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Orthopedic Infections

L G Mercuri
Prosthetic joint infections are not only distressing complications for patients and surgeons, but also have an enormous financial impact on healthcare systems. The reported incidence of prosthetic joint infection is likely underestimated due to difficulties in their diagnosis. This unfortunate complication has challenged joint replacement surgeons for years, despite all the advances made in this surgical discipline. Since eradication of these infections can be very difficult, prevention remains the primary objective...
October 10, 2018: International Journal of Oral and Maxillofacial Surgery
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
Fabian Kalt, Bettina Schulthess, Fabian Sidler, Sebastian Herren, Sandro F Fucentese, Patrick O Zingg, Martin Berli, Annelies S Zinkernagel, Reinhard Zbinden, Yvonne Achermann
Corynebacterium spp. are rarely considered as pathogens but data in orthopedic infections are sparse. Therefore, we asked how often Corynebacterium spp. caused an infection in a defined cohort of orthopedic patients with a positive culture. In addition, we aimed to determine the species variety and susceptibility of isolated strains in regards to potential treatment strategies. Between 2006 and 2015, we retrospectively assessed all Corynebacterium sp. bone and joint cultures from an orthopedic ward. The isolates were considered as relevant indicating an infection if the same Corynebacterium sp...
October 10, 2018: Journal of Clinical Microbiology
Daniel D Bohl, Andre M Samuel, Matthew L Webb, Adam M Lukasiewicz, Nathaniel T Ondeck, Bryce A Basques, Nidharshan S Anandasivam, Jonathan N Grauer
This study uses a prospective surgical registry to characterize the timing of 10 postoperative adverse events following geriatric hip fracture surgery. There were 19,873 patients identified who were ≥70 years undergoing surgery for hip fracture as part of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). The median postoperative day of diagnosis (and interquartile range) for myocardial infarction was 3 (1-5), cardiac arrest requiring cardiopulmonary resuscitation 3 (0-8), stroke 3 (1-10), pneumonia 4 (2-10), pulmonary embolism 4 (2-11), urinary tract infection 7 (2-13), deep vein thrombosis 9 (4-16), sepsis 9 (4-18), mortality 11 (6-19), and surgical site infection 16 (11-22)...
September 2018: American Journal of Orthopedics
Y-C Chiu, T-C Chung, C-H Wu, K-L Tsai, I-M Jou, Y-K Tu, C-H Ma
AIMS: This study reports the outcomes of a technique of soft-tissue coverage and Chopart amputation for severe crush injuries of the forefoot. PATIENTS AND METHODS: Between January 2012 to December 2016, 12 patients (nine male; three female, mean age 38.58 years; 26 to 55) with severe foot crush injury underwent treatment in our institute. All patients were followed-up for at least one year. Their medical records, imaging, visual analogue scale score, walking ability, complications, and functional outcomes one year postoperatively based on the American Orthopedic Foot and Ankle Society (AOFAS) and 36-Item Short-Form Health Survey (SF-36) scores were reviewed...
October 2018: Bone & Joint Journal
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
John K Houten, Gila R Weinstein, Michael Collins
INTRODUCTION: Cervical spondylotic myelopathy (CSM) most commonly occurs at the C3-7 levels and is successfully treated by multilevel anterior cervical discectomy and fusion (ACDF) or cervical laminectomy and fusion (CLF), but no procedure has clearly demonstrated superiority. Most prior investigations comparing approaches are limited by marked heterogeneity in the composition of the study groups. This investigation compares ACDF versus CLF surgery specifically at C3-7 in terms of long-term neurological outcome and the fate of the adjacent levels...
October 2, 2018: Journal of Neurosurgical Sciences
Anuj Chawla, Ernest Beng Kee Kwek
PURPOSE: Osteopetrosis is a hereditary skeletal disorder in which defective osteoclast function leads to abnormally hard and brittle bones. This study aims to describe the pattern of fractures occurring in this group of patients, possible complications, and strategies to avoid them. METHODS: This is a case series of six osteopetrotic patients with a total of 12 fractures managed in our institution over a period of nine years. Patient records were also reviewed for complications both intra- and post-operatively...
October 4, 2018: International Orthopaedics
Myrna Dyck, John M Embil, Elly Trepman, Eric Bohm
BACKGROUND: Surgical site infections (SSIs) increase morbidity and mortality after primary hip and knee arthroplasty. We evaluated a surveillance program that tracked risk factors associated with infection after primary hip and knee arthroplasty in the Winnipeg Regional Health Authority. METHODS: Surveillance data from April 2010 to March 2015 were reviewed for all 12,636 primary hip or knee arthroplasties, including 1-year follow-up. Procedures were evaluated in earlier (April 2010 to December 2012) and later periods (January 2013 to March 2015)...
September 28, 2018: American Journal of Infection Control
Aliya Bekmurzayeva, Wynter J Duncanson, Helena S Azevedo, Damira Kanayeva
Stainless steel (SS) has been widely used as a material for fabricating cardiovascular stents/valves, orthopedic prosthesis, and other devices and implants used in biomedicine due to its malleability and resistance to corrosion and fatigue. Despite its good mechanical properties, SS (as other metals) lacks biofunctionality. To be successfully used as a biomaterial, SS must be made resistant to the biological environment by increasing its anti-fouling properties, preventing biofilm formation (passive surface modification), and imparting functionality for eluting a specific drug or capturing selected cells (active surface modification); these features depend on the final application...
December 1, 2018: Materials Science & Engineering. C, Materials for Biological Applications
Amy K Shumaker
Acral lick dermatitis is a common, frustrating disease. It is characterized by incessant licking behavior resulting in raised, thickened, ulcerative plaques, most commonly affecting the lower extremities of dogs. Underlying primary diseases, such as allergic disorders (atopic dermatitis, food allergy, flea allergy), orthopedic or neurologic disorders, parasitic diseases (eg, demodicosis), infections (fungal, bacterial), neoplasia or psychogenic disorders (compulsive/obsessive-compulsive disorder), and perpetuating factors (especially secondary infections) drive the itch-lick cycle...
September 26, 2018: Veterinary Clinics of North America. Small Animal Practice
Giorgio Burastero, Luca Cavagnaro, Francesco Chiarlone, Mattia Alessio-Mazzola, Giuliana Carrega, Lamberto Felli
BACKGROUND: Femoral and tibial massive bone defects are common findings in septic total knee revision and pose considerable challenges for the orthopedic surgeon. The aim of this study was to report the midterm clinical and radiographic outcomes with the use of tantalum cones for the management of massive bone defects after 2-stage knee revision. METHODS: We retrospectively reviewed the medical records of 60 patients (mean age, 67.9 ± 8.8 years) treated with 94 tantalum cones associated with constrained or semiconstrained knee for massive bone loss (mean follow-up, 43...
August 30, 2018: Journal of Arthroplasty
Ju Liu, Weihu Yang, Bailong Tao, Tingting Shen, Ye He, Xinkun Shen, Kaiyong Cai
The inherent bioinertness and potential bacterial infection risk are the two leading causes for Ti implant failure. To improve osseointegration and antibiosis, in this work, a novel antimicrobial osteogenic growth peptide was first synthesized by conjugating osteogenic growth peptide (OGP) and ciprofloxacin (CIP). Then, the synthetic antimicrobial peptide was immobilized onto Ti implant surface for chemoselective binding via the amide reaction. Thereafter, the capabilities of modified Ti implant on osseointegration and antibiosis were measured with cell experiments and antimicrobial activity in vitro...
September 7, 2018: Journal of Biomedical Materials Research. Part A
Shaheer Maher, Arash Mazinani, Mohammad Reza Barati, Dusan Losic
Therapeutics delivery to bones to treat skeletal diseases or prevent postsurgical infections is challenging due to complex and solid bone structure that limits blood supply and diffusion of therapeutics administered by systemic routes to reach effective concentration. Titanium (Ti) and their alloys are employed as mainstream implant materials in orthopedics and dentistry; having superior mechanical/biocompatibility properties which could provide an alternative solution to address this problem. Areas covered: This review presents an overview of recent development of Ti drug-releasing implants, with emphasis on nanoengineered Titania nanotubes (TNTs) structures, for solving key problems to improve implants osseointegration, overcome inflammation and infection together with providing localized drug delivery (LDD) for bone diseases including cancer...
October 2018: Expert Opinion on Drug Delivery
Cortney E Heim, Sean C West, Hesham Ali, Tammy Kielian
Myeloid-derived suppressor cells (MDSCs) are a heterogeneous population of immature monocytes and granulocytes. While neutrophils (PMNs) are classically identified as highly differentiated cells specialized for anti-microbial defense, our laboratory has reported minor contributions of PMNs to the immune response during S. aureus biofilm infection. However, these two cell types can be difficult to differentiate because of shared surface marker expression. Here we describe a more refined approach to distinguish MDSCs from PMNs utilizing the integrin receptor CD11b combined with conventional Ly6G and Ly6C expression...
September 24, 2018: Infection and Immunity
Michael Harris, Hamza Ahmed, Leslie Pace, Jon Minter, Michael Neel, Jessica Jennings
Bone void fillers (BVFs) containing calcium sulfate, tricalcium phosphate (TCP), and hydroxyapatite can be loaded with antibiotics for infection treatment or prevention under surgeon-directed use. The aim of this study was to characterize the handling and elution properties of a triphasic BVF loaded with common antibiotics. BVF was mixed with vancomycin and/or tobramycin to form pellets, and the set time was recorded. A partial refreshment elution study was conducted with time points at 4, 8, and 24 h, as well as 2, 7, 14, 28, and 42 days...
September 21, 2018: Journal of Functional Biomaterials
Stephanie Victoria Camargo Leão Edelmuth, Gabriella Nisimoto Sorio, Fabio Antonio Anversa Sprovieri, Julio Cesar Gali, Sonia Ferrari Peron
Objective: To analyze comorbidities and clinical complications, and to determine the factors associated with mortality rates of elderly patients admitted with a hip fracture in a tertiary public hospital. Methods: Sixty-seven medical records were reviewed in a retrospective cohort study, including patients equal to or older than 65 years admitted to this institution for hip fracture between January 2014 and December 2014. The evaluated items constituted were the following: interval of time between fracture and hospital admission, time between admission and surgical procedure, comorbidities, clinical complications, type of orthopedic procedure, surgical risk, cardiac risk, and patient outcome...
September 2018: Revista Brasileira de Ortopedia
Frank-Christiaan B M Wagenaar, Claudia A M Löwik, Akos Zahar, Paul C Jutte, Thorsten Gehrke, Javad Parvizi
BACKGROUND: Persistent wound drainage after total joint arthroplasty (TJA) is an important complication with potential substantial adverse consequences, in particular periprosthetic joint infection. METHODS: This review evaluated the available literature regarding several issues in the field of persistent wound drainage after TJA and offers a classification of persistent wound drainage and an algorithmic approach to the decision-making process. RESULTS: Available literature addressing the diagnosis and treatment of persistent wound drainage after TJA is scarce and an evidence-based clinical guideline is lacking...
September 3, 2018: Journal of Arthroplasty
Elena T Contreras, Deanna R Worley, Ross H Palmer, Felix M Duerr
Surgical management of postamputation orthopedic disease (PAOD) in canine amputees has rarely been documented, and no reports describing outcome of stifle surgery in canine amputees are available. The objective of this multisite retrospective case series was to describe cases and evaluate satisfaction with and outcome of postamputation orthopedic surgery in canine amputees. Data was obtained through medical records and owner survey responses; data included signalment, amputation cause, diagnosis, surgical treatment, timeframes, and outcome assessment...
September 2018: Topics in Companion Animal Medicine
Yan Zhang, Bin Zhang, Jiazhen Li, Xinchang Lu, Yi Zhang
Objective: To summarize the preliminary effectiveness of surgical treatment of Erdheim-Chester disease (ECD), so as to improve the understanding of the disease by orthopedic surgeons. Methods: The clinical data of 9 patients with ECD between December 2012 and October 2017 were retrospectively analysed. There were 6 males and 3 females with an median age of 42 years (range, 8-61 years). The disease duration was 4-59 months (mean, 39 months). There were 2 cases of multiple lesions, including 1 case involving soft tissue of the buttocks and bilateral tibia, 1 case involving the sinus, skull base, and proximal right tibia; 7 cases with single lesion, including 3 cases of right femoral neck, 1 case of proximal right tibia, 1 case of right humerus, and 2 cases of ribs...
August 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
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