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Orthopedic Infections

Marta Martínez-Pérez, Ana Conde, María-Angeles Arenas, Ignacio Mahíllo-Fernandez, Juan-José de-Damborenea, Ramón Pérez-Tanoira, Concepción Pérez-Jorge, Jaime Esteban
OBJECTIVE: Implant-related infection is a devastating complication in orthopedic surgery. Aiming to minimize this problem, many material modifications have been developed. Here we report a study of a surface modification of Ti-6 Al-4 V alloy using a methodology that enables the study of interactions between bacteria and the material in the presence of eukaryotic cells. METHODS: We mixed different concentrations of collection or clinical strains of staphylococci isolated from implant-related infections with preosteoblastic cells using a previously published methodology, analyzing the minimal concentration of bacteria able to colonize the surface of the material through image analysis...
January 1, 2019: Colloids and Surfaces. B, Biointerfaces
Elien Peeters, Geert Hooyberghs, Stijn Robijns, Ami De Weerdt, Soňa Kucharíková, Hélène Tournu, Annabel Braem, Katerina Čeh, Gregor Majdič, Tanja Španič, Estera Pogorevc, Birgit Claes, Barbara Dovgan, Lenart Girandon, Frédéric Impellizzeri, Martin Erdtmann, Annika Krona, Jef Vleugels, Mirjam Fröhlich, Jordi Garcia-Forgas, Katrijn De Brucker, Bruno P A Cammue, Karin Thevissen, Patrick Van Dijck, Jozef Vanderleyden, Erik Van der Eycken, Hans P Steenackers
Biofilms, especially those formed by Staphylococcus aureus, play a key role in the development of orthopedic implant infections. Eradication of these infections is challenging due to the elevated tolerance of biofilm cells against antimicrobial agents. In this study, we developed an antibiofilm coating consisting of 5-(4-bromophenyl)-N-cyclopentyl-1-octyl-1H-imidazol-2-amine, designated as LC0024, covalently bound to a titanium implant surface (LC0024-Ti). We showed in vitro that the LC0024-Ti surface reduces biofilm formation of S...
December 13, 2018: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
Nadia Masroor, Jenika Ferretti-Gallon, Kaila Cooper, Kimberly Elgin, Kakotan Sanogo, Huong Jane Nguyen, Michelle Doll, Michael P Stevens, Gonzalo Bearman
BACKGROUND: Staphylococcal decolonization decreases the risk of Staphylococcus aureus surgical site infection. This study evaluates patient perceptions and barriers to a universal Staphylococcal decolonization (USD) protocol. METHODS: In October 2013, a protocol for the decolonization of Staphylococcal aureus in elective orthopedic, neurosurgical, and cardiac surgeries was implemented in an effort to further decrease post-operative infections rates. We surveyed patients undergoing these procedures between November 2014 and April 2015 using an anonymous, voluntary, Likert-scale survey; survey questions targeted compliance with the protocol as well as barriers to protocol completion...
December 11, 2018: American Journal of Infection Control
Arnold J Suda, Christian T Schamberger, Tim Viergutz
INTRODUCTION: In distal radius fractures with metaphyseal comminution, bone grafting or the use of a bone substitute may be necessary. Harvesting autologous iliac crest bone graft for other orthopedic procedures has complications. The aim of this study was to evaluate the complication rate after harvesting a small amount of bone as used for the treatment of radius fractures. PATIENTS AND METHODS: Patients treated in a single level I trauma center with surgical treatment for distal radius fracture with iliac crest bone graft between January 2008 and December 2012 were included in this retrospective study...
December 12, 2018: Archives of Orthopaedic and Trauma Surgery
H Chouirfa, H Bouloussa, V Migonney, C Falentin-Daudré
Implanted biomaterials play a key role in the current success of orthopedic and dental procedures. Pure titanium and its alloys are the most commonly used materials for permanent implants in contact with bone. However, implant-related infections remain among the leading reasons for failure. The most critical pathogenic event in the development of infection on biomaterials is biofilm formation, which starts immediately after bacterial adhesion. In the last decade, numerous studies reported the ability of titanium surface modifications and coatings to minimize bacterial adhesion, inhibit biofilm formation and provide effective bacterial killing to protect implanted biomaterials...
January 1, 2019: Acta Biomaterialia
Jaime Gallegos Salazar, William O'Brien, Judith M Strymish, Kamal Itani, Westyn Branch-Elliman, Kalpana Gupta
Importance: Limited data suggest that screening for asymptomatic bacteriuria (ASB) prior to nonurologic procedures is not useful. However, high-quality evidence to support consensus recommendations and influence clinical practice is lacking. Objective: To characterize the association between detection and treatment of preoperative ASB and postoperative outcomes. Design, Setting, and Participants: This retrospective cohort study involved patients, predominantly male veterans, who underwent surgical procedures in 109 US facilities within the US Department of Veterans Affairs health care system from October 1, 2008, to September 30, 2013...
December 12, 2018: JAMA Surgery
Antonio Mazzotti, Fabrizio Perna, Davide Golinelli, Irene Quattrini, Susanna Stea, Barbara Bordini, Cesare Faldini
PURPOSE: The aim of this study was to assess whether preoperative valgus or varus deformity affected survivorship after total knee arthroplasty (TKA) and to quantify the risk factors for implant failure in a registry-based population. METHODS: The Emilia-Romagna Registry of Prosthetic Orthopedic Implants was examined regarding TKAs performed on patients with a preoperative diagnosis of valgus or varus deformity. Demographics, implant characteristic and survivorships were investigated and compared...
December 11, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Frank S Fröschen, Nadine Gravius, Jan-Frederic Lau, Thomas Martin Randau, Eva Kaup, Max J Friedrich, Sascha Gravius
PURPOSE: The contact allergens nickel, cobalt, and chromium are often discussed as possible triggers of allergic reactions to orthopedic implants. Additionally, acrylates and polymerization additives in bone cement (e.g., benzoyl peroxide (BPO)) have been implicated as triggers of eczema, wound healing disorders, and aseptic implant loosening. We report about six patients with aseptic loosening after total knee arthroplasty (TKA), who underwent revision surgery after testing positive for BPO hypersensitivity...
December 11, 2018: International Orthopaedics
Anha Afrin Shefa, Mirana Taz, Monir Hossain, Yong Sik Kim, Sun Young Lee, Byong-Taek Lee
Lethal bleeding due to street accidents, natural calamities, orthopedic/dental surgeries, organ transplantation and household injuries, is the leading cause of morbidity and mortality. In the current study, zinc oxide (ZnO) was incorporated in TEMPO-oxidized cellulose nanofiber (TOCN) and polyethylene glycol (PEG) polymer system for hemorrhage control by freeze drying method. SEM and XRD data showed the presence of ZnO in the porous structure. FT-IR analysis showed that, successful conjugation occurs among the TOCN and PEG...
December 8, 2018: International Journal of Biological Macromolecules
Antoine Grosset, Philippe Mangin, Christine MacNab, Georges Pfister, Nicolas de l'Escalopier, Jean-Marie Cournac, Marc Aletti, Thierry Samson, Sylvain Rigal, Laurent Mathieu
Introduction: Extremity war-wounds present an elevated risk of infection and compromise reconstructive procedures. In a French military hospital, a multi-disciplinary meeting (MDM) was created to standardize the care given to soldiers with osteoarticular infection. The aim of this study was to evaluate the usefulness of MDM decisions. Methods: An observational case study was performed including the French wounded at war treated for an osteoarticular infection between 2004 and 2016...
December 7, 2018: Military Medicine
Mohamed A Abouelkhair, Rebecca E Rifkin, Remiqiusz M Grzeskowiak, Alexandru S Biris, David E Anderson, David A Bemis, Stephen A Kania
Staphylococcus aureus is the causative agent of multiple infections, including bacteremia, infective endocarditis, osteomyelitis, septic arthritis, and prosthetic device infections. We report here the first whole-genome sequence for four S. aureus sequence type 398 isolates from clinical cases of osteomyelitis in four goats with a history of orthopedic surgery.
September 2018: Microbiology resource announcements
Bo Huang, Lei Tan, Xiangmei Liu, Jun Li, Shuilin Wu
Bone-implant materials are important for bone repairing and orthopedics surgery, which include bone plates and bone nails. These materials need to be designed not only considering its biostability and biocompatibility, but also their by-products induced infection after therapy or long-time treatment in vivo . Thus, the development of novel implant materials is quite urgent. Red phosphorus has great biocompatibility and exhibits efficient photothermal ability. Herein, a red phosphorus/IR780/arginine-glycine-asparticacid-cysteine (RGDC) coating on titanium bone-implant was prepared...
March 2019: Bioactive Materials
Yücel Duman, Reşit Sevimli
Staphylococcus aureus is one of the most clinically important bacteria causing infection in humans. It is an important pathogen in surgical site infections (SSIs), especially after orthopedic surgery. Pantone-valentine leukocidin (PVL) has a great importance in the virulence of S.aureus because it can destroy polymorphonuclear cells by necrosis or apoptosis. The spread of PVL positive S.aureus is a great concern, since it may become an important factor for increased morbidity and mortality in SSIs, especially after surgery...
October 2018: Mikrobiyoloji Bülteni
Siyuan Shao, Fangsheng Fu, Ziyi Wang, Fangming Song, Chen Li, Zuo-Xing Wu, Jiaxing Ding, Kai Li, Yu Xiao, Yiji Su, Xixi Lin, Guixin Yuan, Jinmin Zhao, Qian Liu, Jiake Xu
Osteolytic bone diseases are closely linked to the over-activation of osteoclasts and enhancement of bone resorption. It has become a major health issue in orthopedic practice worldwide. Inhibition of osteoclasts is proposed to be the main treatment for osteolytic disorders. Diosmetin (DIO) is a natural flavonoid with properties of antioxidant, anti-infection, and antishock. The effect of DIO on osteoclast differentiation is poorly understood. In this study project, we found that DIO could inhibit osteoclastic formation induced by receptor activator of nuclear factor kappa-B ligand (RANKL) in a dose-dependent manner...
December 4, 2018: Journal of Cellular Physiology
Shichao Zhang, Malcolm M Q Xing, Bingyun Li
Many applications using drug-carrying biomedical materials require on-demand, localized delivery of multiple therapeutic agents in precisely controlled and patient-specific time sequences, especially after assembly of the delivery vehicles; however, creating such materials has proven extremely challenging. Here we report a novel strategy to create polypeptide multilayer films integrated with capsules as vehicles for co-delivery of multiple drugs using layer-by-layer self-assembly technology. Our approach allows the multilayered polypeptide nanofilms and pre-impregnated capsules to assemble into innovative biomedical materials with high and controllable loading of multiple drugs at any time post-preparation, and to achieve pH-responsive and sustained release...
December 4, 2018: ACS Applied Materials & Interfaces
Brian W Powers, Jiali Yan, Jingsan Zhu, Kristin A Linn, Sachin H Jain, Jennifer L Kowalski, Amol S Navathe
BACKGROUND: There is a growing focus on improving the quality and value of health care delivery for high-cost patients. Compared to fee-for-service Medicare, less is known about the clinical composition of high-cost Medicare Advantage populations. OBJECTIVE: To describe a high-cost Medicare Advantage population and identify clinically and operationally significant subgroups of patients. DESIGN: We used a density-based clustering algorithm to group high-cost patients (top 10% of spending) according to 161 distinct demographic, clinical, and claims-based variables...
December 3, 2018: Journal of General Internal Medicine
Justin Roth, Brian Goldman, Lewis Zirkle, John Schlechter, John Ibrahim, David Shearer
BACKGROUND: As the population ages, the developing world industrializes, and more urban centers emerge, the burden of orthopedic trauma will steadily increase. SIGN Fracture Care International has developed a unique intramedullary device for fixation of hip fractures in low-resource settings lacking fluoroscopy. The purpose of this study is to report the safety profile and complication rate for a consecutive series of hip fracture patients managed using this implant. METHODS: We conducted a retrospective analysis of the first 170 patients treated with the SIGN Hip Construct (SHC) from 2009 to 2014 using the SIGN Online Surgical Database (SOSD)...
2018: SICOT-J
Hengrui Chang, Zhanle Zheng, Yiyang Yu, Jiasheng Shao, Yingze Zhang
BACKGROUND: Minimally invasive treatment of complex tibial plateau fracture represents one of the most challenging problems in orthopedic surgery. We intended to describe the percutaneous surgery involving an originally designed traction device which might facilitate the closed reduction for bicondylar tibial plateau fractures. Further, to assess the clinical outcomes of this minimally invasive technique. METHODS: Between December 2015 and July 2016, Twenty-one patients, mean age 43...
November 29, 2018: BMC Musculoskeletal Disorders
Y Z Dong, F Y Liu, Y C Guo
Objective: To explore the clinical effect of double-wing flap for the treatment of toe syndactyly. Methods: Retrospective analysis of 47 patients (60 syndactyly toes) who underwent double-wing flap to reconstruct toe web space in orthopedics department of the Third Affiliated Hospital of Zhengzhou University from February 2010 to October 2017.There were 21 males and 26 females, with an average age of 18.9 months (range: 10-48 months). All patients were treated with zigzag incisions to separate the toe syndactylys without skin grafts...
December 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Dimitris Ntalos, J Berger-Groch, H Rohde, L G Grossterlinden, A Both, A Luebke, M J Hartel, T O Klatte
INTRODUCTION: Establishing a systematic multidisciplinary approach in the treatment of prosthetic joint infections (PJI) of the hip and analyzing its effect on clinical decision-making. PATIENTS AND METHODS: Forty-six patients diagnosed with PJI of the hip were included in the retrospective study. The treatment plan was either established by a single-discipline approach (n = 20) or by a weekly multidisciplinary infections conference (n = 26) consisting of at least an orthopedic surgeon, microbiologist and pathologist...
November 28, 2018: Archives of Orthopaedic and Trauma Surgery
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