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https://www.readbyqxmd.com/read/28343870/cd15-focus-score-infection-diagnosis-and-stratification-into-low-virulence-and-high-virulence-microbial-pathogens-in-periprosthetic-joint-infection
#1
V T Krenn, M Liebisch, B Kölbel, N Renz, T Gehrke, M Huber, M G Krukemeyer, A Trampuz, H Resch, V Krenn
INTRODUCTION: The aim of the work was to validate the CD15 focus score for the infection pathology of periprosthetic joint infection in a large group and to clarify whether a stratification into low-virulence and high-virulence microbial pathogens is possible by means of the CD15 focus score (quantification of CD15 positive granulocytes). METHODS: The histopathology of 275 synovial tissue samples taken intraoperatively during revision operations (n=127 hip, n=141 knee, n=2 shoulder, n=5 ankle) was evaluated according to the SLIM consensus classification (SLIM=synovial-like interface membrane)...
January 12, 2017: Pathology, Research and Practice
https://www.readbyqxmd.com/read/28343826/diagnosis-of-periprosthetic-joint-infection-an-algorithm-based-approach
#2
Nicholas T Ting, Craig J Della Valle
BACKGROUND: Periprosthetic joint infection (PJI) remains one of the most challenging and devastating modes of failure after total hip and knee arthroplasties. Despite the profound urgency and impact of PJI on an individual and societal basis, historically, there have not been standardized definitions of and diagnostic algorithms for infection after total joint arthroplasty. METHODS: In a recent symposium, the American Academy of Hip and Knee Surgeons put forth a standardized approach to the prevention, diagnosis, and management of the patient with a suspected PJI...
March 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28342819/ankylosis-of-the-knee-after-septic-arthritis-following-anterior-cruciate-ligament-reconstruction-in-a-13-year-old-male
#3
Bastian Mester, Falk Ullerich, Tobias Ohmann, Martin Glombitza, Christian Schoepp
We present the case of an adolescent male developing anankylosis of the knee after septic arthritis following anterior cruciate ligamentreconstruction (ACLR).The patientwas shifted to our institutionwithpostoperative septic arthritis associated with a systemic septic condition. Before, repeated arthroscopic surgery had beenconductedwithoutany improvement. MRI showed a concomitant osteomyelitis. The infection (Gächter IV, S. aureus) was controlled by an open surgical approach and graft removal.An increasing joint stiffness wasdocumented...
March 22, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28342778/-the-burden-of-fungal-infections-in-algeria
#4
REVIEW
M Chekiri-Talbi, D W Denning
In Algeria, superficial mycoses are very commonly diagnosed. Deep fungal infections are less often observed. Few data from Algeria are found in the literature. We report for the first time the main causes of these diseases in our country and provide burden estimates. We searched for existing data and estimated the incidence and prevalence of fungal diseases based on the population at risk and available epidemiological data. Demographic data were derived from the Service (Office) of the Statistics (ONES), World Health Organization (WHO), The Joint Nations Programme on HIV/AIDS (UNAIDS) and national published reports...
March 22, 2017: Journal de Mycologie Médicale
https://www.readbyqxmd.com/read/28342028/disparities-in-knee-and-hip-arthroplasty-outcomes-an-observational-analysis-of-the-acs-nsqip-clinical-registry
#5
Peter Cram, Gillian Hawker, John Matelski, Bheeshma Ravi, Andrew Pugely, Rajiv Gandhi, Timothy Jackson
BACKGROUND: Disparities in total joint arthroplasty (TJA) have largely been studied in single center studies and using administrative data. Our objective was to investigate differences in TJA outcomes in white men, black men, white women, and black women using a large international registry. METHODS: We used 2010-2013 data from the ACS-NSQIP to identify four groups of adults (white men, black men, white women, black women) who underwent primary total knee arthroplasty (TKA) or total hip arthroplasty (THA)...
March 24, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28341537/interleukin-6-expression-in-disc-derangement-of-human-temporomandibular-joint-and-association-with-osteoarthrosis
#6
Flavio de Alcântara Camejo, Marina Azevedo, Viviane Ambros, Karina São Thiago Caporal, Andrea Duarte Doetzer, Luis Eduardo Almeida, Marcia Olandoski, Lucia Noronha, Paula Cristina Trevilatto
The inflammatory process is a coordinated response that protects host after infection or trauma, involving several molecular reactions. Once the inflammation is closely linked to the process of destruction of the temporomandibular joint, this study aims to examine, by immunohistochemistry, the expression of interleukin-6 (IL-6), an important inflammatory marker, in temporomandibular articular discs of patients with anterior disc displacement with (ADDwR) and without reduction (ADDwoR) and its association with osteoarthrosis (OA)...
February 24, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28341280/cost-effectiveness-of-staphylococcus-aureus-decolonization-strategies-in-high-risk-total-joint-arthroplasty-patients
#7
Devin M Williams, Andy O Miller, Michael W Henry, Geoffrey H Westrich, Hassan M K Ghomrawi
BACKGROUND: The risk of prosthetic joint infection increases with Staphylococcus aureus colonization. The cost-effectiveness of decolonization is controversial. We evaluated cost-effectiveness decolonization protocols in high-risk arthroplasty patients. METHODS: An analytical model evaluated risk under 3 protocols: 4 swabs, 2 swabs, and nasal swab alone. These were compared to no-screening and universal decolonization strategies. Cost-effectiveness was evaluated from the hospital, patient, and societal perspective...
February 7, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28339315/identification-of-asymptomatic-prosthetic-joint-infection-microbiologic-and-operative-treatment-outcomes
#8
Przemysław L Bereza, Alicja Ekiel, Aleksandra Auguściak-Duma, Małgorzata Aptekorz, Iwona Wilk, Piotr Wojciechowski, Damian J Kusz, Gayane Martirosian
BACKGROUND: This prospective study investigated the role of mechanical and biological factors in aseptic implant loosening or presumed silent prosthetic joint infection (PJI). METHODS: Thirty-seven patients were investigated. Microbiologic and molecular methods were used to detect bacteria on the surface of the failed implants removed during revision arthroplasty. Histopathologic analysis was performed. The influence of body mass index (BMI) and various co-morbidities on implant failure also was determined...
March 24, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28337986/simultaneous-treatment-of-temporomandibular-joint-ankylosis-with-severe-mandibular-deficiency-by-standard-tmj-prosthesis
#9
YiHui Hu, LuZhu Zhang, DongMei He, Chi Yang, MinJie Chen, ShanYong Zhang, Hui Li, Edward Ellis Iii
Temporomandibular joint (TMJ) ankylosis is a refractory disease that is difficult to predictably treat. This study evaluated the prognosis of using standard alloplastic TMJ prostheses for the treatment of TMJ ankylosis in Chinese patients with severe mandibular deficiency. Patients treated from 2013 to 2015 were reviewed. The computer-aided design and manufacture (CAD/CAM) technique was used to guide bony mass removal and locate the TMJ prosthesis (Biomet, USA). Eleven patients were included in this study. All prostheses were successfully installed and stabilized intraoperatively...
March 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28337666/joint-infection-due-to-raoultella-planticola-first-report
#10
E Bonnet, F Julia, G Giordano, J Lourtet-Hascoet
The genus Raoultella has been separated from the genus Klebsiella in 2001. Two main species are responsible for human infections: R. ornithinolytica and R. planticola. The most frequent infections due to R. planticola include cystitis, pneumonia and bacteremia (mostly in immunocompromised hosts). To date, no joint or bone infection has been reported. We describe the first case of septic arthritis due to R. planticola following an arthroscopy with intra-articular injection of corticosteroids. Evolution was favorable after arthroscopic lavage and antibiotic therapy with quinolones...
March 23, 2017: Infection
https://www.readbyqxmd.com/read/28337536/functional-and-patient-reported-outcomes-of-the-swanson-metacarpo-phalangeal-arthroplasty-in-the-rheumatoid-hand
#11
Firas K Elherik, Sean Dolan, John Antrum, Frank Unglaub, Colin R Howie, Steffen J Breusch
INTRODUCTION: Replacement of the metacarpo-phalangeal joints (MCPJ) with silastic Swanson's implants can help decrease pain, stiffness and allow for improved function in rheumatoid arthritis (RA). There is a lack of patient reported outcome measure (PROM) studies assessing the efficacy of this procedure in RA. The aim of this study was to report any change in function, pain, stiffness and satisfaction following the Swanson MCPJ replacement using patient reported outcomes in a rheumatoid population...
March 24, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28337426/pathogen-identification-in-suspected-cases-of-pyogenic-spondylodiscitis
#12
Ahmad Farajzadeh Sheikh, Azar D Khosravi, Hamed Goodarzi, Roohangiz Nashibi, Alireaza Teimouri, Azim Motamedfar, Reza Ranjbar, Sara Afzalzadeh, Mehrandokht Cyrus, Mohammad Hashemzadeh
Pyogenic spinal infection continues to represent a worldwide problem. In approximately one-third of patients with pyogenic spondylodiscitis, the infectious agent is never identified. Of the cases that lead to organismal identification, bacteria are more commonly isolated from the spine rather than fungi and parasites. This study applied universal prokaryotic 16S rRNA PCR as a rapid diagnostic tool for the detection of bacterial agents in specimens from patients suspected of pyogenic spondylodiscitis. Gram and Ziehl-Neelsen staining were used as a preliminary screening measure for microbiologic evaluation of patient samples...
2017: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/28336247/surgical-case-order-has-an-effect-on-the-risk-of-subsequent-periprosthetic-joint-infection
#13
Antonia F Chen, Michael M Kheir, Joshua M Greenbaum, Camilo Restrepo, Mitchell G Maltenfort, Javad Parvizi
BACKGROUND: Periprosthetic joint infection (PJI) after total joint arthroplasty (TJA) is a serious complication with multiple etiologies. Prior spine literature has shown that later cases in the day were more likely to develop surgical site infection. However, the effect of case order on PJI after TJA is unknown. This study aims to determine the influence of case order, prior infected case, and terminal cleaning on the risk for a subsequent PJI. METHODS: A retrospective, single-institution study was conducted on 31,499 TJAs performed from 2000 to 2014...
February 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28336043/pediatric-septic-arthritis
#14
REVIEW
Nicole I Montgomery, Howard R Epps
Acute septic arthritis is a condition with the potential for joint destruction, physeal damage, and osteonecrosis, which warrants urgent identification and treatment. The organism most frequently responsible is Staphylococcus aureus; however, our understanding of pathogens continues to evolve as detection methods continue to improve. MRI has improved our ability to detect concurrent infections and is a useful clinical tool where available. The treatment course involves intravenous antibiotics followed by transition to oral antibiotics when clinically appropriate...
April 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28335753/leuconostoc-mesenteroides-periprosthetic-knee-infection-an-unusual-fastidious-gram-positive-bacteria-a-case-report
#15
Rafael Franco-Cendejas, Claudia A Colín-Castro, Melissa Hernández-Durán, Luis E López-Jácome, Silvestre Ortega-Peña, Guillermo Cerón-González, Samuel Vanegas-Rodríguez, Jaime A Mondragón-Eguiluz, Eduardo Acosta-Rodríguez
BACKGROUND: Periprosthetic joint infections are mainly caused by Gram-positive cocci. Leuconostoc mesenteroides is a rare microorganism mainly causing bloodstream infections. At times, it might be confused with another type of cocci and give rise to misdiagnosed infections. Molecular diagnosis and biofilm production comprise important techniques to guide antibiotic treatment. CASE PRESENTATION: A 68-year-old Hispanic female with a previous history of bilateral knee arthroplasty presented with acute right-knee inflammation and gait impairment...
March 23, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28333947/surgical-interventions-to-treat-humerus-shaft-fractures-a-network-meta-analysis-of-randomized-controlled-trials
#16
Jia-Guo Zhao, Jia Wang, Xiao-Hui Meng, Xian-Tie Zeng, Shi-Lian Kan
BACKGROUND: There are three main surgical techniques to treat humeral shaft fractures: open reduction and plate fixation (ORPF), intramedullary nail (IMN) fixation, and minimally invasive percutaneous osteosynthesis (MIPO). We performed a network meta-analysis to compare three surgical procedures, including ORPF, IMN fixation, and MIPO, to provide the optimum treatment for humerus shaft fractures. METHODS: MEDLINE, EMBASE, Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, and Cochrane library were researched for reports published up to May 2016...
2017: PloS One
https://www.readbyqxmd.com/read/28332761/a-uk-national-survey-of-care-pathways-and-support-offered-to-patients-receiving-revision-surgery-for-prosthetic-joint-infection-in-the-highest-volume-nhs-orthopaedic-centres
#17
Andrew J Moore, Michael R Whitehouse, Rachael Gooberman-Hill, Jason Heddington, Andrew D Beswick, Ashley W Blom, Tim J Peters
BACKGROUND: Deep prosthetic joint infection (PJI) is a devastating complication of joint replacement surgery. It is difficult to treat, and patients often require multiple major revision surgeries to eradicate the infection. Treatment can have negative and long-term impact on patients' quality of life. Understanding current service provision provides valuable information needed to design and evaluate support interventions for patients. AIM: This survey aimed to identify usual care pathways and support in UK National Health Service (NHS) orthopaedic centres for patients receiving revision surgery for PJI after hip or knee replacement...
March 23, 2017: Musculoskeletal Care
https://www.readbyqxmd.com/read/28331279/unplanned-90-day-readmissions-in-a-specialty-orthopaedic-unit-a-prospective-analysis-of-consecutive-12729-admissions
#18
Mahender Avinash, S Rajasekaran, Siddharth N Aiyer
INTRODUCTION: Unplanned readmissions are an undesirable and expensive outcome of clinical practice. Previous reported literature is limited by retrospective study designs and 30 day study intervals. We analyzed causes for 90-day unplanned readmission, temporal occurrence of major causes, possible predisposing factors, bed days lost and economic impact. MATERIALS & METHODS: A prospective analysis of 12729 admissions was performed over 1 year in an Orthopaedic unit...
June 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28329470/cutaneous-manifestations-of-disseminated-gonococcemia
#19
Surget V Beatrous, Stratton B Grisoli, Ryan R Riahi, Ryan J Matherne, Ryan J Matherne
BACKGROUND: Sexually transmitted infections, includingurogenital gonorrheal infection, are a growing healthconcern in the United States. Nearly 50% of cervicalinfections are asymptomatic. If left undiagnosedand untreated, there is a risk of disseminatedinfection. PURPOSE: To describe an 18-year-old womanpresenting with disseminated gonococcal infectionconfirmed by blood cultures, skin biopsy, and urinegonococcal probe. We also describe the presentation,diagnosis, and treatment of disseminated gonococcalinfection, including discussion of the variousmorphologies of cutaneous lesions that have beenreported in the literature...
January 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/28328742/treatment-of-proximal-humerus-fractures-in-children-with-a-modified-palm-tree-technique
#20
Ayman M Ali, Sallam I Fawzy, Medhat Moaty, Mohamed Abelaziz
Although most pediatric proximal humeral fractures can be successfully treated conservatively with satisfactory results, many operative techniques have been described for the treatment of displaced proximal humeral fractures. The aim of this study is to evaluate the efficacy of percutaneous fixation using a modified palm tree technique for proximal humerus fractures in children. Between March 2011 and May 2013, the modified palm tree technique was used for the management of 30 children (20 boys and 10 girls) with displaced proximal humeral fractures...
March 21, 2017: Journal of Pediatric Orthopedics. Part B
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