeks to 6 months posteroperatively |
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