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Articular infection

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https://www.readbyqxmd.com/read/29340748/lack-of-level-i-evidence-on-how-to-prevent-infection-after-elective-shoulder-surgery
#1
Carola F Eck, Julie A Neumann, Orr Limpisvasti, Christopher R Adams
PURPOSE: Infection is a concern after all orthopedic procedures, including shoulder surgery. This systematic review of literature aimed to determine risk factors for infection as well as the availability and effectiveness of measures utilized to prevent infection after elective shoulder surgery. METHODS: An electronic database search was performed using MEDLINE (1950-October 2017), EMBASE (1980-October 2017), CINAHL (1982-October 2017), and the Cochrane database to identify studies reporting a risk factor or preventive measure for infection after shoulder surgery...
January 16, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29327559/-combined-surgical-approaches-in-the-treatment-of-complex-tibial-plateau-fractures
#2
Guang-Hua Yuan, Xiao Zheng, Kang Chen
OBJECTIVE: To explore the early clinical efficacy of a posteromedial inverted "L" shape approach combined an assisted antero lateral assisted approach for the treatment of complex fractures of tibial plateau. METHODS: From March 2011 to June 2014, the posteromedial inverted "L" shape approach combined with the antero lateral assisted approach in the treatment of Schatzker type IV, V, VI tibial plateau fracture were performed in 34 cases. There were 23 males and 11 females, ranging in age from18 to 67 years old, averaged 34...
January 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29322889/outcomes-of-open-reduction-and-internal-fixation-in-displaced-intra-articular-scapular-fractures-a-case-series
#3
M Zahid, E H Rashid, H Inam, A J Zubairi, N Baloch, P M Hashmi
Scapular fractures are rare injuries and usually occur due to high energy trauma. Displaced Intra articular fractures usually require operative treatment and yields better outcomes as compared to conservative management. To assess the functional and radiological outcomes of displaced intra-articular scapular fractures managed with open reduction and internal fixation. 12 patients were retrospectively reviewed and included in the study. Post-operative functional outcomes were assessed using mean quick DASH (Disability of arm, hand and shoulder) score while radiological outcomes were analyzed as percentage of implant cut-through, mal-union, non-union or infection...
March 2017: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/29319583/the-infectious-and-non-infectious-etiology-clinical-picture-and-outcome-of-neutropenia-in-immunocompetent-hospitalized-children
#4
Odeya David, Yariv Fruchtman, Ruslan Sergienko, Joseph Kapelushnik, Eugene Leibovitz
BACKGROUND: Acquired neutropenia in immunocompetent children is common and its differential diagnosis ranges from benign causes to life-threatening diseases. We described the etiology, clinical picture and outcome of new onset neutropenia in immunocompetent children assessed in the emergency department and hospitalized at our medical center. PATIENTS AND METHODS: Previously healthy children admitted with neutropenia (absolute neutrophil count [ANC] <1.5 x 10/L) were included...
January 9, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29305995/acute-septic-arthritis-of-the-knee-a-rare-case-report-of-infection-with-parvimonas-micra-after-an-intra-articular-corticosteroid-injection-for-osteoarthritis
#5
Assem A Sultan, William A Cantrell, Anton Khlopas, Connor Cole, Nicolas S Piuzzi, Nipun Sodhi, Peter Brooks, Michael A Mont
Acute bacterial mono-articular septic arthritis affects most commonly the lower extremity joints in adult population and most commonly caused by Staphylococcus aureus. Various risk factors determine susceptibility to infection including host immunity, medical co-morbidity and joint structural abnormality and other organisms may be involved. Parvimonas micra (P. micra) is among the rare organisms that may be associated with atypical septic arthritis and primarily affects the native knee joint. Only 3 case reports in the literature have reported on pyogenic pyogenic joint infection caused by this organism...
January 3, 2018: Anaerobe
https://www.readbyqxmd.com/read/29305635/-therapeutic-strategies-for-joint-infections
#6
U-J Gerlach
Joint infections represent a severe complication that results in irreversible joint destruction when left untreated or treated inadequately. The reasons for joint infections include endogenous hematological and exogenous factors. In the patient cohort described here, the empyema was almost exclusively acquired through iatrogenic measures (e.g. arthroscopic operations, punctures and intra-articular infections) or as a result of fractures close to the joint and penetrating injuries. Acute joint empyema is an orthopedic emergency, which must be immediately surgically treated because irreversible cartilage damage can rapidly occur due to the pathophysiological process...
January 5, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29305426/rapid-detection-of-periprosthetic-joint-infection-using-a-combination-of-16s-rdna-polymerase-chain-reaction-and-lateral-flow-immunoassay-a-pilot-study
#7
V Janz, J Schoon, C Morgenstern, B Preininger, S Reinke, G Duda, A Breitbach, C F Perka, S Geissler
OBJECTIVES: The objective of this study was to develop a test for the rapid (within 25 minutes) intraoperative detection of bacteria from synovial fluid to diagnose periprosthetic joint infection (PJI). METHODS: The 16s rDNA test combines a polymerase chain reaction (PCR) for amplification of 16s rDNA with a lateral flow immunoassay in one fully automated system. The synovial fluid of 77 patients undergoing joint aspiration or primary or revision total hip or knee surgery was prospectively collected...
January 2018: Bone & Joint Research
https://www.readbyqxmd.com/read/29248185/soft-tissue-complications-and-timing-of-surgery-in-patients-with-a-tongue-type-displaced-intra-articular-calcaneal-fracture-an-international-retrospective-cohort-study
#8
A Siebe De Boer, Esther M M Van Lieshout, Freek Van 't Land, Dominique Misselyn, Tim Schepers, Dennis Den Hartog, Michael H J Verhofstad
INTRODUCTION: Tongue-type displaced intra-articular calcaneal fractures (DIACF) are associated with a specific pattern of fracture displacement in contrast to joint depression fractures. This may result in tension of soft tissue in the posterior part of the heel. Tension-induced ischemia can result in skin necrosis. The objectives of this study were to investigate whether patients with tongue-type calcaneal fractures exert a higher risk of complications, especially of the posterior soft tissues, than joint depression type fractures...
December 11, 2017: Injury
https://www.readbyqxmd.com/read/29246530/controversies-in-rheumatoid-arthritis-glucocorticoid-therapy
#9
Adeline Ruyssen-Witrand, Arnaud Constantin
Despite therapeutic innovations in the past 20 years, glucocorticoids (GC) are still widely used for the symptomatic treatment of rheumatoid arthritis (RA). Studies have demonstrated the clinical and structural efficacy of moderate doses (i.e. 30-60 mg/d) GC in addition to disease modifying anti-rheumatic drug (DMARD) initiation in early RA. A combination of a low dose of GC (i.e. 7.5-10 mg/d) and DMARDs increases remission rates and decreases the risk of medium-term structural progression in early RA. Intravenous and intramuscular administration of GC associated with DMARD initiation or intra-articular GC injections in symptomatic joints in tight control strategies increase remission rates in early RA...
December 12, 2017: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/29245290/operative-versus-nonoperative-treatment-of-displaced-intra-articular-calcaneal-fractures-a-meta-analysis-of-current-evidence-base
#10
REVIEW
Ning Wei, Peizhi Yuwen, Wei Liu, Yanbin Zhu, Wenli Chang, Chen Feng, Wei Chen
BACKGROUND: The relative efficacy of operative and nonoperative treatments for the displaced intra-articular calcaneal fractures (DIACF) remains uncertain. OBJECT: We conducted a meta-analysis to compare the effectiveness of operative and nonoperative treatments in treating patients with DIACF. METHODS: Databases including Cochrane Library, Medline, Embase, CBM, CNKI, and Google Scholar were searched. After independent study selection by 2 authors, data were extracted and collected independently...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29240012/surgical-treatment-of-chronic-elbow-dislocation-allowing-early-range-of-motion-operative-technique-and-clinical-results
#11
Duane R Anderson, Justin M Haller, Lucas A Anderson, Samuel Hailu, Abebe Chala, Shawn W O'Driscoll
OBJECTIVES: Describe the surgical treatment and patient outcomes of chronic elbow dislocations. DESIGN: Retrospective review SETTING:: Two tertiary referral centers. PATIENTS/PARTICIPANTS: All patients with surgically treated chronic elbow dislocation with no associated articular fracture from January 2009 - January 2015. INTERVENTION: Review of patient demographics, injury chronicity, surgical technique, and patient outcomes...
December 6, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29239539/-fractures-of-the-distal-humerus-in-the-elderly-osteosynthesis-or-elbow-arthoplasty
#12
Diogo Vieira Cardoso, Gregory Cunningham
With an aging population, distal humerus fractures are becoming an emerging problem. Whereas open reduction and internal fixation has been the treatment of choice, results have not been as conclusive in elderly patients. Over two thirds of the cases in this population present with a highly comminuted articular fracture and poor bone stock, jeopardizing the quality and stability of the construct. Total elbow arthroplasty has gained popularity in the treatment of such fractures, and has shown higher results in terms of pain, function, and patient satisfaction...
December 13, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29239251/treatment-of-distal-interphalangeal-ganglion-cysts-by-volar-corticosteroid-injection
#13
Kent Weinheimer, Nathan Patrick, Michael Darowish
BACKGROUND: Various options exist for operative and nonoperative treatment of symptomatic distal interphalangeal (DIP) ganglion cysts. We describe the technique and efficacy of a novel treatment of DIP ganglion cysts using a volar, transtendon, intra-articular injection of corticosteroid. METHODS: This was a single center, retrospective study (2010-2015) of 21 patients who received a volar, intra-articular corticosteroid injection for treatment of DIP ganglion cysts...
December 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29238722/clinical-epidemiological-and-histopathological-features-of-respiratory-involvement-in-rheumatoid-arthritis
#14
REVIEW
Alessia Alunno, Roberto Gerli, Roberto Giacomelli, Francesco Carubbi
Although by definition rheumatoid arthritis (RA) is an articular disorder, it is a systemic disease, and 18-40% of patients experience extra-articular manifestations (EAMs). The involvement of the respiratory system occurs in about 30-40% of RA patients, and in about 10-20% of them it represents the first manifestation of RA. A wide range of pulmonary manifestations are detectable in RA patients, including pulmonary parenchymal disease, pleural involvement, and airway and pulmonary inflammation. The clinical, radiological, and histological spectra of respiratory manifestations in RA reflect chronic immune activation, increased susceptibility to infection (often related to immunosuppressive medications), or direct drug...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29232748/-combined-posteromedial-and-anterolateral-approach-in-the-floating-position-two-column-fracture-of-the-tibia-head
#15
Maike Reul, Harm Hoekstra
Background The posterior tibial plateau is often affected in intra-articular tibial fractures. Moreover, treating these posterior fractures is recognised as an important prognostic factor. Open reduction and internal fixation of lateral and posterior two column tibial plateau fractures can be achieved via a combined reversed L-shape approach and an anterolateral approach in the floating position without intraoperative repositioning of the patient. Material and Methods The operative procedure starts in the posterior position with visualisation of the posterior column after lateral retraction of the medial head of the M...
December 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29225019/primary-versus-revision-anterior-cruciate-ligament-reconstruction-patient-demographics-radiographic-findings-and-associated-lesions
#16
Justin J Mitchell, Mark E Cinque, Grant J Dornan, Lauren M Matheny, Chase S Dean, Brad Kruckeberg, Gilbert Moatshe, Jorge Chahla, Robert F LaPrade
PURPOSE: The purpose of this study was to evaluate the differences in intra-articular pathology, demographic characteristics, and radiographic characteristics of the knee associated with primary anterior cruciate ligament reconstruction (ACLR) versus revision ACLR at the time of initial presentation with either a native anterior cruciate ligament tear or an anterior cruciate ligament graft tear. Secondarily, we aimed to investigate risk factors for concomitant medial and lateral meniscal tears and cartilage injuries at the time of ACLR...
December 7, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29191469/role-of-anterolateral-reconstruction-in-patients-undergoing-anterior-cruciate-ligament-reconstruction
#17
REVIEW
C Lutz
There is renewed interest in anterolateral reconstruction (ALR) for patients undergoing anterior cruciate ligament (ACL) reconstruction. This is the result of isolated ACL reconstruction and double-bundle reconstruction providing inadequate control over the pivot shift, and recent anatomical and biomechanical studies on the anterolateral ligament (ALL) and its role in the knee's rotational stability.From a technical point of view, ALR can be performed either as a continuity of the intra-articular ACL reconstruction or an independent procedure...
November 27, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29168180/cxcr2-is-critical-for-bacterial-control-and-development-of-joint-damage-and-pain-in-staphylococcus-aureus-induced-septic-arthritis-in-mouse
#18
Daiane Boff, Vivian L S Oliveira, Celso M Queiroz Junior, Tarcília A Silva, Marcelo Allegretti, Waldiceu A Verri, Paul Proost, Mauro M Teixeira, Flavio A Amaral
Staphylococcus aureus is the main pathogen associated with septic arthritis. Upon infection, neutrophils are quickly recruited to the joint by different chemoattractants, especially CXCR1/2 binding chemokines. Although their excessive accumulation is associated with intense pain and permanent articular damage, neutrophils have an important function in controlling bacterial burden. This work aimed to study the role of CXCR2 in the control of infection, hypernociception and tissue damage in S. aureus-induced septic arthritis in mice...
November 22, 2017: European Journal of Immunology
https://www.readbyqxmd.com/read/29163995/delayed-tibial-osteomyelitis-after-anterior-cruciate-ligament-reconstruction-with-hamstrings-autograft-and-bioabsorbable-interference-screw-a-case-report-and-review-of-the-literature
#19
Kevin S Weiss, Justin M Weatherall, Jen Eick, James R Ross
Osteomyelitis following arthroscopically assisted anterior cruciate ligament (ACL) reconstruction has rarely been reported in the literature. We report a case of a 20-year-old female who had delayed tibial osteomyelitis and a pretibial cyst with culture-positive, oxacillin sensitive Staphylococcus epidermidis 15 months after an ACL reconstruction with hamstring autograft. Soft tissue fixation within the tibial tunnel was with a poly-L-D-lactic acid (PLDLA) bioabsorbable interference screw. The patient underwent surgical treatment with curettage, debridement, hardware removal, and bone grafting of the tibial tunnel followed by a course of intravenous antibiotics...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29158645/evaluation-of-functional-outcome-of-pilon-fractures-managed-with-limited-internal-fixation-and-external-fixation-a-prospective-clinical-study
#20
Umesh Kumar Meena, Mahesh Chand Bansal, Prateek Behera, Rahul Upadhyay, Gyan Chand Gothwal
Introduction: The management of pilon fractures is controversial primarily due to the high rate of complications irrespective of the mode of treatment. Limited internal fixation with external fixation is associated with minimal soft tissue handling. This may reduce the chances of wound dehiscence and infection. This study was designed to evaluate the functional and clinical outcomes in patients treated with limited internal fixation combined with external fixation in pilon fractures. Material and methods: This study was conducted as a prospective clinical study on 56 skeletally mature patients with closed fractures with poor skin condition, and with open grade 1 and grade 2 distal tibial intra-articular fractures...
November 2017: Journal of Clinical Orthopaedics and Trauma
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