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https://www.readbyqxmd.com/read/28421514/corr-insights-%C3%A2-vancomycin-prophylaxis-for-total-joint-arthroplasty-incorrectly-dosed-and-has-a-higher-rate-of-periprosthetic-infection-than-cefazolin
#1
Alex Soriano
No abstract text is available yet for this article.
April 18, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28421237/radiographic-interpretation-of-carpometacarpal-arthroplasty-correlation-between-radiographic-loosening-and-clinical-outcome
#2
Laurence Stillwater, Brett Memauri, Imran Ratanshi, Avinash Islur, Thelina Amaratunga
OBJECTIVE: To assess the radiographic appearance and interpretation of loosening in patients following first carpometacarpal joint pyrohemisphere arthroplasty. MATERIALS AND METHODS: A retrospective review over a 6-year period was performed identifying patients with first carpometacarpal pyrohemisphere implants. All postoperative radiographs were reviewed and compared with clinical information. Loosening was defined as greater than 1 mm of periprosthetic lucency or increasing lucency on serial studies...
April 19, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28420544/disclosing-agents-for-the-intraoperative-identification-of-biofilms-on-orthopedic-implants
#3
Joshua A Parry, Melissa J Karau, Sanjeev Kakar, Arlen D Hanssen, Robin Patel, Matthew P Abdel
BACKGROUND: Disclosing agents are dyes used in dentistry to colorize plaque (biofilm) and may offer a means for intraoperative detection of biofilms on orthopedic implants. Methylene blue (MB) stains biofilm and is safely used in orthopedic applications. Injection of MB into acutely infected prosthetic knees before debridement may enable visualization of biofilm, which could influence treatment decisions. The aims of this study were to determine if MB could be used to visualize biofilm on total knee arthroplasty (TKA) implants and to determine if MB staining has an antimicrobial effect that might interfere with subsequent culture...
March 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28419029/females-with-unexplained-joint-pain-following-total-joint-arthroplasty-exhibit-a-higher-rate-and-severity-of-hypersensitivity-to-implant-metals-compared-with-males-implications-of-sex-based-bioreactivity-differences
#4
Marco S Caicedo, Edward Solver, Latasha Coleman, Joshua J Jacobs, Nadim J Hallab
BACKGROUND: Recent studies indicate that females demonstrate an increased risk of experiencing adverse local tissue reactions, aseptic loosening, and revision after primary metal-on-metal hip resurfacing arthroplasty compared with males; the underlying biological mechanisms responsible for sex discrepancies in implant failure remain unclear. In addition to anatomical and biomechanical sex differences, there may be inherent immunological disparities that predispose females to more aggressive adaptive immune reactivity to implant debris, i...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28418574/inadequacy-of-joint-aspiration-for-detection-of-persistent-periprosthetic-infection-during-two-stage-septic-revision-knee-surgery
#5
Bernd Preininger, Viktor Janz, Philipp von Roth, Andrej Trampuz, Carsten F Perka, Tilman Pfitzner
Despite the lack of validation, synovial aspiration remains a common practice during 2-stage septic revision total knee arthroplasty (TKA). The goal of this study was to investigate the diagnostic validity of synovial polymethylmethacrylate (PMMA) spacer aspiration of temporary knee arthrodesis to detect persistent periprosthetic joint infection before TKA reimplantation. This retrospective cohort study included 73 consecutive patients who underwent 2-stage septic revision TKA according to a standard protocol...
April 18, 2017: Orthopedics
https://www.readbyqxmd.com/read/28416968/safety-and-efficacy-of-resistive-polymer-versus-forced-air-warming-in-total-joint-surgery
#6
Melanie F Sandoval, Paul D Mongan, Michael R Dayton, Craig A Hogan
BACKGROUND: Forced-air warming is used as a mechanism to prevent hypothermia and adverse outcomes associated with hypothermia among patients undergoing surgery. Patient safety in healthcare includes the use of devices and technology that minimize potential adverse events to patients. The present study sought to compare the capabilities of patient warming between two different devices that use different mechanisms of warming: forced-air warming and non-air warming. METHODS: One hundred twenty patients undergoing total hip or total knee arthroplasty received patient warming via a forced warming device or non-air warming fabric conductive material...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28416830/-analysis-on-the-causes-of-unscheduled-suspensions-of-knee-and-hip-arthroplasty
#7
Y Li, Z J Li, K Zhang, H Tian, Y Q Liu, H Cai, F Li, M W Zhao
OBJECTIVE: To analyze and summarize the causes of unscheduled suspension of knee and hip arthroplasty and to provide the method for optimizing the patient's preoperative management and improving the efficiency of medical resources as well as the patient's satisfaction. METHODS: The data for this report was retrospectively collected from September 2013 to August 2014 in our hospital, from cases of knee and hip arthroplasty that were suspended before the scheduled operation time...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28416826/-surgical-technique-and-early-clinical-outcomes-of-direct-anterior-approach-to-total-hip-arthroplasty
#8
M Lv, J Q Zhang, X S Wang, Y Huang, W Li, C Y Zhang
OBJECTIVE: To describe the surgical technique of direct anterior approach to total hip arthroplasty and to report the early clinical outcomes. METHODS: A series of 100 consecutive, unselected patients who had 116 primary total hip arthroplasty surgeries (16 bilateral) done through direct anterior approach from March 11 2015 to June 21 2016 was reviewed. There were 50 male patients and 50 female patients. The average patient age was 51 years, and the average body mass index was 24...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28413142/outcomes-of-modular-dual-mobility-acetabular-components-in-revision-total-hip-arthroplasty
#9
E Grant Sutter, Taylor R McClellan, David E Attarian, Michael P Bolognesi, Paul F Lachiewicz, Samuel S Wellman
BACKGROUND: There is a high rate of dislocation after revision total hip arthroplasty. This study evaluated the outcomes of 1 modular dual mobility component in revision total hip arthroplasty in patients at high risk of dislocation. METHODS: We reviewed 64 revisions performed in 27 (42%) patients for recurrent dislocation, 16 (25%) for adverse local tissue reaction, 11 (17%) for reimplantation infection, and 10 (16%) for aseptic loosening, malposition, or fracture...
March 23, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28411549/stability-of-knee-ligament-complex-of-thiel-embalmed-cadaver-compared-to-in-vivo-knee
#10
Florian Völlner, Ulrike Pilsl, Benjamin Craiovan, Florian Zeman, Michael Schneider, Michael Wörner, Joachim Grifka, Markus Weber
BACKGROUND: The first biomechanical evaluation of new implants is usually carried out with cadavers. Fixation of Thiel-embalmed cadavers is supposed to preserve the histological structure, colour and consistency of the tissue and has a low risk of infection and toxicity. However, the biomechanical properties of Thiel-fixated tissue are still unknown. The aim of this study was to quantify the effect of the Thiel-embalming method on the elastic properties of the ligament complex of the knee compared to in vivo knees during total knee arthroplasty...
April 7, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28410835/modified-extended-trochanteric-osteotomy-for-the-treatment-of-vancouver-b2-b3-periprosthetic-fractures-of-the-femur
#11
Andreas Ladurner, Pia Zurmühle, Vilijam Zdravkovic, Karl Grob
BACKGROUND: Femoral component revision is the treatment of choice for Vancouver type B2/B3 periprosthetic femur fractures (PFFs). The purpose of this study was to report the clinical outcome of revision total hip arthroplasty with the use of a modified extended trochanteric osteotomy (ETO) in PFF treatment. METHODS: A total of 43 cases between 2000 and 2014 were analyzed. Clinical and radiographic evaluation was performed with a mean follow-up of 40 months. Patient survival after revision surgery, complications, radiographic outcomes, and quality of life and hip function were assessed...
March 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28407472/introduction-to-the-centers-for-disease-control-and-prevention-and-healthcare-infection-control-practices-advisory-committee-guideline-for-prevention-of-surgical-site-infection-prosthetic-joint-arthroplasty-section
#12
John Segreti, Javad Parvizi, Elie Berbari, Philip Ricks, Sandra I Berríos-Torres
Peri-prosthetic joint infection (PJI) is a severe complication of total joint arthroplasty that appears to be increasing as more of these procedures are performed. Numerous risk factors for incisional (superficial and deep) and organ/space (e.g., PJI) surgical site infections (SSIs) have been identified. A better understanding and reversal of modifiable risk factors may lead to a reduction in the incidence of incisional SSI and PJI. The Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC) recently updated the national Guideline for Prevention of Surgical Site Infection...
April 13, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28403859/managing-uncertainty-a-qualitative-study-of-surgeons-decision-making-for-one-stage-and-two-stage-revision-surgery-for-prosthetic-hip-joint-infection
#13
Andrew J Moore, Ashley W Blom, Michael R Whitehouse, Rachael Gooberman-Hill
BACKGROUND: Approximately 88,000 primary hip replacements are performed in England and Wales each year. Around 1% go on to develop deep prosthetic joint infection. Between one-stage and two-stage revision arthroplasty best treatment options remain unclear. Our aims were to characterise consultant orthopaedic surgeons' decisions about performing either one-stage or two-stage revision surgery for patients with deep prosthetic infection (PJI) after hip arthroplasty, and to identify whether a randomised trial comparing one-stage with two-stage revision would be feasible...
April 12, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28401341/vancomycin-prophylaxis-for-total-joint-arthroplasty-incorrectly-dosed-and-has-a-higher-rate-of-periprosthetic-infection-than-cefazolin
#14
Michael M Kheir, Timothy L Tan, Ibrahim Azboy, Dean D Tan, Javad Parvizi
BACKGROUND: In total joint arthroplasty (TJA), vancomycin is used as perioperative antibiotic prophylaxis in patients with penicillin allergy or in patients colonized with methicillin-resistant Staphylococcus aureus (MRSA). Although vancomycin dosing should be weight-based (15 mg/kg), not all surgeons are aware of this; a fixed 1-g dose is instead frequently administered. QUESTIONS/PURPOSES: (1) Is there a difference in the risk of periprosthetic joint infection (PJI) in patients receiving vancomycin or cefazolin prophylaxis after primary TJA? (2) What proportion of patients is adequately dosed with vancomycin? (3) Compared with actual fixed dosing, does weight-based dosing result in a greater proportion of patients staying above the recommended 15-mg/L level at the beginning and end of surgery? (4) Are patients overdosed with vancomycin at greater risk of developing nephrotoxicity and acute kidney injury? METHODS: A single-institution, retrospective study was performed on 1828 patients undergoing primary TJAs who received vancomycin prophylaxis between 2008 and 2014...
April 11, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28396931/does-low-constraint-mobile-bearing-knee-prosthesis-give-satisfactory-results-for-severe-coronal-deformities-a-five-to-twelve-year-follow-up-study
#15
Jaroslaw Czekaj, Camdon Fary, Thierry Gaillard, Sebastien Lustig
PURPOSE: Severe varus and valgus knee deformities traditionally are replaced with constrained implants, with a number of disadvantages. We present our results in this challenging group using a low constraint deep-dish mobile bearing implant design. METHODS: One hundred fifty-four patients (170 arthroplasties) who underwent primary TKA using a deep-dish, mobile bearing posterior-stabilized implant for severe varus (HKA < 170°) or valgus (HKA > 190°) deformity between 2004 and 2009 were evaluated at a mean of 6...
April 11, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28395945/radiographic-changes-and-clinical-outcomes-associated-with-an-adjustable-diaphyseal-press-fit-humeral-stem-in-primary-reverse-shoulder-arthroplasty
#16
Samuel M Harmsen, Tom R Norris
BACKGROUND: Press-fit humeral fixation in reverse shoulder arthroplasty (RSA) has become increasingly popular; however, radiographic analysis of these stems is limited. We aimed to evaluate the radiographic and clinical outcomes of an adjustable diaphyseal press-fit humeral stem in primary RSA. METHODS: We conducted a retrospective review of 232 primary RSAs in 219 patients performed by a single surgeon using this system. Radiographic outcomes were evaluated in patients with at least 2 years of radiographic follow-up...
April 7, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28395391/dual-mobility-acetabular-cups-in-primary-total-hip-arthroplasty-in-patients-at-high-risk-for-dislocation
#17
Steven F Harwin, Jaydev B Mistry, Morad Chughtai, Anton Khlopas, Chukwuweike Gwam, Jared M Newman, Carlos A Higuera, Peter M Bonutti, Arthur L Malkani, Frank R Kolisek, Ronald E Delanois, Michael A Mont
INTRODUCTION: Postoperative dislocation occurs in approximately 2% of primary total hip arthroplasties (THAs). Risk factors associated with dislocation include: age of 70 years or older, body mass index (BMI) of 30 kg/m2 or greater, alcohol abuse, and neuro-degenerative diseases such as multiple sclerosis or Parkinson's disease. As a result, dual-mobility articulations, which have been typically used for revision procedures, have become an increasingly popular option for these "at risk" primary THAs...
April 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28395370/intra-articular-tranexamic-acid-in-primary-total-knee-arthroplasty-meta-analysis
#18
Joseph T Moskal, Susan G Capps
Total knee arthroplasty (TKA) is associated with an increased need for blood transfusions and thus an increase in risks associated with blood transfusion such as transfusion reactions, infections, fluid overload, and altered mental status. Tranexamic acid (TXA) is an antifibrinolytic medication that can reduce perioperative blood loss in TKA. However, the best method of delivery has not been defined although topical intra-articular TXA (IA-TXA) may have a theoretical advantage as it is applied directly when and where it is needed to control bleeding...
April 10, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28391430/why-does-total-elbow-arthroplasty-fail-today-a-systematic-review-of-recent-literature
#19
Ante Prkic, Chantal Welsink, Bertram The, Michel P J van den Bekerom, Denise Eygendaal
BACKGROUND: Total elbow arthroplasty is a relatively uncommon type of arthroplasty, which has undergone several design changes in the past four decades. However, research on improvement requires knowledge of failure mechanisms that can be addressed. Therefore, we conducted a systematic review on modes of failure of total elbow arthroplasty. METHODS: We conducted searches on PubMed/Medline, Embase and Cochrane databases to identify studies describing modes of failure of primary total elbow arthroplasties...
April 9, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28390887/single-stage-revision-arthroplasty-for-infection-an-underutilized-treatment-strategy
#20
Jonathan J Negus, Peter B Gifford, Fares S Haddad
BACKGROUND: The burden of revision arthroplasty surgery for infection is rising as the rate of primary arthroplasty surgery increases. Infected arthroplasty rates are now relatively low, but the sheer increase in volume is leading to considerable patient morbidity and significant increases in costs to the health care system. Single-stage revision for infection is one of the several accepted treatment options, but the indications and results are debated. This review aims to clarify the current evidence...
March 2, 2017: Journal of Arthroplasty
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