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Musculoskeletal infection

Michael A Benvenuti, Thomas J An, Megan E Mignemi, Jeffrey E Martus, Gregory A Mencio, Stephen A Lovejoy, Jonathan G Schoenecker, Derek J Williams
OBJECTIVE: There are currently no algorithms for early stratification of pediatric musculoskeletal infection (MSKI) severity that are applicable to all types of tissue involvement. In this study, the authors sought to develop a clinical prediction algorithm that accurately stratifies infection severity based on clinical and laboratory data at presentation to the emergency department. METHODS: An IRB-approved retrospective review was conducted to identify patients aged 0 to 18 who presented to the pediatric emergency department at a tertiary care children's hospital with concern for acute MSKI over a 5-year period (2008 to 2013)...
March 7, 2018: Journal of Pediatric Orthopedics
Ann Alriksson-Schmidt, Annika Lundkvist Josenby, Barbro Lindquist, Lena Westbom
PURPOSE: To increase knowledge about pain and general health in adults with myelomeningocele, a health condition with several risk factors for pain such as musculoskeletal deformities, shunt dysfunctions, bowel problems, and urinary tract infections/stones. METHODS: Descriptive correlational pilot study (N= 51, 53% males). Chi-square tests were used to test associations among presence, impact, severity, and pain site in relation to sex and age. ANOVA was used to analyze associations between sex, age, and general health (today)...
November 18, 2018: Journal of Pediatric Rehabilitation Medicine
Steven Pong, Pamela Holliday, Geoff Fernie
BACKGROUND: Improving hand hygiene compliance among health care professionals is the most effective way to reduce health care-acquired infections. Electronic systems developed to increase hand hygiene performance show promise but might not maintain staff participation over time. In this study, we investigated an intermittent deployment strategy to overcome potentially declining participation levels. METHODS: An electronic monitoring system was deployed 3 times at 6-month intervals on a musculoskeletal rehabilitation nursing unit in Toronto...
November 27, 2018: American Journal of Infection Control
Yoshiharu Shimozono, Lisa A Fortier, Donald Brown, John G Kennedy
Regenerative cell therapies are emerging as promising treatments for numerous musculoskeletal conditions, including knee osteoarthritis (OA). Adipose-derived stem cells and possibly other adipose-based therapies have a greater chondrogenic potential than stem cells derived from bone marrow, and thus a lot of attention is being placed on them as potential regenerative agents in the treatment of knee OA. Several types of adipose-based therapies have good basic science and preclinical data supporting their translation to human therapeutic intervention...
November 30, 2018: Journal of Knee Surgery
M R Medellin, T Fujiwara, R Clark, L M Jeys
AIMS: The aim of this study was to describe, analyze, and compare the survival, functional outcome, and complications of minimally invasive (MI) and non-invasive (NI) lengthening total femoral prostheses. PATIENTS AND METHODS: A total of 24 lengthening total femoral prostheses, 11 MI and 13 NI, were implanted between 1991 and 2016. The characteristics, complications, and functional results were recorded. There were ten female patients and ten male patients. Their mean age at the time of surgery was 11 years (2 to 41)...
December 2018: Bone & Joint Journal
Debrup Chakladar, Rakesh K Mondal, Tapas Kumar Sabui, Souravi Bhowmik, Tamoghna Biswas
OBJECTIVE: Musculoskeletal manifestations in children infected with human immunodeficiency virus (HIV) are responsible for increased morbidity and decreased quality of life. Even in this era of highly active anti-retroviral therapy (HAART), there are limited studies on different rheumatological manifestations in pediatric patients with HIV, and the spectrum of musculoskeletal manifestation in pediatric HIV is yet to be established. METHODS: A single-center, prospective, observational study was carried out from October 2014 to September 2016 in a tertiary care hospital of Eastern India with 517 children infected with HIV aged between 3 and 19 years...
October 12, 2018: European Journal of Rheumatology
Wesley Frevert, Thomas W Wright, Kevin W Farmer, Qingping Yang, Aimee M Struk, Greg Schultz
Successfully treating shoulder arthroplasty infection requires diagnosis and bacterial identification. Higher incidence of infection with low-virulence bacteria makes this challenging. This study evaluates shoulder prostheses for infection using sonication and a functional biofilm assay. Nineteen patients undergoing revision shoulder arthroplasty were followed prospectively. Periprosthetic tissue and prosthetic components were obtained during the revision and evaluated with a functional biofilm assay. Results were compared with conventional cultures and laboratory results...
2018: Journal of Surgical Orthopaedic Advances
M Siddika, S Sen, M N Islam, M K Bhuiyan
The cross sectional study was done to estimate the prevalence of various congenital malformations among the patients delivered in Community Based Medical College Hospital (CBMCH), Mymensingh, Bangladesh and corresponding risk factors were also studied from July 2014 to December 2015. A total of 2560 babies who were born at Community Based Medical College Hospital (CBMCH) were enrolled in this study. The newborn babies were examined and assessed for detection of congenital malformation, system wise distribution and risk factors attributable...
October 2018: Mymensingh Medical Journal: MMJ
G C Jing, Y Chen, L Wang, D Xu, W J Zheng, M T Li, X F Zeng, F C Zhang
A 45-year-old woman was admitted to the Department of Rheumatology and Immunology, Peking Union Medical College Hospital, due to weakness of the upper limbs, fever, and blurred vision. She was clinically diagnosed as systemic lupus erythematosus overlapped primary biliary cirrhosis, with renal, retinal, hematological and musculoskeletal involvement, combined with severe pulmonary infection and respiratory failure. Treated with glucocorticoids, ursodeoxycholic acid, antibiotics and respiratory support, the patient got better...
December 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
John W Krumme, Madelyn F Lauer, Justin T Stowell, Nebiyu M Beteselassie, Suhel Y Kotwal
Due to its high sensitivity, low cost, accessibility, and ease of use, bone scintigraphy is used in orthopedic surgery for the diagnosis and management of varied pathology. It is commonly used for insufficiency fractures, metastatic neoplasia, staging and surveillance of sarcoma, and nonaccidental trauma. It augments diagnoses, including stress or occult fractures, musculoskeletal neoplasia or infection, and chronic regional pain syndrome, in patients presenting with normal results on radiographs. Bone scan images are resistant to metal-based implant artifact, allowing effective evaluation of failed total joint prostheses...
November 26, 2018: Orthopedics
Sean P Ryan, Tyler J Vovos, Cierra S Hong, Michael A Bergen, Peter M Formby, Michael P Bolognesi, Thorsten M Seyler
BACKGROUND: Choosing the intervention for prosthetic joint infections, whether debridement, antibiotics, and implant retention (DAIR), or explant and antibiotic spacer placement, is multifactorial. One characteristic that may influence this decision is a previously established relationship with the patient. We hypothesized that patients receiving their arthroplasty at an outside institution and presenting with infection would be more likely to undergo removal of their implant without an attempt at DAIR compared to patients who underwent primary arthroplasty at the investigating institution...
October 9, 2018: Journal of Arthroplasty
Iman Vadiee, David J Backstein
BACKGROUND: The gold-standard method in North America for the management of infected total knee arthroplasty is 2-stage revision arthroplasty. This has provided generally a high success rate. However, persistent infection after 2-stage revision knee arthroplasty does occur. The purpose of this study was to predict the success rate of second, 2-stage revision arthroplasty. METHODS: All infected total knee arthroplasty treated between 2000 and 2015 that were operated by a single senior surgeon were reviewed retrospectively...
October 25, 2018: Journal of Arthroplasty
John I Hogan, Rocío M Hurtado, Sandra B Nelson
Although less common as causes of musculoskeletal infection than pyogenic bacteria, both Mycobacterium tuberculosis and nontuberculous mycobacteria can infect bones and joints. Although tuberculous arthritis and osteomyelitis have been recognized for millennia, infections caused by nontuberculous mycobacteria are being identified more often, likely because of a more susceptible host population and improvements in diagnostic capabilities. Despite advances in modern medicine, mycobacterial infections of the musculoskeletal system remain particularly challenging to diagnose and manage...
February 2019: Thoracic Surgery Clinics
Cole A Bortz, Peter G Passias, Frank A Segreto, Samantha R Horn, Renaud Lafage, Justin S Smith, Breton G Line, Gregory M Mundis, Michael P Kelly, Paul Park, Daniel M Sciubba, D Kojo Hamilton, Jeffrey L Gum, Douglas C Burton, Robert A Hart, Frank J Schwab, Shay Bess, Christopher Shaffrey, Eric O Klineberg
STUDY DESIGN: This is a retrospective review of prospective multicenter cervical deformity (CD) database. OBJECTIVE: Assess the impact of complication type and Clavien complication (Cc) grade on clinical outcomes of surgical CD patients BACKGROUND:: Validated for general surgery, the Clavien-Dindo complication classification system allows for broad comparison of postoperative complications; however, the applicability of this system is unclear in CD-specific populations...
November 16, 2018: Clinical Spine Surgery
Emna Romdhane, Soumaya Rammeh, Hend Riahi, Yosra Chebbi, Chelli Bouaziz Mouna, Wafa Achour, Leila Slim-Saidi, Hanène Tiouiri Benaissa, Mohamed Fethi Ladeb
BACKGROUND: Tuberculous spondylodiscitis (TS) is the most common form of musculoskeletal tuberculosis. Currently, histology is widely used to distinguish tuberculous from nontuberculous disease. OBJECTIVES: The aim of the present study was to assess the accuracy of histology compared with bacteriology in the diagnosis of TS. METHODS: This is a single-center case series carried out from January 2014 to February 2018 in a pathology department...
November 7, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
J T Weston, C D Watts, T M Mabry, A D Hanssen, D J Berry, M P Abdel
AIMS: The results of irrigation and debridement with component retention (IDCR) in the treatment of acutely infected total knee arthroplasties (TKAs) have been variable. The aim of this study was to assess the outcome after IDCR when combined with chronic antibiotic suppression. We also evaluated survivorship free from subsequent infection, removal of the components, and death, as well as the risk factors for failure. PATIENTS AND METHODS: This was a single-centre retrospective review of 134 infected primary TKAs that were treated with IDCR...
November 2018: Bone & Joint Journal
Sarah Dotson, Alejandro Landa, Jessie Ehrisman, Angeles Alvarez Secord
Background: Widespread concerns have been raised regarding the safety of power morcellation of uterine specimens because of the potential to disseminate occult malignancy. We sought to assess the safety and feasibility of contained manual uterine morcellation within a plastic specimen bag among women with uterine neoplasms. Methods: A retrospective single-institution descriptive cohort study was conducted from 2003 to 2014. Patients with leiomyoma and/or uterine malignancy who underwent minimally invasive surgery with contained uterine manual morcellation were identified from surgical logs...
2018: Gynecologic Oncology Research and Practice
Minhao Wu, Shiyi Yao, Yuanlong Xie, Feifei Yan, Zhouming Deng, Jun Lei, Lin Cai
The vast majority of giant-cell tumors occur around the knee and characteristically affect the subchondral bone. Thermal damage to the articular cartilage arising from the application of polymethylmethacrylate (PMMA) or extensive intralesional curettage presents a challenging problem to orthopedic surgeons and patients due to compliance issues. For this reason, we developed a new subchondral bone-grafting procedure to restore massive bone defects and reduce degenerative changes in the knee.The aim of this study was to describe the novel subchondral bone-grafting procedure and evaluate clinical outcomes in patients with giant-cell tumors around the knee...
November 2018: Medicine (Baltimore)
Dimitrios K Filippiadis, George Charalampopoulos, Argyro Mazioti, Kalliopi Keramida, Alexis Kelekis
Percutaneous, image-guided musculoskeletal biopsy, due to its minimal invasive nature, when compared with open surgical biopsy, is a safe and effective technique which is widely used in many institutions as the primary method to acquire tissue and bone samples. Indications include histopathologic and molecular assessment of a musculoskeletal lesion, exclusion of malignancy in a bone/vertebral fracture, examination of bone marrow, and infection investigation. Preprocedural workup should include both imaging (for lesion assessment and staging) and laboratory (including coagulation tests and platelet count) studies...
October 2018: Seminars in Interventional Radiology
Casper S Ottesen, Anders Troelsen, Håkon Sandholdt, Steffen Jacobsen, Henrik Husted, Kirill Gromov
BACKGROUND: Acute periprosthetic joint infection (PJI) following primary total knee arthroplasty (TKA) surgery can be treated with debridement, antibiotics, and implant retention (DAIR). However, varying results have been reported in the literature and optimal timing of the procedure is still debated. In this retrospective cohort study, we investigate (a) success rate of DAIR for treating PJI following primary TKA surgery and (b) whether time after primary surgery until DAIR and (c) type of isolated microorganism influence outcome...
October 9, 2018: Journal of Arthroplasty
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