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Orthopedic infection control

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https://www.readbyqxmd.com/read/28069094/a-practical-tool-for-surveillance-of-surgical-site-infections-a-5-year-experience-in-orthopedic-surgeries
#1
Shmuel Benenson, Allon E Moses, Matan J Cohen, Meir Brezis, Naomi Minster, Carmela Schwartz, Leonid Kandel, Meir Liebergall, Yoav Mattan
Continuous surveillance of surgical-site infection (SSI) is labor intensive. We developed a semiautomatic surveillance system partly assisted by surgeons. Most patients who developed postdischarge SSI were readmitted, which allowed us to limit postdischarge surveillance to this group. This procedure significantly reduced workload while maintaining high sensitivity and specificity for SSI diagnosis. Infect Control Hosp Epidemiol 2017;1-4.
January 10, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28064219/active-and-passive-immunization-against-staphylococcus-aureus-periprosthetic-osteomyelitis-in-rats
#2
Niels H Søe, Nina Vendel Jensen, Asger Lundorff Jensen, Janne Koch, Steen Seier Poulsen, Gerald B Pier, Helle Krogh Johansen
BACKGROUND/AIM: Staphylococcus aureus infection associated with orthopedic implants cannot always be controlled. We used a knee prosthesis model with implant-related osteomyelitis in rats to explore induction of an effective immune response with active and passive immunization. MATERIALS AND METHODS: Fifty-two Sprague-Dawley rats were divided into active (N=28) and passive immunization groups (N=24). A bacterial inoculum of 10(3) S. aureus MN8 was injected into the tibia and the femur marrow before insertion of a non-constrained knee prosthesis in each rat...
January 2017: In Vivo
https://www.readbyqxmd.com/read/28053147/bone-and-joint-infections-caused-by-mucormycetes-a-challenging-osteoarticular-mycosis-of-the-twenty-first-century
#3
Saad J Taj-Aldeen, Maria N Gamaletsou, Blandine Rammaert, Nikolaos V Sipsas, Valerie Zeller, Emmanuel Roilides, Dimitrios P Kontoyiannis, Michael Henry, Vidmantas Petraitis, Brad Moriyama, David W Denning, Olivier Lortholary, Thomas J Walsh
Osteomyelitis and arthritis caused by mucormycetes are rare diseases that rank among the most challenging complications in orthopedic and trauma surgery. The aim of this work is to review the epidemiological, clinical, diagnostic, and therapeutic aspects of the osteoarticular mucormycosis with particular emphasis on high-risk patients. A systematic review of osteoarticular mucormycosis was performed using PUBMED and EMBASE databases from 1978 to 2014. Among 34 patients with median age 41 (0.5-73 years), 24 (71%) were males...
January 3, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/27993719/minimally-invasive-percutaneous-plates-versus-conventional-fixation-techniques-for-distal-tibial-fractures-a-meta-analysis
#4
REVIEW
Ang Li, Zhijian Wei, Han Ding, Haoshuai Tang, Yang Liu, Jiaxiao Shi, Hengxing Zhou, Shi-Qing Feng
OBJECTIVE: This meta-analysis was performed to determine the effects of minimally invasive percutaneous plate osteosynthesis (MIPO) versus conventional fixation techniques (CFT) for treating distal tibial fractures. METHODS: A literature search was performed in EMBASE, Medline, the Cochrane Library, and Web of Science. The trials searched were evaluated for eligibility. The Cochrane Collaboration's Review Manager software was used to perform meta-analyses. RESULTS: Eight studies were enrolled, including five randomized controlled trials, one control-matched trial and two retrospective cohort trials...
December 16, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27989720/prevention-of-propionibacterium-acnes-biofilm-formation-in-prosthetic-infections-in-vitro
#5
Robert P Howlin, Christopher Winnard, Elizabeth M Angus, Connor J Frapwell, Jeremy S Webb, John J Cooper, Sean S Aiken, Julie Y Bishop, Paul Stoodley
BACKGROUND: The role of Propionibacterium acnes in shoulder arthroplasty and broadly in orthopedic prosthetic infections has historically been underestimated, with biofilm formation identified as a key virulence factor attributed to invasive isolates. With an often indolent clinical course, P acnes infection can be difficult to detect and treat. This study investigates absorbable cements loaded with a broad-spectrum antibiotic combination as an effective preventive strategy to combat P acnes biofilms...
December 15, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27987791/antibacterial-ability-and-angiogenic-activity-of-cu-ti-o-nanotube-arrays
#6
Mingxiang Zong, Long Bai, Yanlian Liu, Xin Wang, Xiangyu Zhang, Xiaobo Huang, Ruiqiang Hang, Bin Tang
Bacterial infection and loosening of orthopedic implants remain two disastrously postoperative complications. Angiogenesis is critical important to facilitate implant osseointegration in vivo. TiO2 nanotubes arrays (NTAs) with proper dimensions possess good osseointegration ability. Accordingly, the present work incorporated copper (Cu) into TiO2 NTAs (Cu-Ti-O NTAs) to enhance their antibacterial ability and angiogenesis activity, which was realized through anodizing magnetron-sputtered TiCu coatings with different Cu contents on pure titanium (Ti)...
February 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/27907013/development-and-implementation-of-the-ebola-traveler-monitoring-program-and-clinical-outcomes-of-monitored-travelers-during-october-may-2015-minnesota
#7
Aaron DeVries, Pamela Talley, Kristin Sweet, Susan Kline, Patricia Stinchfield, Pritish Tosh, Richard Danila
BACKGROUND: In October 2014, the United States began actively monitoring all persons who had traveled from Guinea, Liberia, and Sierra Leone in the previous 21 days. State public health departments were responsible for monitoring all travelers; Minnesota has the largest Liberian population in the United States. The MDH Ebola Clinical Team (ECT) was established to assess travelers with symptoms of concern for Ebola virus disease (EVD), coordinate access to healthcare at appropriate facilities including Ebola Assessment and Treatment Units (EATU), and provide guidance to clinicians...
2016: PloS One
https://www.readbyqxmd.com/read/27890407/postoperative-tachycardia-clinically-meaningful-or-benign-consequence-of-orthopedic-surgery
#8
Alana E Sigmund, Yixin Fang, Matthew Chin, Harmony R Reynolds, Leora I Horwitz, Ezra Dweck, Eduardo Iturrate
OBJECTIVE: To determine the clinical significance of tachycardia in the postoperative period. PATIENTS AND METHODS: Individuals 18 years or older undergoing hip and knee arthroplasty were included in the study. Two data sets were collected from different time periods: development data set from January 1, 2011, through December 31, 2011, and validation data set from December 1, 2012, through September 1, 2014. We used the development data set to identify the optimal definition of tachycardia with the strongest association with the vascular composite outcome (pulmonary embolism and myocardial necrosis and infarction)...
January 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/27890310/same-day-total-hip-arthroplasty-performed-at-an-ambulatory-surgical-center-90-day-complication-rate-on-549-patients
#9
Gregg R Klein, Jason M Posner, Harlan B Levine, Mark A Hartzband
BACKGROUND: There is an increasing interest in outpatient total hip arthroplasty (THA), as there are perceived benefits to the patient, insurer, and overall healthcare system. However, the safety of outpatient total joint arthroplasty has not been studied. METHODS: Five hundred forty-nine patients who underwent mini-posterior THA at a freestanding independent ambulatory surgical center (ASC) were reviewed. All patients were discharged to home on the day of surgery...
October 20, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27869063/screening-patients-undergoing-total-hip-or-knee-arthroplasty-with-perioperative-urinalysis-and-the-effect-of-a-practice-change-on-antimicrobial-use
#10
Samuel Bailin, Nicolas Noiseux, Jean M Pottinger, Birgir Johannsson, Ambar Haleem, Sarah Johnson, Loreen A Herwaldt
OBJECTIVE To identify predictors of treatment for urinary tract infections (UTI) among patients undergoing total hip (THA) or knee (TKA) arthroplasties and to assess an intervention based on these predictors. DESIGN We conducted a retrospective cohort study of 200 consecutive patients undergoing THA/TKA between February 21, 2011, and June 30, 2011, to identify predictors of treatment for UTI and a prospective cohort study of 50 patients undergoing these procedures between May 21, 2012, and July 17, 2012, to assess the association of signs or symptoms and UTI treatment...
November 21, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27855775/use-of-closed-suction-drain-after-primary-total-knee-arthroplasty-an-overrated-practice
#11
Gaurav M Sharma, Gauresh Palekar, Dilip D Tanna
PURPOSE: The age-old practice of closed suction drain following orthopedic procedures has been challenged since past few decades. Our aim was to assess the effectiveness of closed suction drain after total knee arthroplasty. MATERIALS AND METHODS: One hundred twenty patients (135 knees) with primary Total Knee Arthroplasty were divided into a study group (no drain) and a control group (drain used). Inclusion criteria were grade 3 and grade 4 osteoarthritis of the knee...
2016: SICOT-J
https://www.readbyqxmd.com/read/27783835/percutaneous-acetabuloplasty-for-metastatic-lesions-to-the-pelvis
#12
Ryan A Durfee, Scott A Sabo, G Douglas Letson, Odion Binitie, David Cheong
Metastatic lesions of the acetabulum can be painful and debilitating. First-line treatment is multimodal and consists of disease-specific chemotherapy, osteoclastic inhibitors, analgesics, and radiation therapy. When these therapies fail, surgical intervention usually is indicated and varies from regional defect stabilization to large periacetabular reconstructions that are demanding procedures with high rates of complications. Percutaneous cement augmentation (acetabuloplasty) of lesions in selected patients has been explored as a less invasive method of lesional control...
October 25, 2016: Orthopedics
https://www.readbyqxmd.com/read/27745737/preoperative-antibiotic-prophylaxis-in-prosthetic-joint-infections-not-a-concern-for-intraoperative-cultures
#13
Daniel Pérez-Prieto, María E Portillo, Lluís Puig-Verdié, Albert Alier, Carlo Gamba, Pau Guirro, Santos Martínez-Díaz, Juan P Horcajada, Andrej Trampuz, Joan C Monllau
BACKGROUND: Culture negative prosthetic joint infections (PJI) still remain an issue even with the advantages of the new diagnostic tools for PJI. This is why some orthopedic surgeons have reservations relative to the use of preoperative antibiotic prophylaxis when a PJI is suspected. The purpose of the present study was to evaluate the influence of preoperative antibiotic prophylaxis on intraoperative cultures. MATERIAL AND METHODS: An enhanced diagnostic protocol for PJI (Zimmerli criteria) was used for the inclusion criteria in order to collect all PJI that were seen in a university hospital...
December 2016: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/27704758/additively-manufactured-macroporous-titanium-with-silver-releasing-micro-nanoporous-surface-for-multipurpose-infection-control-and-bone-repair-%C3%A2-a-proof-of-concept
#14
Zhaojun Jia, Peng Xiu, Pan Xiong, Wenhao Zhou, Yan Cheng, Shicheng Wei, Yufeng Zheng, Tingfei Xi, Hong Cai, Zhongjun Liu, Cai-Mei Wang, Wei-Ping Zhang, Zhi-Jiang Li
Restoring large-scale bone defects, where osteogenesis is slow while infections lurk, with biomaterials represents a formidable challenge in orthopedic clinics. Here, we propose a scaffold-based multipurpose anti-infection and bone repairing strategy to meet such restorative needs. To do this, personalized multifunctional titanium meshes were produced through an advanced additive manufacturing process and dual "TiO2‒poly(dopamine)/Ag (nano)" post modifications, yielding macroporous constructs with micro/nanoporous walls and nanosilver bullets immobilized/embedded therein...
October 5, 2016: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/27704604/early-implant-associated-osteomyelitis-results-in-a-peri-implanted-bacterial-reservoir
#15
Louise Kruse Jensen, Janne Koch, Bent Aalbaek, Arshnee Moodley, Thomas Bjarnsholt, Kasper Nørskov Kragh, Andreas Petersen, Henrik Elvang Jensen
Implant-associated osteomyelitis (IAO) is a common complication in orthopedic surgery. The aim of this study was to elucidate how deep IAO can go into the peri-implanted bone tissue within a week. The study was performed in a porcine model of IAO. A small steel implant and either 10(4) CFU/kg body weight of Staphylococcus aureus or saline was inserted into the right tibial bone of 12 pigs. The animals were consecutively killed on day 2, 4 and 6 following implantation. Bone tissue around the implant was histologically evaluated...
January 2017: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
https://www.readbyqxmd.com/read/27686251/evaluation-of-injectable-robenacoxib-for-the-treatment-of-post-operative-pain-in-cats-results-of-a-randomized-masked-placebo-controlled-clinical-trial
#16
Stephen King, Elizabeth S Roberts, Jonathan N King
BACKGROUND: Few pharmaceuticals are registered in cats for the management of post-operative pain and inflammation. The objective of this study was to assess the field efficacy and safety of an injectable formulation of the nonsteroidal anti-inflammatory drug robenacoxib in cats undergoing surgery. The study was a multi-center, prospective, randomized, masked, parallel-group, placebo-controlled clinical trial. A total of 349 cats were enrolled and underwent surgery comprising forelimb onychectomy, as an example of orthopedic surgery, plus either ovariohysterectomy or castration...
September 29, 2016: BMC Veterinary Research
https://www.readbyqxmd.com/read/27684083/visibility-of-tinted-chlorhexidine-gluconate-skin-preparation-on-varied-skin-pigmentations
#17
Claire M McDaniel, Ryan W Churchill, Evan Argintar
Preoperative skin preparation with antimicrobial agents decreases the risk of surgical site infection, but concerns have been raised about the visibility of a common surgical preparatory agent (ChloraPrep; Becton, Dickinson & Co, Franklin Lakes, New Jersey), depending on skin pigmentation. Poor visibility may lead to failure to identify inadequately prepared skin, increasing the risk of surgical site infection. This study was conducted to determine whether different tints of ChloraPrep and different skin pigmentations affect the ability of orthopedic surgeons to identify the adequacy of skin preparation...
September 29, 2016: Orthopedics
https://www.readbyqxmd.com/read/27672479/cytocompatibility-with-osteogenic-cells-and-enhanced-in-vivo-anti-infection-potential-of-quaternized-chitosan-loaded-titania-nanotubes
#18
Ying Yang, Haiyong Ao, Yugang Wang, Wentao Lin, Shengbing Yang, Shuhong Zhang, Zhifeng Yu, Tingting Tang
Infection is one of the major causes of failure of orthopedic implants. Our previous study demonstrated that nanotube modification of the implant surface, together with nanotubes loaded with quaternized chitosan (hydroxypropyltrimethyl ammonium chloride chitosan, HACC), could effectively inhibit bacterial adherence and biofilm formation in vitro. Therefore, the aim of this study was to further investigate the in vitro cytocompatibility with osteogenic cells and the in vivo anti-infection activity of titanium implants with HACC-loaded nanotubes (NT-H)...
2016: Bone Research
https://www.readbyqxmd.com/read/27641367/unraveling-the-relationship-between-delirium-brain-damage-and-subsequent-cognitive-decline-in-a-cohort-of-individuals-undergoing-surgery-for-hip-fracture
#19
Sara J E Beishuizen, Rikie M Scholtens, Barbara C van Munster, Sophia E de Rooij
OBJECTIVES: To assess the association between serum S100B levels (a marker of brain damage), delirium, and subsequent cognitive decline. DESIGN: Substudy of a multicenter randomized controlled trial. SETTING: Surgical, orthopedic, and trauma surgery wards of two teaching hospitals. PARTICIPANTS: Individuals aged 65 and older (range 65-102) admitted for hip fracture surgery (N = 385). MEASUREMENTS: During hospitalization, presence of delirium was assessed daily...
September 19, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27639312/selective-etching-of-injection-molded-zirconia-toughened-alumina-towards-osseointegrated-and-antibacterial-ceramic-implants
#20
Quentin Flamant, Carlos Caravaca, Sylvain Meille, Laurent Gremillard, Jérôme Chevalier, Katia Biotteau-Deheuvels, Meinhard Kuntz, Rona Chandrawati, Inge K Herrmann, Christopher D Spicer, Molly M Stevens, Marc Anglada
: Due to their outstanding mechanical properties and excellent biocompatibility, zirconia-toughened alumina (ZTA) ceramics have become the gold standard in orthopedics for the fabrication of ceramic bearing components over the last decade. However, ZTA is bioinert, which hampers its implantation in direct contact with bone. Furthermore, periprosthetic joint infections are now the leading cause of failure for joint arthroplasty prostheses. To address both issues, an improved surface design is required: a controlled micro- and nano-roughness can promote osseointegration and limit bacterial adhesion whereas surface porosity allows loading and delivery of antibacterial compounds...
September 14, 2016: Acta Biomaterialia
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