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Joint AND infection

Samuel R Huntley, Sung Lee, Rishi Kalra, Gerald McGwin, Sameer Naranje, Ashish Shah
BACKGROUND: Surgical site infections (SSI) in orthopaedic surgery are common nosocomial complications that contribute significantly to patient morbidity and increased healthcare costs. While past studies support an increase in the incidence of SSI during the summer months in orthopaedic spine surgery and joint arthroplasty, there has not been any study examining the association between season and SSI in the setting of orthopaedic foot and ankle surgery. METHODS: A retrospective analysis of data from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database from 2011-2015 was conducted...
May 2, 2018: Foot
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
Pierre Sautet, Thibaut Mékidèche, Romain Guilhaumou, Matthew P Abdel, Jean-Noël Argenson, Sébastien Parratte, Matthieu Ollivier
Revisions TKAs are being completed with uncemented constructs more frequently. We hypothesized that tantalum cones could be an efficient carrier of antibiotics in uncemented procedures. We aimed to compare the release of vancomycin between 1) tantalum and smooth stainless cylinders, 2) different concentrations of vancomycin and 3) different durations of bathing. Specifically designed tantalum cylinders were bathed in a vancomycin solution with various durations of baths. We investigated rinses between each interval as well as the dose of vancomycin...
October 16, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Brendan F Boyce, Jinbo Li, Lianping Xing, Zhenqiang Yao
Skeletal health is maintained by bone remodeling, a process in which microscopic sites of effete or damaged bone are degraded on bone surfaces by osteoclasts and subsequently replaced by new bone, which is laid down by osteoblasts. This normal process can be disturbed in a variety of pathologic processes, including localized or generalized inflammation, metabolic and endocrine disorders, primary and metastatic cancers, and during aging as a result of low-grade chronic inflammation. Osteoclast formation and activity are promoted by factors, including cytokines, hormones, growth factors, and free radicals, and require expression of macrophage-colony stimulating factor (M-CSF) and receptor activator of NF-κB ligand (RANKL) by accessory cells in the bone marrow, including osteoblastic and immune cells...
2018: Frontiers in Immunology
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
J Kruidenier, L W van der Plaat, I N Sierevelt, D Hoornenborg, D Haverkamp
BACKGROUND: With longer follow-up, survival rate of total ankle replacements (TAR) diminishes. It is therefore important to have a reliable fall-back option in case of failed TAR. Revision arthroplasty is often impossible because of loss of bonestock or infection. Conversion to ankle fusion is then indicated. We investigated the clinical, radiographic and patient reported results for fusion after failed TAR in a consecutive group of patients. We concentrated on the influence of inflammatory joint disease (IJD) on union rate...
August 24, 2018: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Andrew J Curley, Elizabeth B Terhune, Anthony T Velott, Evan H Argintar
Negative pressure wound therapy is becoming more commonly used to prevent wound complications in joint arthroplasty, although few studies have assessed its outcomes compared with those of a traditional dry sterile dressing. This retrospective study assessed complications that required return to the operating room in a cohort of patients who received a dry sterile dressing (n=159) vs negative pressure wound therapy (n=32). There were significantly more overall complications (P=.0293) in the dry sterile dressing group (23...
October 15, 2018: Orthopedics
Sean P Ryan, Cary Politzer, Cynthia Green, Samuel Wellman, Michael Bolognesi, Thorsten Seyler
Malnutrition is not uncommon in arthroplasty patients, and hypoalbuminemia has been shown to be predictive of postoperative complications. The authors sought to compare albumin concentration with a global assessment of physical health, the American Society of Anesthesiologists (ASA) score, to further discriminate the importance of albumin in predicting postoperative complications. A cohort of 128,412 patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA) were identified from 2005 to 2015 through use of the American College of Surgeons National Surgical Quality Improvement Program database...
October 15, 2018: Orthopedics
E Carlos Rodriguez-Merchan
Background: Periprosthetic infection is the most serious joint replacement complication, occurring in 0.8-1.9% of total knee arthroplasties (TKAs).This review aims to define the role of preoperative aspiration culture (PAC) for diagnosis of TKA infection. Methods: A PubMed (MEDLINE) search related to TKA infection and PAC was analyzed. The main criteria for selection were that the articles were focused in the aforementioned question. Results: Twenty articles were found, but only fourteen were selected and reviewed because they were deeply focused on the topic...
September 2018: Archives of Bone and Joint Surgery
Tsun Yee Law, Jennifer Kurowicki, Samuel Rosas, Karim Sabeh, Spencer Summers, Zachary Hubbard, Martin Roche
As an increasing number of states begin to legalize marijuana for either medical or recreational use, it is important to determine its effects on joint arthroplasty. The purpose of this study is to determine the impact of cannabis use on total knee arthroplasty (TKA) revision incidence, revision causes, and time to revision by analyzing the Medicare database between 2005 and 2014. A retrospective review of the Medicare database for TKA, revision TKA, and causes was performed utilizing Current Procedural Terminology (CPT) and International Classification of Disease ninth revision codes (ICD-9)...
2018: Journal of Long-term Effects of Medical Implants
Romain Guery, Anoosha Habibi, Jean-Benoît Arlet, François Lionnet, Victoire de Lastours, Jean-Winoc Decousser, Jean-Luc Mainardi, Keyvan Razazi, Laurence Baranes, Pablo Bartolucci, Bertrand Godeau, Fréderic Galacteros, Marc Michel, Matthieu Mahevas
BACKGROUND: Non-typhoidal salmonellosis (NTS) often occurs in children with sickle-cell disease (SCD) and remains a significant cause of mortality in developing countries. However, there is lack of reports on the clinical presentation, outcome and complications of NTS in adults with SCD. METHODS: We performed a chart review between 2006 and 2016 of adults SCD diagnosed with NTS in 3 referral centers monitoring approximately 3500 SCD adults. RESULTS: Twenty-three episodes of NTS were diagnosed among 22 SCD adults...
October 14, 2018: Infectious Diseases
Dehui Zeng, Pingbo Yao, Hong Zhao
Abundant evidence indicted that P2X7 receptor show a essential role in human health and some human diseases including hypertension, atherosclerosis, pulmonary inflammation, tuberculosis infection, psychiatric disorders, and cancer. P2X7 receptor also has an important role in some central nervous system diseases such as neurodegenerative disorders. Recently, more research suggested that P2X7 receptor also plays a crucial role in bone and joint diseases. But the effect of P2X7 receptor on skeletal and joint diseases has not been systematically reviewed...
October 14, 2018: Journal of Cellular Physiology
Allan Bybeck Nielsen, Ulrikka Nygaard, Thomas Hoffmann, Kim Kristensen
No abstract text is available yet for this article.
October 13, 2018: Archives of Disease in Childhood
George Markopoulos, Dimitrios Kitridis, Konstantinos Tsikopoulos, Dimitrios Georgiannos, Ilias Bisbinas
BACKGROUND: Urinary catheters are commonly used in patients undergoing total hip and knee arthroplasty. Bladder training before catheter removal is reported to shorten the time to return to normal bladder function and reduce the incidence of urinary retention. OBJECTIVE: To evaluate the results of bladder training in patients with total hip and knee arthroplasty. DESIGN: Randomized controlled trial. SETTING: Orthopaedic Department of a tertiary Military Hospital...
September 11, 2018: International Journal of Nursing Studies
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
Andrea Vergara, Mariana J Fernández-Pittol, Ernesto Muñoz-Mahamud, Laura Morata, Jordi Bosch, Jordi Vila, Alex Soriano, Climent Casals-Pascual
BACKGROUND: Periprosthetic joint infection (PJI) remains a major clinical challenge. In this study, we evaluated the diagnostic performance of lipocalin-2 (LCN2), a well-characterized neutrophil protein, in synovial fluid to discriminate PJI and aseptic implant failure. METHODS: Synovial fluid from patients with acute or chronic PJI, aseptic failure, or controls was obtained during surgery. LCN2 was quantified using a modified enzyme immunoassay coupled with chemiluminescence (Architect Urine NGAL; Abbott Laboratories)...
September 22, 2018: Journal of Arthroplasty
Yuko Hamaguchi, Takayuki Yamaguchi, Hiroshi Nishiura
To assess tuberculosis transmission frequency at a population level, the age-dependent Mantoux test has been used widely to estimate the annual risk of infection (ARI) with Mycobacterium tuberculosis. However, the widespread Bacille Calmette-Guerin (BCG) immunization program implemented in Japan in the 20th century has made natural infections with M. tuberculosis difficult to distinguish from immune responses against this vaccine. Consequently, a recognized alternative method for measuring the frequency of primary infections, the interferon-gamma release assay (IGRA), which partially decays as a function of time after infection, is used...
October 10, 2018: Journal of Theoretical Biology
C G Todd, M McGee, K Tiernan, P Crosson, E O'Riordan, J McClure, I Lorenz, B Earley
The study objectives were to: 1) evaluate the diagnostic performance of passive immunity tests for classification of failure of passive transfer (FPT) risk, based on their relationships with calf health and performance, and 2) describe the epidemiology of morbidity and mortality in suckler beef and dairy calves under Irish conditions. A total of 1392 suckler beef calves (n = 111 farms) and 2090 dairy calves (84 farms) were included in this observational study. Blood samples were collected by jugular venipuncture...
November 1, 2018: Preventive Veterinary Medicine
Panakkool Thamban Aneesh, Ameri Kottarathil Helna, Appukuttan Biju Kumar, Balu Alagar Venmathi Maran
The parasitic copepod Lernaeenicus stromatei Gnanamuthu, 1953 infecting black pomfret, Parastromateus niger (Bloch) (Carangidae) is redescribed based on a neotype and additional fresh material obtained from hosts collected at different fish landing centers on the Chennai Coast (Tamil Nadu), Malabar Coast (Kerala), and from West Bengal, India. A female L. stromatei obtained from the Chennai Coast has been designated as a neotype and deposited in the National Zoological Collections of Zoological Survey of India (NZC-ZSI)...
September 18, 2018: Zootaxa
Annett Klinder, Sarah Zaatreh, Martin Ellenrieder, Sylvio Redanz, Andreas Podbielski, Tobias Reichel, Hans Bösebeck, Wolfram Mittelmeier, Rainer Bader
Two-stage revision arthroplasty is the treatment of choice for periprosthetic infection, a serious complication after knee or hip arthroplasty. Our prospective clinical trial aimed to investigate the concentrations of gentamicin and vancomycin in wound exudate and tissue in two-stage revision arthroplasty. Wound exudate and periprosthetic membrane samples were collected from 18 patients (10 hip and eight knee patients), who were due for two-stage treatment after a periprosthetic joint infection. Samples were taken during insertion of antibiotic-impregnated spacers and after their removal...
October 12, 2018: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
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