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Orthopedic Infections

Zhang Yuan, Peng Liu, Yansha Hao, Yao Ding, Kaiyong Cai
In orthopedic fields, effective anti-infection property and promotive biocompatibility on surface of titanium implants are two crucial factors for long-term successful implants. Herein, Ag nanoparticles (NPs) loaded TiO2 nanotubes (TNT) arrays were fabricated on Ti substrates with assistance of ultraviolet irradiation. Then, bioactive multilayer films of chitosan (CHI) and dialdehyde alginate (ADA) pair were deposited onto the Ag-loaded TNT arrays via a layer-by-layer (LBL) self-assembly technique, which could effectively achieve the impactful antibacterial ability of titanium and endow the substrates with favorable biocompatibility...
July 29, 2018: Colloids and Surfaces. B, Biointerfaces
Alexander J Rondon, Michael M Kheir, Timothy L Tan, Noam Shohat, Max R Greenky, Javad Parvizi
BACKGROUND: One of the most effective prophylactic strategies against periprosthetic joint infection (PJI) is administration of perioperative antibiotics. Many orthopedic surgeons are unaware of the weight-based dosing protocol for cefazolin. This study aimed at elucidating what proportion of patients receiving cefazolin prophylaxis are underdosed and whether this increases the risk of PJI. METHODS: A retrospective study of 17,393 primary total joint arthroplasties receiving cefazolin as perioperative prophylaxis from 2005 to 2017 was performed...
July 5, 2018: Journal of Arthroplasty
Jaiben George, Jared M Newman, Mhamad Faour, William Messner, Alison K Klika, Wael K Barsoum, Carlos A Higuera
Although total hip arthroplasty and total knee arthroplasty commonly overlap, there are concerns about the safety and quality of this scenario. The objectives of this study were to (1) compare the operative time and the incidence of 90-day complications between overlapping and nonoverlapping total joint arthroplasties; and (2) evaluate the effect of the duration of overlap on operative time and the incidence of 90-day complications. A total of 9192 patients who underwent primary total hip arthroplasty or total knee arthroplasty at a large academic hospital from 2005 to 2014 were identified...
August 9, 2018: Orthopedics
Roberto Ferraresi, Andrea Casini, Maurizio Caminiti, Fabrizio Losurdo, Giacomo Clerici
The diabetic foot represents one of the most dangerous complications of diabetic disease, and it is characterized by the presence of infection, ulceration, or necrosis of the foot tissues associated with various degrees of neuropathy or ischemia. If not correctly and promptly treated, it leads to high rates of major amputations. Although in Italy diabetics are about 5% of the population, more than 50% of major amputations are performed in diabetic patients. Compared to non-diabetic patients, diabetic peripheral artery disease localizes more distally, mostly in the below-the-knee vessels, is typically bilateral with multi-level involvement, and presents earlier onset and more aggressive course...
September 2018: Giornale Italiano di Cardiologia
Arash Aali-Rezaie, Pouya Alijanipour, Noam Shohat, Hamed Vahedi, Carol Foltz, Javad Parvizi
BACKGROUND: Revision total joint arthroplasties (TJAs) have been empirically associated with significant postoperative morbidity and mortality. Red blood cell distribution width (RDW), a frequently measured hematological parameter, has been shown to predict mortality in hip fracture patients. However, its utility in risk-stratifying patients before revision TJA remains unknown. The aim of this study was to investigate the possible relationship between preoperative RDW levels and outcome of revision arthroplasty in terms of mortality, adverse outcomes, and length of hospital stay...
July 4, 2018: Journal of Arthroplasty
Duncan Rozario
Catheter-associated urinary tract infections (CAUTI) cause significant morbidity and mortality in the surgical population as well as significant costs to health care. It can be surprisingly difficult to address this common complication without a multifaceted, multimodal team-based approach to the problem. We used our National Surgical Quality Improvement Program (NSQIP) data on the incidence of CAUTI in our "procedure targeted" and "essentials" general surgery and orthopedic surgery cases before and after the implementation of our reduction strategy and found a significant improvement...
August 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Chao Liu, Yue Zhou
OBJECTIVE: To compare the clinical outcomes of patients withlumbar disc herniation with bi-radicular symptomsundergoing percutaneous endoscopic lumbar discectomy and minimally invasive transforaminal lumbar interbody fusion at a single clinic. METHODS: From January 2008 to January 2016, 89consecutive patients with lumbar disc herniation with bi-radicular symptoms were treated with percutaneous endoscopic lumbar discectomy(PELD) or minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF)...
July 25, 2018: World Neurosurgery
E Carlos Rodriguez-Merchan
INTRODUCTION: Tobacco use is related to augmented morbidity and mortality. People who smoke heavily before orthopaedic surgery may have more non-medical complications than non-smokers. Therefore, all orthopedic surgery patients should be screened for tobacco use. AIM: To investigate the musculoskeletal effects of peri-operative smoking. METHODS: A narrative review of the literature on the topic was performed. RESULTS: Orthopaedic peri-operative complications of smoking include impaired wound healing, augmented infection, delayed and/or impaired fracture union and arthrodesis, and worst total knee and hip arthroplasty results...
July 27, 2018: Hospital Practice (Minneapolis)
Lars Helbig, Georg W Omlor, Adriana Ivanova, Thorsten Guehring, Robert Sonntag, J Philippe Kretzer, Susann Minkwitz, Britt Wildemann, Gerhard Schmidmaier
BACKGROUND: Bone infections due to trauma and subsequent delayed or impaired fracture healing represent a great challenge in orthopedics and trauma surgery. The prevalence of such bacterial infection-related types of delayed non-union is high in complex fractures, particularly in open fractures with additional extensive soft-tissue damage. The aim of this study was to establish a rat model of delayed osseous union secondary to bacterial osteitis and investigate the impact of rhBMP-7 and rhBMP-2 on fracture healing in the situation of an ongoing infection...
July 27, 2018: BMC Musculoskeletal Disorders
Aaron R Bishop, Sunjung Kim, Matthew W Squire, Warren E Rose, Heidi-Lynn Ploeg
Infection incidence for total hip and knee arthroplasty (THA and TKA, respectively) is between 0.2% and 5% and results in approximately 100,000 device failures per year in the United States. Treatment requires prolonged systemic antibiotic therapy with additional surgical revisions. As a prophylactic measure against infection, antibiotics can be incorporated into bone cement during THA and TKA to provide drug administration at the implant site. Antibiotics in bone cement are only effective if they can elute out of the cement at a concentration that is active against common organisms...
June 28, 2018: Journal of the Mechanical Behavior of Biomedical Materials
Nurizzati Mohd Daud, Rania Hussein Al-Ashwal, Mohammed Rafiq Abdul Kadir, Syafiqah Saidin
Immobilization of chlorhexidine (CHX) on stainless steel 316L (SS316L), assisted by a polydopamine film as an intermediate layer is projected as an approach in combating infection while aiding bone regeneration for coating development on orthopedic and dental implants. This study aimed to investigate the ability of CHX coating to promote apatite layer, osteoblast cells viability, adhesion, osteogenic differentiation and mineralization. Stainless steel 316L disks were pre-treated, grafted with a polydopamine film and immobilized with different concentrations of CHX (10-30mM)...
July 23, 2018: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
Shanxi Wang, Lei Liu
BACKGROUND: Gas gangrene is an invasive, fatal anaerobic infection that is characterized by acute, rapid evolution and high mortality. Gas gangrene is often secondary to open fractures with deep wounds but is extremely rare in the patients undergoing elective surgery. Implant removal is a common elective operation in orthopedics after the union of fractures, and the complications of this surgery include infection, nerve injury and re-fracture. However, to the knowledge of the authors, there is no report in the literature on gas gangrene following implant removal...
July 25, 2018: BMC Musculoskeletal Disorders
Yennifer Cortes, Karin Amilon, Elisabeth Rink, Georgina Black, Zofia Lisowski, Xavier Donadeu, Cristina L Esteves
Equine Mesenchymal stem/stromal cells (MSCs) are multipotent cells that are widely used for treatment of musculoskeletal injuries, and there is significant interest in expanding their application to non-orthopedic conditions. MSCs possess antibacterial and immunomodulatory properties which may be relevant for combatting infection, however, comparative studies using MSCs from different origins have not been carried out in the horse, and this was the focus of the present study. Our results showed that MSC-conditioned media attenuated the growth of Escherichia coli, and that this effect was, on average, more pronounced for endometrium (EM)- and adipose tissue (AT)- than for bone marrow (BM)-derived MSCs...
July 25, 2018: Stem Cells and Development
Thais Queiroz Santolim, André Mathias Baptista, Arlete Mazzini Miranda Giovani, Juan Pablo Zumárraga, Olavo Pires DE Camargo
Objectives: The advantages of using a peripherally inserted central catheter (PICC) in hospitalized patients make this device very important for intravenous therapy. This study describes the use of PICCs at the Institute of Orthopedics and Traumatology at the Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo over the last 10 years. Methods: This retrospective study analyzed 1,057 medical records and included 1,023 medical files with complete information on the punctured vein, diagnosis, duration of catheterization, complications, and catheter tip positioning...
May 2018: Acta Ortopedica Brasileira
Emma Littlehales, Odhrán Murray, Robert Dunsmuir
DRESS (drug reaction with eosinophilia and systemic symptoms) is a potentially serious complication when prolonged courses of antibiotics are given to patients, with an average onset of 2-6 weeks after commencement. There is a high mortality rate (1-10%). We report the case of a 62-year-old male who developed DRESS after seven weeks of antibiotic treatment with vancomycin for a deep spinal metalwork infection. We describe the typical rash and biochemical results, including eosinophilia, as well as the systemic signs seen in this case...
2018: Case Reports in Orthopedics
Nastassia Tvardik, Ivan Kergourlay, André Bittar, Frédérique Segond, Stefan Darmoni, Marie-Hélène Metzger
OBJECTIVE: There is a growing interest in using natural language processing (NLP) for healthcare-associated infections (HAIs) monitoring. A French project consortium, SYNODOS, developed a NLP solution for detecting medical events in electronic medical records for epidemiological purposes. The objective of this study was to evaluate the performance of the SYNODOS data processing chain for detecting HAIs in clinical documents. MATERIALS AND METHODS: The collection of textual records in these hospitals was carried out between October 2009 and December 2010 in three French University hospitals (Lyon, Rouen and Nice)...
September 2018: International Journal of Medical Informatics
Benjamin I Rosner, Marc Gottlieb, William N Anderson
BACKGROUND: The accuracy of patient self-report of health care utilization and complications has yet to be determined. If patients are accurate and engaged self-reporters, collecting this information in a manner that is temporally proximate to the health care utilization events themselves may prove valuable to health care organizations undertaking quality improvement initiatives for which such data are often unavailable. OBJECTIVE: The objective of this study was to measure the accuracy of patient self-report of health care utilization and complications in the 90 days following orthopedic procedures using an automated digital patient engagement platform...
July 20, 2018: Journal of Medical Internet Research
Fei Zhang, Wu-Xun Peng, Lei Wang, Jian Zhang, Wen-Tao Dong, Jian-Hua Wu, Huai Zhang, Jian-Bo Wang, Yin Zhao
BACKGROUND/AIMS: Avascular necrosis of the femoral head (ANFH) is the focus and difficulty of orthopedic diseases. Recently, tissue engineering bone for this disease has shown a good therapeutic effect. The aim of the present study was to investigate the therapeutic effect of basic fibroblast growth factor (FGF-2) as cytokines transfected bone marrow mesenchymal stem cells (BMSCs) in constructing tissue-engineered bone for avascular necrosis of the femoral head. METHODS: The FGF-2 gene overexpressed lentivirus-transfected rBMSCs with xenogeneic antigen-extracted cancellous bone (XACB) to construct tissue engineered bone, and the model of early avascular necrosis of the femoral head was established by lipopolysaccharide (LPS) combined with hormone...
July 19, 2018: Cellular Physiology and Biochemistry
Bo-Hua Li, Shan-Xi Wang, Jun Li, Fu-Guo Huang, Zhou Xiang, Yue Fang, Gang Zhong, Min Yi, Xiao-Dan Zhao, Lei Liu
PURPOSE: To investigate the early and mid-term results of open reduction and internal fixation (ORIF) with transarticular external fixation (TEF) but no deltoid ligament repair (DLR) in the treatment of supination-external rotation type IV equivalent (SER IV E) ankle fractures (AO/OTA classification 44-B 3.1) and provide evidence for clinical practice. METHODS: This study cohort consisted of 22 patients with SER IV E ankle fractures that underwent ORIF with TEF but no DLR between December 2011 and December 2014...
June 2, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Alauddin Kochai, Mehmet Türker, Özgür Çiçekli, Uğur Özdemir, Levent Bayram, Ünal Erkorkmaz, Erhan Şükür
OBJECTIVES: This study aims to compare the three most commonly used fixation techniques: tension-band wire fixation, partially threaded cannulated screws, and fully threaded cannulated headless compression screws. PATIENTS AND METHODS: Ninety patients with medial malleolus fractures were included in the study. Patients were divided into three groups. Group A included patients who underwent tension-band wire fixation (n=26), Group B partially threaded cannulated compression screws (n=32), and Group C fully threaded cannulated headless compression screws (n=32)...
August 2018: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
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