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Bone & Joint Journal

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https://www.readbyqxmd.com/read/29092998/michael-alexander-reykers-freeman-ba-cantab-1953-mb-bch-cantab-1956-frcs-1959-md-cantab-1964-md-hc-swe-1992-1931-to-2017
#1
G Scott
No abstract text is available yet for this article.
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092997/the-orthopaedic-manifestation-and-outcomes-of-methicillin-sensitive-staphylococcus-aureus-septicaemia
#2
D Makki, T Elgamal, P Evans, D Harvey, G Jackson, S Platt
AIMS: The aim of this paper was to present the clinical features of patients with musculoskeletal sources of methicillin-sensitive Staphylococcus aureus (MSSA) septicaemia. PATIENTS AND METHODS: A total of 137 patients presented with MSSA septicaemia between 2012 and 2015. The primary source of infection was musculoskeletal in 48 patients (35%). Musculoskeletal infection was considered the primary source of septicaemia when endocarditis and other obvious sources were excluded...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092996/the-levels-of-vancomycin-in-the-blood-and-the-wound-after-the-local-treatment-of-bone-and-soft-tissue-infection-with-antibiotic-loaded-calcium-sulphate-as-carrier-material
#3
P Wahl, M Guidi, E Benninger, K Rönn, E Gautier, T Buclin, J-L Magnin, F Livio
AIMS: Calcium sulphate (CaSO4) is a resorbable material that can be used simultaneously as filler of a dead space and as a carrier for the local application of antibiotics. Our aim was to describe the systemic exposure and the wound fluid concentrations of vancomycin in patients treated with vancomycin-loaded CaSO4 as an adjunct to the routine therapy of bone and joint infections. PATIENTS AND METHODS: A total of 680 post-operative blood and 233 wound fluid samples were available for analysis from 94 implantations performed in 87 patients for various infective indications...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092995/clicky-hip-alone-is-not-a-true-risk-factor-for-developmental-dysplasia-of-the-hip
#4
K Nie, S Rymaruk, R W Paton
AIMS: A clicky hip is a common referral for clinical and sonographic screening for developmental dysplasia of the hip (DDH). There is controversy regarding whether it represents a true risk factor for pathological DDH. Therefore a 20-year prospective, longitudinal, observational study was undertaken to assess the relationship between the presence of a neonatal clicky hip and pathological DDH. PATIENTS AND METHODS: A total of 362 infants from 1997 to 2016 were referred with clicky hips to our 'one-stop' paediatric hip screening clinic...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092994/low-intensity-pulsed-ultrasound-for-treatment-of-tibial-fractures-an-economic-evaluation-of-the-trust-study
#5
J E Tarride, R B Hopkins, G Blackhouse, N Burke, M Bhandari, H Johal, G H Guyatt, J W Busse
AIMS: This 501-patient, multi-centre, randomised controlled trial sought to establish the effect of low-intensity, pulsed, ultrasound (LIPUS) on tibial shaft fractures managed with intramedullary nailing. We conducted an economic evaluation as part of this trial. PATIENTS AND METHODS: Data for patients' use of post-operative healthcare resources and time taken to return to work were collected and costed using publicly available sources. Health-related quality of life, assessed using the Health Utilities Index Mark-3 (HUI-3), was used to derive quality-adjusted life years (QALYs)...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092993/the-effect-of-a-single-early-high-dose-vitamin-d-supplement-on-fracture-union-in-patients-with-hypovitaminosis-d-a-prospective-randomised-trial
#6
N Haines, L B Kempton, R B Seymour, M J Bosse, C Churchill, K Hand, J R Hsu, D Keil, J Kellam, N Rozario, S Sims, M A Karunakar
AIMS: To evaluate the effect of a single early high-dose vitamin D supplement on fracture union in patients with hypovitaminosis D and a long bone fracture. PATIENTS AND METHODS: Between July 2011 and August 2013, 113 adults with a long bone fracture were enrolled in a prospective randomised double-blind placebo-controlled trial. Their serum vitamin D levels were measured and a total of 100 patients were found to be vitamin D deficient (< 20 ng/ml) or insufficient (< 30 ng/mL)...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092992/evaluation-of-fever-in-the-immediate-post-operative-period-following-shoulder-arthroplasty
#7
B M Saltzman, B C Mayo, D D Bohl, R M Frank, B J Cole, N N Verma, G P Nicholson, A A Romeo
AIMS: To determine the incidence and timing of post-operative fevers following shoulder arthroplasty and the resulting investigations performed. PATIENTS AND METHODS: A retrospective review was conducted of all patients undergoing shoulder arthroplasty over a nine-year period. The charts of all patients with a post-operative fever (≥ 38.6°C) were reviewed and the results of all investigations were analysed. RESULTS: A total of 2167 cases (in 1911 patients) were included of whom 92 (4...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092991/lunate-morphology-as-a-risk-factor-of-idiopathic-ulnar-impaction-syndrome
#8
J H Park, W Y Jang, D H Kwak, J W Park
AIMS: Positive ulnar variance is an established risk factor for idiopathic ulnar impaction syndrome (UIS). However, not all patients with positive ulnar variance develop symptomatic UIS and other factors, including the morphology of the lunate, may be involved. The aim of this study was to clarify the relationship between lunate morphology and idiopathic UIS. PATIENTS AND METHODS: A cohort of 95 patients with idiopathic UIS (UIS group) was compared with 95 asymptomatic controls with positive ulnar variance...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092990/multiple-limb-salvage-attempts-for-diabetic-foot-infections-is-it-worth-it
#9
C C Hong, J H Tan, S H Lim, A Nather
AIMS: Limb salvage for diabetic foot infections often require multiple procedures. Some patients will eventually end up with below knee amputation (BKA) when all limb salvage attempts fail. We seek to study the patients' ability to return to normal life, functional status, prosthesis usage and perspectives on multiple limb salvage procedures that culminated in BKA to review if they would undertake a similar path if their situation was repeated. PATIENTS AND METHODS: A total of 41 patients who underwent BKA between July 2011 and June 2013 were reviewed...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092989/an-evolution-in-the-management-of-fractures-of-the-ankle-safety-and-efficacy-of-posteromedial-approach-for-haraguchi-type-2-posterior-malleolar-fractures
#10
N Bali, I Aktselis, A Ramasamy, S Mitchell, P Fenton
AIMS: There has been an evolution recently in the management of unstable fractures of the ankle with a trend towards direct fixation of a posterior malleolar fragment. Within these fractures, Haraguchi type 2 fractures extend medially and often cannot be fixed using a standard posterolateral approach. Our aim was to describe the posteromedial approach to address these fractures and to assess its efficacy and safety. PATIENTS AND METHODS: We performed a review of 15 patients with a Haraguchi type 2 posterior malleolar fracture which was fixed using a posteromedial approach...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092988/a-positive-bacterial-culture-during-re-implantation-is-associated-with-a-poor-outcome-in-two-stage-exchange-arthroplasty-for-deep-infection
#11
D Akgün, M Müller, C Perka, T Winkler
AIMS: The aim of this study was to identify the incidence of positive cultures during the second stage of a two-stage revision arthroplasty and to analyse the association between positive cultures and an infection-free outcome. PATIENTS AND METHODS: This single-centre retrospective review of prospectively collected data included patients with a periprosthetic joint infection (PJI) of either the hip or the knee between 2013 and 2015, who were treated using a standardised diagnostic and therapeutic algorithm with two-stage exchange...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092987/the-unsuspected-prosthetic-joint-infection-incidence-and-consequences-of-positive-intra-operative-cultures-in-presumed-aseptic-knee-and-hip-revisions
#12
A M E Jacobs, M Bénard, J F Meis, G van Hellemondt, J H M Goosen
AIMS: Positive cultures are not uncommon in cases of revision total knee and hip arthroplasty (TKA and THA) for presumed aseptic causes. The purpose of this study was to assess the incidence of positive intra-operative cultures in presumed aseptic revision of TKA and THA, and to determine whether the presence of intra-operative positive cultures results in inferior survival in such cases. PATIENTS AND METHODS: A retrospective cohort study was assembled with 679 patients undergoing revision knee (340 cases) or hip arthroplasty (339 cases) for presumed aseptic causes...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092986/the-analysis-of-synovial-fluid-in-total-knee-arthroplasties-with-flexion-instability
#13
N M Hernandez, M J Taunton, K I Perry, K C Mara, A D Hanssen, M P Abdel
AIMS: Patients with flexion instability after total knee arthroplasty (TKA) often present with a recurrent effusion, which may be a haemarthrosis. While the radiographic factors contributing to flexion instability have been elucidated, the clinical diagnosis remains challenging. Our aim, in this study, was to determine the mean white cell count and differential profile in pre-operative aspirations of synovial fluid in a consecutive series of patients undergoing revision TKA for flexion instability...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092985/fixation-and-clinical-outcome-of-uncemented-peri-apatite-coated-versus-cemented-total-knee-arthroplasty-five-year-follow-up-of-a-randomised-controlled-trial-using-radiostereometric-analysis-rsa
#14
K T van Hamersveld, P J Marang-van de Mheen, R Tsonaka, E R Valstar, S Toksvig-Larsen
AIMS: The optimal method of tibial component fixation remains uncertain in total knee arthroplasty (TKA). Hydroxyapatite coatings have been applied to improve bone ingrowth in uncemented designs, but may only coat the directly accessible surface. As peri-apatite (PA) is solution deposited, this may increase the coverage of the implant surface and thereby fixation. We assessed the tibial component fixation of uncemented PA-coated TKAs versus cemented TKAs. PATIENTS AND METHODS: Patients were randomised to PA-coated or cemented TKAs...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092984/outcomes-following-debridement-antibiotics-and-implant-retention-in-the-management-of-periprosthetic-infections-of-the-hip-a-review-of-cohort-studies
#15
S-T J Tsang, J Ting, A H R W Simpson, P Gaston
AIMS: The aims of the study were to review and analyse the reported series of debridement, antibiotics and implant retention (DAIR) in the management of infected total hip arthroplasties (THAs) to establish the overall success and the influencing factors. PATIENTS AND METHODS: Using a standardised recognised study protocol, meta-analysis of observational studies in epidemiology guidelines, a comprehensive review and analysis of the literature was performed. The primary outcome measure was the success of treatment...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092983/the-rim-cutter-does-not-show-an-advantage-over-modern-cementing-techniques-a-five-year-radiological-and-clinical-follow-up-of-the-rim-cutter-used-with-flanged-acetabular-components
#16
P J T S vanWinterswijk, S L Whitehouse, A J Timperley, M J W Hubble, J R Howell, M J Wilson
AIMS: We report the incidence of radiolucent lines (RLLs) using two flanged acetabular components at total hip arthroplasty (THA) and the effect of the Rim Cutter. PATIENTS AND METHODS: We performed a retrospective review of 300 hips in 292 patients who underwent primary cemented THA. A contemporary flanged acetabular component was used with (group 1) and without (group 2) the use of the Rim Cutter and the Rimfit acetabular component was used with the Rim Cutter (group 3)...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092982/multiple-boluses-of-intravenous-tranexamic-acid-to-reduce-hidden-blood-loss-and-the-inflammatory-response-following-enhanced-recovery-primary-total-hip-arthroplasty-a-randomised-clinical-trial
#17
J Xie, Q Hu, J Ma, Q Huang, F Pei
AIMS: The aim of this study was to examine the efficacy and safety of multiple boluses of intravenous (IV) tranexamic acid (TXA) on the hidden blood loss (HBL) and inflammatory response following primary total hip arthroplasty (THA). PATIENTS AND METHODS: A total of 150 patients were allocated randomly to receive a single bolus of 20 mg/kg IV TXA before the incision (group A), a single bolus followed by a second bolus of 1 g IV-TXA three hours later (group B) or a single bolus followed by two boluses of 1 g IV-TXA three and six hours later (group C)...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092981/metaphyseal-debonding-of-the-corail-collarless-cementless-stem-report-of-18-cases-and-case-control-study
#18
M A Buttaro, J I Oñativia, P A Slullitel, M Andreoli, F Comba, G Zanotti, F Piccaluga
AIMS: The Corail stem has good long-term results. After four years of using this stem, we have detected a small group of patients who have presented with symptomatic metaphyseal debonding. The aim of this study was to quantify the incidence of this complication, to delineate the characteristics of patients presenting with this complication and to compare these patients with asymptomatic controls to determine any important predisposing factors. PATIENTS AND METHODS: Of 855 Corail collarless cementless stems implanted for osteoarthritis, 18 presented with symptomatic metaphyseal debonding...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092980/population-based-contracting-population-health-part-ii
#19
REVIEW
D J Jacofsky
Modern healthcare contracting is shifting the responsibility for improving quality, enhancing community health and controlling the total cost of care for patient populations from payers to providers. Population-based contracting involves capitated risk taken across an entire population, such that any included services within the contract are paid for by the risk-bearing entity throughout the term of the agreement. Under such contracts, a risk-bearing entity, which may be a provider group, a hospital or another payer, administers the contract and assumes risk for contractually defined services...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092979/aspirin-and-the-prevention-of-venous-thromboembolism-following-total-joint-arthroplasty-commonly-asked-questions
#20
REVIEW
I Azboy, R Barrack, A M Thomas, F S Haddad, J Parvizi
The number of arthroplasties being performed increases each year. Patients undergoing an arthroplasty are at risk of venous thromboembolism (VTE) and appropriate prophylaxis has been recommended. However, the optimal protocol and the best agent to minimise VTE under these circumstances are not known. Although many agents may be used, there is a difference in their efficacy and the risk of bleeding. Thus, the selection of a particular agent relies on the balance between the desire to minimise VTE and the attempt to reduce the risk of bleeding, with its undesirable, and occasionally fatal, consequences...
November 2017: Bone & Joint Journal
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