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Septic arthritis knee

Brian R Waterman, William Arroyo, Eric J Cotter, Michael A Zacchilli, E'Stephan J Garcia, Brett D Owens
Background: There remains a debate over whether to retain the index anterior cruciate ligament (ACL) graft in the setting of septic arthritis. Purpose: To evaluate and compare clinical outcomes for the treatment of septic arthritis after ACL reconstruction (ACLR) in those with and without early graft retention. Study Design: Case series; Level of evidence, 4. Methods: The Military Health System was queried for all ACLR procedures performed between 2007 and 2013...
March 2018: Orthopaedic Journal of Sports Medicine
Scott A Weisenberg
A 78-year-old man developed right knee pain and swelling without other systemic symptoms. He had travelled frequently to the Central Valley of California. He was diagnosed with coccidioidomycosis based on joint fluid culture. Coccidioidal complement fixation antibody titres were extremely elevated. Arthroscopic debridement and fluconazole therapy did not lead to satisfactory improvement. Subsequent open debridement and change to itraconazole was followed by resolution of clinical signs of infection.
March 13, 2018: BMJ Case Reports
Karthikeyan E Ponnusamy, Jacquelyn D Marsh, Lyndsay E Somerville, Richard W McCalden, Edward M Vasarhelyi
BACKGROUND: We compared 90-day costs and outcomes for primary total knee arthroplasty patients among nonobese (body mass index [BMI] 18.5-24.9), overweight (25-29.9), obese (30-34.9), severely obese (35-39.9), morbidly obese (40-49.9), and super-obese (50+) cohorts. METHODS: We conducted a retrospective review of an institutional database of total knee arthroplasty patients from 2006 to 2013 with a minimum of 3-year follow-up. Sixty-five super-obese patients were identified, and five other cohorts were randomly selected in a 2:1 ratio (total, n = 715)...
February 15, 2018: Journal of Arthroplasty
Philipp Schuster, Markus Geßlein, Michael Schlumberger, Philipp Mayer, Hermann Josef Bail, Jörg Richter
PURPOSE: No systematic studies on optimal treatment of postoperative septic arthritis following arthroscopic meniscus repair are available. The purpose of this study was to retrospectively evaluate the fate of repaired menisci in cases of postoperative septic arthritis, with treatment for infection focused on arthroscopic irrigation and debridement (I&D) and intention to maintain the meniscus. METHODS: Data of two sports orthopedics centers of the last 10 years were pooled (approximately 25,000 arthroscopic procedures of the knee)...
March 6, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Yoshihiro Katsuura, Brandon Cincere, Garrick Cason, James Osborn
Here, we present a rare case of metastatic methicillin sensitive Staphylococcus aureus (MSSA) infection arising from an unknown focus and spreading throughout the lumbar spine with associated pyomyositis of the paraspinal musculature, and septic arthritis of the knee, ankle and sternoclavicular joint. This case highlights the potential for missed aspects and delay in diagnosis in the care of metastatic S. aureus and the need for multispecialty intervention. Treatment of S. aureus infections requires a high index of suspicion and careful examination of multiple organ systems to identify the full extent of the disease...
March 5, 2018: BMJ Case Reports
Mark P Cote
Septic arthritis is a rare but potentially devastating complication after anterior cruciate ligament (ACL) reconstruction. Studies examining surgical treatment options including graft retention and removal are largely inconclusive. Although the literature indicated that 43.8% of patients who have the graft removed later go on to have a revision ACL reconstruction compared with only 6.5% among those whose graft is retained, this expected-value decision analysis found removal to be the optimal treatment for patients with septic arthritis after ACL reconstruction...
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Hervé Ouanezar, William G Blakeney, Charles Latrobe, Adnan Saithna, Levi Reina Fernandes, Jean Romain Delaloye, Mathieu Thaunat, Bertrand Sonnery-Cottet
PURPOSE: Repairs of the posterior horn of the lateral meniscus can be technically challenging. In contrast to medial meniscus repairs, the capsule around the posterior segment attachment of the lateral meniscus is quite thin. This study evaluates the clinical results of an arthroscopic all-inside repair technique for unstable, vertical, lateral meniscus tears, using a suture repair placed directly into the popliteus tendon. METHODS: A retrospective analysis of prospectively collected data from the SANTI database was performed...
March 3, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Elvira Bangert, Alexander Hofkirchner, Tanveer E Towheed
No abstract text is available yet for this article.
February 22, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Gireesh Sankaran, Balaji Zacharia, Antony Roy, Sulaikha Puthan Purayil
PURPOSE: The study was carried out to evaluate the clinical and bacteriological profile of SA in young infants (age ≤ 3 months) in a tertiary referral centre and to assess the risk factors and to document the changing trends in the epidemiology. METHODS: This was a prospective descriptive study on all young infants with SA. Clinical and perinatal history, examination, radiological and laboratory findings (blood count, ESR, CRP, blood and joint cultures) were studied...
February 9, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
A Mena Rosón, H Valencia García, F J Moreno Coronas
Septic arthritis after knee arthroscopy is an extremely rare condition. A rate of 0.15-0.84% cases of postoperative infection is estimated in several series. The arthroscopy procedure most frequently related with an infectious complication is anterior cruciate ligament (ACL) reconstruction, with a prevalence of 0.3-1.7% cases. Staphylococcus sp. is the pathogen most commonly cultured. We describe a case of septic arthritis after ACL reconstruction. We found no published case of septic arthritis caused by this microorganism after knee arthroscopy...
February 5, 2018: Revista Española de Cirugía Ortopédica y Traumatología
Emilie Hill, Adrienne D Workman, Francesca Lee, Rita Hollaway, Dominick Cavuoti, Bonnie C Prokesch
A 22-year-old female with sickle cell disease presented with fevers, bilateral knee pain, and lethargy. Laboratory data revealed a leukocytosis and lactic acidosis. Blood and synovial fluid cultures grew a non-toxin-producing strain of Clostridium difficile. This case highlights the fact that nontoxigenic Clostridium difficile can cause significant disease.
February 2018: Open Forum Infectious Diseases
Águeda Prior-Español, Yaiza García-Mira, Sonia Mínguez, Melania Martínez-Morillo, Laia Gifre, Lourdes Mateo
OBJECTIVE: Septic arthritis is a medical emergency and crystal-induced arthritis is a risk factor for its development. If both occur simultaneously, crystal-induced arthritis may mask the diagnosis of infection and delay antibiotic therapy. METHOD: Retrospective analysis of patients with coexistence of septic and crystal-induced arthritis. We included only patients with isolation of crystals in synovial fluid analysis and positive culture of synovial fluid and/or blood culture...
February 1, 2018: Reumatología Clinica
Jourdan M Cancienne, Mark D Miller, James A Browne, Brian C Werner
PURPOSE: To determine the association between glycemic control and infection following knee arthroscopy, and to determine the clinical utility of a threshold HbA1c level. METHODS: A national database identified patients who underwent knee arthroscopy from 2007 to 2016. Patients with concomitant open portions, more complex knee procedures, procedures performed for infection and patients with prior septic knee arthritis were excluded. Patients with an HbA1c level checked within 3 months of surgery were compared to control groups of nondiabetics and diabetics undergoing knee arthroscopy without a perioperative HbA1c...
February 2, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Assem A Sultan, William A Cantrell, Anton Khlopas, Connor Cole, Nicolas S Piuzzi, Nipun Sodhi, Peter Brooks, Michael A Mont
Acute bacterial mono-articular septic arthritis affects most commonly the lower extremity joints in adult population and most commonly caused by Staphylococcus aureus. Various risk factors determine susceptibility to infection including host immunity, medical co-morbidity and joint structural abnormality and other organisms may be involved. Parvimonas micra (P. micra) is among the rare organisms that may be associated with atypical septic arthritis and primarily affects the native knee joint. Only 3 case reports in the literature have reported on pyogenic pyogenic joint infection caused by this organism...
January 3, 2018: Anaerobe
Samuel Rosas, Daniel Rosas, Valentina Múnera Orozco, Manuela Parra Cardona, Chukwuweike Gwam, Simon Pedro Aristizabal
Pediatric septic arthritis can be a devastating disease. Often, the diagnosis can be challenging as autoimmune and infectious causes may present in a similar fashion. Thus, we present the case of a five-year-old male patient, from the Pacific coast of Colombia, with chronic morning knee pain and stiffness thought to be caused by an autoimmune disease. He presented with a mild effusion of the left knee, a flexed posture, and limited extension to 25°. Inflammatory markers demonstrated an infectious pattern. Autoimmune markers were negative...
December 22, 2017: Surgical Technology International
Francesco d'Aleo, Roberta Bonanno, Angelina Midiri, Giuseppe Mancuso, Stefania Cordaro, Amiel Warm, Elisa Verduci, Concetta Beninati, Carmelo Biondo
We present a case of rice body formation in the left knee joint of a 2-month-old infant affected by Candida albicans septic arthritis which has never been reported before. Rice body formation has been described in association with rheumatoid or tuberculous arthritis and is very rare in Candida arthritis. After three weeks of therapy with amphotericin B administered intravenously, the infant recovered fully from infection. Septic arthritis is a serious cause of morbidity and for proper evaluation and treatment fungal septic arthritis should be included in the differential diagnosis...
December 1, 2017: Le Infezioni in Medicina
M M Elzohairy
BACKGROUND: Pyomyositis PM is defined as a primary pyogenic infection of the striated skeletal muscle; although it has many dystrophic musculoskeletal complications, it is always misdiagnosed by many orthopedic surgeons. HYPOTHESIS: PM is rare in temperate climates and usually considered to be a tropical disease, until recent times, after globalization, it is possible to occur in the subtropical climate as in our country. MATERIAL AND METHODS: In the present series, the results of 15 children patients with primary pyomyositis have been reviewed...
December 21, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
Elias G Joseph, Emily P Ernest, Matthew J Dietz
CASE: A 66-year-old Caucasian man with Klippel-Trenaunay-Weber syndrome (KTWS) presented with chronic changes related to the KTWS, along with worsening pain and motion associated with residual damage from an episode of spontaneous septic arthritis that occurred 1 year prior. He underwent total joint arthroplasty with a rotating hinged knee implant. CONCLUSION: Arthroplasty is a treatment option for patients with KTWS; however, there are risks that must be considered...
July 2017: JBJS Case Connector
C Orellana-Reta, L A Valdez-Jiménez
OBJECTIVE: The aim of this study was to evaluate the functional and radiographic results of adolescent patients with angular deformities of the pelvic limbs treated with an open wedge osteotomy system. MATERIAL AND METHODS: Observational, prospective, analytical and cross-sectional study of patients with angular deformity of the pelvic limbs treated with an open wedge osteotomy. We made a radiographic evaluation of the femorotibial angle, MAD angle, lower limb discrepancy, and pre- and postoperative degrees of the rotational center of deformity (CORA), as well as a telephone survey of the postoperative functional evaluation IKDC 2000...
May 2017: Acta Ortopédica Mexicana
Nawal El Houmami, Dimitri Ceroni, Karine Codjo Seignon, Jean-Christophe Pons, Cédric Lambert, Guillaume André Durand, Philippe Minodier, Léopold Lamah, Philippe Bidet, Jacques Schrenzel, Didier Raoult, Pierre-Edouard Fournier
Kingella kingae is an important cause of invasive infections in young children from Western countries. Although increasing reports indicate that this organism is the leading agent of bone and joint infections in early childhood, data on K. kingae infections from resource-limited settings are scarce, and none has yet been reported in Africa. We herein report the diagnostic and epidemiological investigations of the first case of K. kingae arthritis identified in a child from sub-Saharan Africa. A 5-year-old Cameroonian boy presented with a sudden painful limp which appeared in the course of a mild rhinopharyngitis...
2017: Frontiers in Pediatrics
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