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Orthopedic infection control

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https://www.readbyqxmd.com/read/29347851/the-era-of-biofunctional-biomaterials-in-orthopedics-what-does-the-future-hold
#1
Mubashar Rehman, Asadullah Madni, Thomas J Webster
Titanium-based materials do not fulfill all the requirements of orthopedic implants due to a mismatch in mechanical properties with bone which are prone to change during the course of bone growth. Biofunctional biomaterials are a new class of materials that show bioactivity and adaptability at any stage of bone growth. Areas covered: Different biofunctional biomaterials have evolved over time that can enhance calcium phosphate (CaP) precipitation, stimulate osteogenic differentiation, and can control osteoblast gene expression...
January 18, 2018: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/29279933/effect-of-antibiotic-prophylaxis-on-surgical-site-infections-following-removal-of-orthopedic-implants-used-for-treatment-of-foot-ankle-and-lower-leg-fractures-a-randomized-clinical-trial
#2
RANDOMIZED CONTROLLED TRIAL
Manouk Backes, Siem A Dingemans, Marcel G W Dijkgraaf, H Rogier van den Berg, Bart van Dijkman, Jochem M Hoogendoorn, Pieter Joosse, Ewan D Ritchie, W Herbert Roerdink, Judith P M Schots, Nico L Sosef, Ingrid J B Spijkerman, Bas A Twigt, Alexander H van der Veen, Ruben N van Veen, Jefrey Vermeulen, Dagmar I Vos, Jasper Winkelhagen, J Carel Goslings, Tim Schepers
Importance: Following clean (class I, not contaminated) surgical procedures, the rate of surgical site infection (SSI) should be less than approximately 2%. However, an infection rate of 12.2% has been reported following removal of orthopedic implants used for treatment of fractures below the knee. Objective: To evaluate the effect of a single dose of preoperative antibiotic prophylaxis on the incidence of SSIs following removal of orthopedic implants used for treatment of fractures below the knee...
December 26, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29245290/operative-versus-nonoperative-treatment-of-displaced-intra-articular-calcaneal-fractures-a-meta-analysis-of-current-evidence-base
#3
REVIEW
Ning Wei, Peizhi Yuwen, Wei Liu, Yanbin Zhu, Wenli Chang, Chen Feng, Wei Chen
BACKGROUND: The relative efficacy of operative and nonoperative treatments for the displaced intra-articular calcaneal fractures (DIACF) remains uncertain. OBJECT: We conducted a meta-analysis to compare the effectiveness of operative and nonoperative treatments in treating patients with DIACF. METHODS: Databases including Cochrane Library, Medline, Embase, CBM, CNKI, and Google Scholar were searched. After independent study selection by 2 authors, data were extracted and collected independently...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29212390/serratiopeptidase-reduces-the-invasion-of-osteoblasts-by-staphylococcus-aureus
#4
Laura Selan, Rosanna Papa, Angela Ermocida, Andrea Cellini, Evaristo Ettorre, Gianluca Vrenna, Davide Campoccia, Lucio Montanaro, Carla Renata Arciola, Marco Artini
Finding new strategies to counteract periprosthetic infection and implant failure is a main target in orthopedics. Staphylococcus aureus, the leading etiologic agent of orthopedic implant infections, is able to enter and kill osteoblasts, to stimulate pro-inflammatory chemokine secretion, to recruit osteoclasts, and to cause inflammatory osteolysis. Moreover, by entering eukaryotic cells, staphylococci hide from the host immune defenses and shelter from the extracellular antibiotics. Thus, infection persists, inflammation thrives, and a highly destructive osteomyelitis occurs around the implant...
December 1, 2017: International Journal of Immunopathology and Pharmacology
https://www.readbyqxmd.com/read/29185295/complications-and-survival-of-megaprostheses-after-resection-of-bone-metastases
#5
M De Gori, A D’Arienzo, L Andreani, G Beltrami, D A Campanacci, P De Biase, F Frenos, S Giannotti, F Sacchetti, F Totti, P Parchi, R Capanna
Treatment of bone metastases is often palliative, aiming at pain control and stabilization or prevention of pathological fractures. However, a complete resection with healing purposes can be performed in selected cases. The aim of our work was to evaluate the survival of megaprostheses used for reconstruction after bone metastases. Between January 2001 and March 2015, we implanted 169 Megasystem-C® (Waldemar LINK® GmbH & Co. KG, Hamburg, Germany) after bone metastasis resection. Patients, 95 females and 74 males, were operated at an average age of 61 (12-87) years for proximal femoral resection in 135 (79...
October 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29133624/histopathological-histomorphometrical-and-radiological-evaluations-of-hydroxyapatite-bioactive-glass-and-fluorapatite-bioactive-glass-nanocomposite-foams-as-cell-scaffolds-in-rat-tibia-an-in-vivo-study
#6
Maryam Seyedmajidi, Sina Haghanifar, Karimollah Hajian-Tilaki, Seyedali Seyedmajidi
Bone defects are common and persistent problems in clinical orthopedics and dentistry. The development of synthetic reconstruction materials is essential owing to the restricted access to natural bone grafts, disease transmission risks, surgical costs, donor-site morbidity, infections, and immune response-related complications. Accordingly, the aim of the present study was to evaluate the histopathological, histomorphometrical, and radiological characteristics of composite foams containing hydroxyapatite/bioactive glass (HA/BG) and fluorapatite/bioactive glass (FA/BG) as cell scaffolds in rat tibia reconstruction...
November 14, 2017: Biomedical Materials
https://www.readbyqxmd.com/read/29089254/biocompatibility-and-degradation-properties-of-we43-mg-alloys-with-and-without-heat-treatment-in%C3%A2-vivo-evaluation-and-comparison-in-a-cranial-bone-sheep-model
#7
Andrea Torroni, Chongchen Xiang, Lukasz Witek, Eduardo D Rodriguez, Paulo G Coelho, Nikhil Gupta
PURPOSE: Orthopedic and maxillofacial bone fractures are routinely treated by titanium internal fixation, which may be prone to exposure, infection or intolerance. Magnesium (Mg) and its alloys represent promising alternatives to produce biodegradable osteosynthesis devices, with biocompatibility and, specifically, hydrogen gas production during the degradation process, being the main drawback. Aim of this study is to test and compare biocompatibility, degradation rate and physiscochemical properties of two Mg-alloys to identify which one possesses the most suitable characteristics to be used as resorbable hardware in load-bearing fracture sites...
September 28, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29024614/staphylococcus-aureus-infections-in-german-patients-with-type-2-diabetes-mellitus-after-orthopedic-surgery-incidence-risk-factors-and-clinical-and-health-economic-outcomes
#8
Fraence Gottschalk, Thomas Wilke, Sabrina Mueller, Kirstin Heinrich, Ulf Maywald, Andreas Fuchs, Holly Yu
BACKGROUND: This study assessed Staphylococcus aureus infection risk in patients with type 2 diabetes mellitus (T2DM) undergoing an orthopedic knee, hip, or spine surgery. PATIENTS AND METHODS: All patients with a diagnosis of T2DM in the period from 2010 to 2012 were identified from a German claims database. First inpatient knee, hip, or spine surgery was used as index date. Cumulative incidence of S. aureus infections was calculated for several time intervals...
October 12, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28992487/agnps-decorated-3d-printed-peek-implant-for-infection-control-and-bone-repair
#9
Lijun Deng, Yi Deng, Kenan Xie
Polyetheretherketone (PEEK) is an ideal substitute material for bone tissue engineering, which can avoid the stress shielding phenomenon due to its similar mechanical properties to natural human bone. Complex bone defect and postoperative infection are still two enormous challenges in orthopedic clinics. It's well-known that additive manufacturing possesses the merits of high-precision and rapid prototyping, thus it easily meets the needs of mold processing. In the present study, we developed a novel Ag-decorated 3D printed PEEK via catecholamine chemistry...
October 2, 2017: Colloids and Surfaces. B, Biointerfaces
https://www.readbyqxmd.com/read/28983214/factors-associated-with-choice-and-success-of-one-versus-two-stage-revision-arthroplasty-for-infected-hip-and-knee-prostheses
#10
Lucas Castellani, Nick Daneman, Samira Mubareka, Richard Jenkinson
BACKGROUND: Prosthetic joint infections (PJI) of hip and knee arthroplasties are becoming increasingly common with an aging population and an increasing demand for these procedures. Despite attempts at standardization, medical and surgical approaches vary widely among practitioners. QUESTIONS/PURPOSES: We first sought to determine if there were specific factors associated with choice of one- versus two-stage revision. Then we investigated whether the type of revision approach influenced clinical treatment success...
October 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28977312/analysis-of-surgical-site-infections-in-pediatric-patients-after-orthopedic-surgery-a-case-control-study
#11
Mariana de Queiroz Leite Chagas, Ana Maria Magalhães Costa, Pedro Henrique Barros Mendes, Saint Clair Gomes
OBJECTIVES: To describe the rate of surgical site infections in children undergoing orthopedic surgery in centers of excellence and analyze the patients' profiles. METHODS: Medical records of pediatric patients undergoing orthopedic surgery in the Jamil Haddad National Institute of Traumatology and Orthopedics from January 2012 to December 2013 were analyzed and monitored for one year. Patients diagnosed with surgical site infection were matched with patients without infection by age, date of admission, field of orthopedic surgery and type of surgical procedure...
January 2017: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
https://www.readbyqxmd.com/read/28976634/antibiotic-eluting-orthopedic-device-to-prevent-early-implant-associated-infections-efficacy-biocompatibility-and-biodistribution-studies-in-an-ovine-model
#12
Marina Gimeno, Pedro Pinczowski, Gracia Mendoza, Javier Asín, Francisco J Vázquez, Eugenio Vispe, Felícito García-Álvarez, Marta Pérez, Jesús Santamaría, Manuel Arruebo, Lluís Luján
Infection of orthopedic devices is a major complication in the postsurgical period generating important health issues and economic consequences. Prevention strategies could be based on local release of antibiotics from the orthopedic device itself to avoid adhesion and growth of bacteria. The purpose of this work is to demonstrate the efficiency to prevent these infections by a cefazolin-eluting, perforated stainless steel implant in an in vivo ovine model. The device was placed in the tibia of sheep, one group receiving cefazolin-loaded implants whereas the control group received empty implants...
October 4, 2017: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/28976593/trowels-and-tribulations-review-of-antimicrobial-impregnated-bone-cements-in-prosthetic-joint-surgery
#13
Vasilios Athans, Michael P Veve, Susan L Davis
Antimicrobial-impregnated bone cement (AIBC) is a staple of contemporary orthopedic surgery and has been used to either treat or prevent prosthetic joint infection. Applied intraoperatively during primary arthroplasty or prosthetic joint exchange, this drug-delivery vehicle has become a popular means of maximizing drug concentrations within a joint space while minimizing systemic exposure. Antimicrobial characteristics conducive to cement loading include availability of a crystalline powder formulation, molecular characteristics, minimal impact on cement integrity, and other variables promoting drug elution...
December 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28881529/-results-for-the-treatment-of-fresh-type-thoracolumbar-vertebral-fracture-according-to-the-intraoperative-ct-scan
#14
Y W Li, H J Wang, Y S Wang, W Cui
Objective: To evaluate the value of intraoperative CT scanning in the treatment of fresh thoracolumbar burst fractures. Methods: From January 2008 to January 2015 , 161 patients with thoracolumbar fractures in Department of Orthopedics, Luohe City Central Hospital, were divided into two groups: 79 cases were treatment group which were treated with intraoperative CT scan and decompression mode was determined according to CT scan results during the period from October 2012 to January 2015. 82 patients as the observation group were treated without intraoperative CT scan and direct laminectomy were performed during the period...
September 5, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28881121/the-predictable-factors-of-the-postoperative-kyphotic-change-of-sagittal-alignment-of-the-cervical-spine-after-the-laminoplasty
#15
Jun Seok Lee, Dong Wuk Son, Su Hun Lee, Dong Ha Kim, Sang Weon Lee, Geun Sung Song
OBJECTIVE: Laminoplasty is an effective surgical method for treating cervical degenerative disease. However, postoperative complications such as kyphosis, restriction of neck motion, and instability are often reported. Despite sufficient preoperative lordosis, this procedure often aggravates the lordotic curve of the cervical spine and straightens cervical alignment. Hence, it is important to examine preoperative risk factors associated with postoperative kyphotic alignment changes. Our study aimed to investigate preoperative radiologic parameters associated with kyphotic deformity post laminoplasty...
September 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28870735/percutaneous-osteotomies-in-hallux-valgus-a-systematic-review
#16
REVIEW
Ana Bia, Francisco Guerra-Pinto, Bruno S Pereira, Nuno Corte-Real, Xavier Martin Oliva
Percutaneous and minimally invasive surgery is one of the greatest advances in the operating field of orthopedic since the late 1990s. The potential advantages include a shorter operative time, quicker recovery, and reduced hospital stay compared with traditional open surgery. However, scientific validation of the safety and efficacy of hallux valgus (HV) percutaneous surgery remains inconclusive. The objective of the present study was to systematically review the published data and clinical evidence for percutaneous HV surgery, evaluate the scientific method of the reports, and clarify the indications, safety, efficacy, and potential risks of these surgical techniques...
September 1, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28827509/early-definitive-fracture-fixation-is-safely-performed-in-the-presence-of-an-open-abdomen-in-multiply-injured-patients
#17
Nina E Glass, Clay Cothren Burlew, Jens Hahnhaussen, Sebastian Weckbach, Fredric M Pieracci, Ernest E Moore, Philip F Stahel
OBJECTIVE: To investigate the safety and feasibility of performing definitive fracture fixation in multiply injured patients in the presence of an open abdomen after laparotomy. DESIGN: Retrospective observational cohort study. SETTING: Level-I academic trauma center. PATIENTS: Adult polytrauma patients with presence of an open abdomen after "damage control" laparotomy and associated major fractures of long bones, acetabulum, pelvis or spine, requiring surgical repair (n=81)...
August 15, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28763892/-efficacy-and-safety-of-drainage-after-total-knee-arthroplasty
#18
F Jing, H M Li, X D Yang, B Li, J Ji, Y L Li, C J Sun
Objective: To determine whether suction drainage is safe and effective compared with no-drainage in total knee arthroplasty. Methods: The literature search was based on PubMed, MEDLINE, EMBASE, Highwire, the Cochrane Library, CBM, CNKI, VIP and WFSD.The data were analysed using RevMan 5.3.Fourteen randomised controlled trials involving 1 009 knees were included in our analysis. Results: Suction drainage increases the rate and volume of blood transfusion.No-drainage group increases the rate of wound problems (OR=1...
July 18, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28735655/an-intramedullary-nail-coated-with-antibiotic-and-growth-factor-nanoparticles-an-individualized-state-of-the-art-treatment-for-chronic-osteomyelitis-with-bone-defects
#19
Roberto Berebichez-Fridman, Pablo Montero-Olvera, Ricardo Gómez-García, Enrique Berebichez-Fastlicht
Among various infections, chronic osteomyelitis is one of the most challenging in terms of treatment. This infection is more common among patients with open fractures and those who have undergone elective orthopedic procedures. The treatment of osteomyelitis requires high antibiotic doses and an aggressive and multifaceted surgical approach. The use of parenteral antibiotics alone, without debridement, is not sufficiently effective, due to the formation of sequestra and the low vascularity of the affected area...
August 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28730548/orthopedic-infections-caused-by-obligatory-anaerobic-gram-negative-rods-report-of-two-cases
#20
Marta Kierzkowska, Piotr Pedzisz, Ireneusz Babiak, Jakub Janowicz, Mateusz Kulig, Anna Majewska, Anna Sawicka-Grzelak, Grazyna Mlynarczyk
Anaerobic bone and joint infections are uncommon, although the number of anaerobic infections is presumably underestimated because of difficulties with isolation and identification of obligate anaerobes. This study describes two cases of complicated Bacteroides fragilis peri-implant infection of the lumbar spine, infection of the hip and osteomyelitis. Bacteria were identified with the use of a mass spectrometer, VITEK MS system. Drug susceptibility was performed with the use of E-test. The EUCAST breakpoints were used for interpretation with B...
October 2017: Medical Microbiology and Immunology
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