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Musculoskeletal infection

Jacob M Babu, Saisanjana Kalagara, Wesley Durand, Valentin Antoci, Matthew E Deren, Eric Cohen
BACKGROUND: Sarcopenia, an age-related loss of muscle mass and function, has been previously linked to an increased risk of morbidity, mortality, and infection after a variety of surgical procedures. This study is the first to evaluate the impact of the psoas-lumbar vertebral index (PLVI), a validated marker for central sarcopenia, on determining post-arthroplasty infection status. METHODS: This is a case-control, retrospective review of 30 patients with prosthetic joint infection (PJI) diagnosed by the Musculoskeletal Infection Society criteria compared to 69 control patients who underwent a total hip or knee arthroplasty...
September 20, 2018: Journal of Arthroplasty
Fábio Videira Santos, Ana Cipriano, Miguel Araújo Abreu, Carlos Andrade, Rui Sarmento-Castro
Lyme disease is an endemic zoonosis, the most prevalent tick-transmitted infection in temperate areas of Europe, North America and Asia. It is a multisystemic disease with cutaneous, musculoskeletal, neurologic and cardiac manifestations, according to the stage of the disease. We describe a case of late neuroborreliosis in an Erasmus programme student living in Porto. We discuss the importance of the epidemiological suspicion, the clinical approach, the diagnostic criteria and the most adequate treatment.
September 28, 2018: Acta Médica Portuguesa
Christopher W Bunt, Christopher E Jonas, Jennifer G Chang
Knee pain affects approximately 25% of adults, and its prevalence has increased almost 65% over the past 20 years, accounting for nearly 4 million primary care visits annually. Initial evaluation should emphasize excluding urgent causes while considering the need for referral. Key aspects of the patient history include age; location, onset, duration, and quality of pain; associated mechanical or systemic symptoms; history of swelling; description of precipitating trauma; and pertinent medical or surgical history...
November 1, 2018: American Family Physician
Andrew J Becker, Lauren C Heathcote, Inge Timmers, Laura E Simons
Introduction: The epidemiology of chronic pain in youth has been increasingly documented over the past decade. However, the precipitating events associated with the onset of pediatric chronic pain are not well studied. Objectives: Understanding the events that precede the onset of pain, and are reported by patients as germane to the early stages of their pain, may add one piece to the puzzle of the causal etiology of pediatric chronic pain disorders. Methods: We conducted a retrospective chart review of 320 young people attending a tertiary care chronic pain clinic with musculoskeletal chronic pain...
September 2018: Pain Reports (Baltimore, Md.)
Abdullah Al-Zaghal, William Raynor, Mohsen Khosravi, Ali Guermazi, Thomas J Werner, Abass Alavi
Medical imaging plays a particularly important role in the care of elderly patients, in whom complex symptomatology and a high prevalence of musculoskeletal diseases necessitate sensitive imaging modalities. MRI is the most commonly used imaging modality in the evaluation of various musculoskeletal disorders. The integration of positron emission technique and computed tomography as well as magnetic resonance imaging allows for generating complimentary data for accurate and quantitative diagnosis. This article highlights the implementations of molecular imaging probes in the assessment of prevalent musculoskeletal disorders among geriatric population with emphasis on osteoarthritis, osteoporosis, diabetic foot, and prosthetic joint infections...
November 2018: Seminars in Nuclear Medicine
Logan Boles, Christopher Alexander, Leslie Pace, Warren Haggard, Joel Bumgardner, Jessica Jennings
Complex open musculoskeletal wounds are a leading cause of morbidity worldwide, partially due to a high risk of bacterial contamination. Local delivery systems may be used as adjunctive therapies to prevent infection, but they may be nondegradable, possess inadequate wound coverage, or migrate from the wound site. To address this issue, a thermo-responsive, injectable chitosan paste was fabricated by incorporating beta-glycerophosphate. The efficacy of thermo-paste as an adjunctive infection prevention tool was evaluated in terms of cytocompatibility, degradation, antibacterial, injectability, and inflammation properties...
October 12, 2018: Journal of Functional Biomaterials
Chidozie H Ewurum, Yingying Guo, Seang Pagnha, Zhao Feng, Xiongbiao Luo
Orthopedic surgery is a widely performed clinical procedure that deals with problems in relation to the bones, joints, and ligaments of the human body, such as musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors, and congenital disorders. Surgical navigation is generally recognized as the next generation technology of orthopedic surgery. The development of orthopedic navigation systems aims to analyze pre-, intra- and/or postoperative data in multiple modalities and provide an augmented reality 3-D visualization environment to improve clinical outcomes of surgical orthopedic procedures...
2018: Advances in Experimental Medicine and Biology
Allison Tetreault, Wendy Ramalingam, Jennifer Black, Nancy H Miller, Nathan Donaldson
CASE: A 19-year-old adolescent with Kniest dysplasia was incidentally found to have osteosarcoma of the proximal aspect of the humerus after having a chest radiograph for evaluation of an upper respiratory infection. He underwent chemotherapy and resection of the tumor, and there was no evidence of metastasis at the 16-month follow-up. CONCLUSION: Patients with osteochondrodysplasias often have multiple orthopaedic symptoms. Changes in chronic pain symptoms should be investigated to rule out insidious secondary causes of musculoskeletal pain, such as osteosarcoma...
October 10, 2018: JBJS Case Connector
Emilie Amaro, Tanya K Marvi, Samuel L Posey, Michael A Benvenuti, Thomas J An, Kevin M Dale, Steven A Lovejoy, Jeffrey E Martus, Megan E Johnson, Gregory A Mencio, Stephanie N Moore-Lotridge, Isaac P Thomsen, Jonathan G Schoenecker
BACKGROUND: The rate of venous thromboembolism in children with musculoskeletal infections (MSKIs) is markedly elevated compared with hospitalized children in general. Predictive biomarkers to identify high-risk patients are needed to prevent the significant morbidity and rare mortality associated with thrombotic complications. We hypothesize that overactivation of the acute phase response is associated with the development of pathologic thrombi and we aim to determine whether elevations in C-reactive protein (CRP) are associated with increased rates of thrombosis in pediatric patients with MSKI...
October 8, 2018: Journal of Pediatric Orthopedics
Daniel C Kolinsky, Stephen Y Liang
Bone and joint infections are potentially limb-threatening or even life-threatening diseases. Emergency physicians must consider infection when evaluating musculoskeletal complaints, as misdiagnosis can have significant consequences. Patients with bone and joint infections can have heterogeneous presentations with nonspecific signs and symptoms. Staphylococcus aureus is the most commonly implicated microorganism. Although diagnosis may be suggested by physical examination, laboratory testing, and imaging, tissue sampling for Gram stain and microbiologic culture is preferable, as pathogen identification and susceptibility testing help optimize long-term antibiotic therapy...
November 2018: Emergency Medicine Clinics of North America
F-C Kuo, Y-D Lu, C-T Wu, H-L You, G-B Lee, M S Lee
AIMS: The aim of this study was to compare the results of 16S/28S rRNA sequencing with the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, and synovial fluid analysis in the diagnosis of prosthetic joint infection (PJI). PATIENTS AND METHODS: Between September 2015 and August 2016, 214 consecutive patients were enrolled. In the study population, there were 25 patients with a PJI and 189 controls. Of the PJI patients, 14 (56%) were women, and the mean age at the time of diagnosis was 65 years (38 to 83)...
October 2018: Bone & Joint Journal
L-K Chen, B T Sullivan, P D Sponseller
Purpose: To compare patient characteristics, operative time, estimated blood loss (EBL), postoperative length of hospital stay (LOS) and complications after insertion and removal of submuscular plates (SMPs) versus flexible nails (FNs) for paediatric diaphyseal femur fractures. Methods: We reviewed records of 58 children (mean age, 7.7 years SD 2.0) with diaphyseal femur fractures who underwent treatment with SMPs (n = 30) or FNs (n = 28) from 2005 to 2017 (mean follow-up, 22 months SD 28)...
October 1, 2018: Journal of Children's Orthopaedics
Jeffrey D Hassebrock, Michael G Fox, Mark J Spangehl, Matthew R Neville, Adam J Schwartz
BACKGROUND: The American Academy of Orthopedic Surgeons clinical practice guideline currently recommends repeat joint aspiration when workup of periprosthetic joint infection (PJI) reveals conflicting data. This guideline is based on a single study of 31 patients published 25 years ago. We sought to determine the correlation between first and second aspirations and factors that may play a role in variability between them. METHODS: Sixty patients with less than 90 days between aspirations and no intervening surgery were identified at our institution and classified by Musculoskeletal Infection Society (MSIS) criteria as infected, not infected, or not able to determine after both aspirations...
September 11, 2018: Journal of Arthroplasty
Anne Kjær Schmidt, Bård Lilleeng, Valborg Baste, Thomas Mildestvedt, Sabine Ruths
OBJECTIVE: To evaluate the use of a small municipality acute bed unit (MAU) in rural Norway resulting from the Coordination reform regarding occupancy-rate, patient characteristics and healthcare provided during the first four years of operation. Further, to investigate whether implementation of the new municipal service avoided acute hospital admissions. DESIGN: Observational study. SETTING: A two-bed municipal acute bed unit. SUBJECTS: All patients admitted to the unit between 2013 and 2016...
October 5, 2018: Scandinavian Journal of Primary Health Care
Seung-Han Shin, Il-Kyu Park, Jin-Woo Kang, Yong-Suk Lee, Yang-Guk Chung
BACKGROUND: Purulent musculoskeletal infections often require surgical debridement and drainage. However, when the infection is extensive or involving multiple layers of tissues, maintaining drainage of the involved spaces can be difficult, even with the application of vacuum-assisted closure (VAC) therapy. Wide exposure and aggressive debridement is often required for such cases, which in turn may complicate wound coverage. METHODS: A retrospective review was performed for 16 patients with musculoskeletal infections treated surgically...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
William C Tally, H Thomas Temple, T Y Subhawong, Timothy Ganey
Background: When conservative treatments fail to alleviate the discomfort of abnormal motion, spinal fusion has been shown to provide symptomatic treatment for spinal instability, stenosis, spondylolisthesis, and symptomatic degenerative disc disease. The trend and rates of fusion over the past few years have been dramatic in the United States. Accompanying that higher incidence has been the shifting from traditional open surgery to minimally invasive techniques to reduce scar tissue formation, extent of muscle stripping, and muscle retraction which all have been shown to adversely affect outcomes...
January 2018: International Journal of Spine Surgery
David N Kugelman, Abdullah M Qatu, Eric J Strauss, Sanjit R Konda, Kenneth A Egol
OBJECTIVES: What patient characteristics and injury factors predict decreased knee range of motion (ROM) after operative management of tibial plateau fractures? DESIGN: Prospective cohort study. SETTING: Academic medical center. PATIENTS: Over 11 years, tibial plateau fractures at a single academic institution were prospectively followed. A total of 266 patients were included in this study. INTERVENTION: Surgical repair of tibial plateau fractures and secondary interventions due to arthrofibrosis...
November 2018: Journal of Orthopaedic Trauma
Turgut Akgül, İsmail Cem Sormaz, Murat Aksoy, Adem Uçar, Harzem Özger, Levent Eralp
OBJECTIVES: This paper aims to evaluate the extremity function and vascular outcome after limb-sparing surgery for extremity musculoskeletal tumors invading vascular structure required reconstruction. METHODS: Of the 507 patients with musculoskeletal tumors, who underwent surgery between 2004 and 2007, 17 (3,3%) patients with major vessel involvement were included in the study. The mean age was 37.8 ± 14.5, with a female/male ratio of 8/9. Thirteen (76.4%) patients had Stage IIb disease, and 2 (11,7%) patients had Stage III disease...
September 28, 2018: Acta Orthopaedica et Traumatologica Turcica
Abhishek Abhishek, Annamaria Iagnocco, J W J Bijlsma, Michael Doherty, Frédéric Lioté
Objectives: To survey the undergraduate rheumatic and musculoskeletal diseases (RMDs) curriculum content in a sample of medical schools across Europe. Methods: The undergraduate musculoskeletal diseases and disability curriculum of University of Nottingham, UK, was used as a template to develop a questionnaire on curriculum content. The questionnaire elicited binary (yes/no) responses and included the option to provide additional information as free text. The survey was mailed to members of the European League Against Rheumatism (EULAR) School of Rheumatology (Undergraduate Classroom) and to EULAR Standing Committee on Education and Training members in January 2017, with a reminder in February 2017...
2018: RMD Open
Jae Hoon Lee, Chung Soo Han, Jong Hun Baek
PURPOSE: The femur is prone to nonunion after biologic reconstruction following tumor resection, due to high bending forces. Nonunion at the host-graft junction is difficult to treat since the graft is in an avascular state. We aimed to investigate the clinical and radiographic results of an onlay free vascularized fibular grafting (VFG) as a salvage procedure for nonunion management after biologic reconstruction of the femur following bone tumor resection. METHODS: We retrospectively reviewed 10 patients (8 men and 2 women, median age: 15...
May 2018: Journal of Orthopaedic Surgery
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