Klaus-Dieter Kühn – författare

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

Periprosthetic joint infection (PJI) is among the most serious complications in the field of endoprosthetics. The number of PJIs is increasing worldwide and poses a real interdisciplinary challenge for everyone involved. For the patient concerned, it is necessary to promptly work out an adequate therapy solution to fight off the infection. Both the clinical experience of the surgeon and the proper diagnostic processes are prerequisite for the reliable detection and identification of an infection. The microbiologist is responsible for identifying the causative germs by screening the patient’s synovial fluid and tissue samples. Based on the findings and subsequent resistance testing, the infectious disease specialist can recommend the appropriate antibiotic therapy. Furthermore, the clinical pharmacist is consulted regularly throughout the therapy to discuss the risk of potential drug interactions. The surgeon will proceed with the revision surgery, following defined algorithms. Adequate radical debridement of infected and necrotic surrounding tissue is the most important step towards a successful cure of the infection. Accompanying the surgery, anti-infective agents are given systemically and locally. While systemic application of anti-infectives mainly reduces the number of haematogenic-spreading planktonic germs, local application immediately forms a colonization barrier and protects the implant from sessile biofilm formation. Concurrently, antibiotics are actively released from the implant, resulting in local germ reduction. Thus, local agents are embedded in the concept of surgical PJI treatment as a reliable adjuvant measure and they sustainably support the successful outcome. In one-stage procedures, local agents are released from specialized antibiotic-loaded bone cements, while in two- or multi-stage procedures, local agents are released from corresponding temporary spacers (interim prostheses). Even from an economic standpoint, the combination of systemicand local agent application is meaningful. Furthermore, there are some interesting trends towards the coating of metallic implants to protect against biofilm formation on the implant surface.

On the basis of their personal experience, specialists from all over the world present, explain and discuss preventive approaches, appropriate diagnostic strategies for detection, reproducible effective surgical treatments  as well as the economic impact of PJI. The reader can use this book as a solid platform for comparing their own approach to PJI treatment with the specialists’ recommendations.  

The Editors of “Essentials of Cemented Knee Arthroplasty” have compiled a comprehensive textbook on what many consider the most successful surgical procedure of the century.  This book rounds out the compendium previously published by Springer on arthroplasty related topics: “The Well Cemented Total Hip Arthroplasty”, “PMMA Cements”, and “Management of Periprosthetic Joint Infection”.   Unique to this text is the high quality contributions from over 160 world wide experts in the field, and provides a unique international perspective on the multifaceted topic of knee replacement surgery.  Sections include a focus on Surgical Indications, Implant Design, Novel Technologies, Complications, and  Cementing Technique, amongst others. Each Chapter not only draws on the most current literature on the subject, but also crystalizes the most important points into clinically relevant, practically applicable “take home messages”.  This singular text is notable for not only its breadth, but also its depth, and will be an invaluable resource for knee arthroplasty surgeons throughout the globe.