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https://www.readbyqxmd.com/read/29909958/preventing-complications-associated-with-operating-on-taper-corrosion
#1
Tad M Mabry
BACKGROUND: Revision total hip arthroplasty for the treatment of taper corrosion has become increasingly common. The purpose of this portion of the symposium was to describe the most common complications of this procedure and to delineate specific measures that might be taken to prevent these complications. METHODS: A literature review was performed focusing on the results and complications of revision total hip arthroplasty performed for taper corrosion. RESULTS: The most common modes of failure after revision total hip arthroplasty in the setting of taper corrosion include the 4 I's: infection, instability, implant loosening, and ions (recurrent adverse local tissue reaction)...
May 29, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29909445/centers-for-disease-control-and-prevention-2017-guidelines-for-prevention-of-surgical-site-infections-review-and-relevant-recommendations
#2
REVIEW
K Keely Boyle, Sridhar Rachala, Scott R Nodzo
PURPOSE OF REVIEW: The associated patient morbidity and resource-intensive nature of managing surgical site infections (SSI) has focused attention toward not only improving treatment protocols but also enhancing preventative measures. The purpose of this review was to summarize the relevant updated CDC guidelines for the prevention of SSI that were released in 2017. The CDC recommends the integration of the guidelines for improvement in quality metrics, reportable outcomes, and patient safety...
June 16, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29908796/mortality-and-implant-survival-with-simultaneous-and-staged-bilateral-total-knee-arthroplasty-experience-from-the-australian-orthopaedic-association-national-joint-replacement-registry
#3
Hwa Sen Chua, Sarah L Whitehouse, Michelle Lorimer, Richard De Steiger, Linda Guo, Ross W Crawford
BACKGROUND: Total knee arthroplasty (TKA) is an effective procedure for relieving pain and restoring function in osteoarthritis, with a significant proportion of patients having severe disease bilaterally. However, although there are differences in patient selection criteria for bilateral procedures, there is no consensus regarding the optimal timing for bilateral TKA. The aim of this study was to compare rates and causes of revision and 30-day mortality between simultaneous and staged bilateral TKA using data from the Australian Orthopaedic Association National Joint Replacement Registry...
May 17, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29908759/cutibacterium-acnes-and-the-shoulder-microbiome
#4
Boyang Qiu, Kait Al, Ana M Pena-Diaz, George S Athwal, Darren Drosdowech, Kenneth J Faber, Jeremy P Burton, David B O'Gorman
BACKGROUND: Advances in DNA sequencing technologies have made it possible to detect microbial genome sequences (microbiomes) within tissues once thought to be sterile. We used this approach to gain insights into the likely sources of Cutibacterium acnes (formerly Propionibacterium acnes) infections within the shoulder. METHODS: Tissue samples were collected from the skin, subcutaneous fat, anterior supraspinatus tendon, middle glenohumeral ligament, and humeral head cartilage of 23 patients (14 male and 9 female patients) during primary arthroplasty surgery...
June 13, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29908253/a-microbiological-assessment-of-sterile-surgical-helmet-systems-using-particle-counts-and-culture-plates-recommendations-for-safe-use-whilst-scrubbing
#5
T S Moores, S A Khan, B D Chatterton, G Harvey, S C Lewthwaite
BACKGROUND: Infection occurs in 2-4% of arthroplasty cases, identifying potential sources of infection can help to reduce infection rates. The aim of this study was to identify the impact and potential for contamination of our hands and gowns whilst scrubbing using sterile surgical helmet systems (SSHS). METHOD: A colony-forming unit (CFU) is a pathogenic particle of 0.5 to 5 micrometres. A standard arthroplasty hood and a SSHS with and without the fan on for a 3-minute exposure to represent scrubbing time, were tested on 3 subjects and a mannequin with concurrent particle counts and culture plates...
June 13, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29907913/total-hip-arthroplasty-in-osteonecrosis-secondary-to-sickle-cell-disease
#6
Mohamed Zubair Farook, Moji Awogbade, Karthik Somasundaram, Ines L H Reichert, Patrick L S Li
BACKGROUND: Sickle cell disease (SCD) is a multisystem disease, and the predominant articular manifestation is osteonecrosis (ON). Total hip arthroplasty (THA) is technically challenging, and the complication rates are high. In this retrospective study, we have analysed the outcome of THA in a cohort of patients with SCD at our institution. MATERIALS AND METHODS: We identified 34 THAs between 1999 and 2016 in 30 patients (mean age 37 years) from our SCD database...
June 15, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29905045/-clinical-research-of-debridement-with-prosthesis-retention-for-periprosthetic-joint-infection-after-arthroplasty
#7
Xinggui Song, Xin Li, Junlei Song, Chi Xu, Rui Li, Heng Li, Jiying Chen
Objective: To investigate the mid-term effectiveness of debridement with prosthesis retention for periprosthetic joint infection (PJI) after total hip arthroplasty (THA) and total knee arthroplasty (TKA), and analyze the influence factors that affected the effectiveness. Methods: A clinical data of 45 cases with PJI after THA (16 cases) and TKA (29 cases) that were treated with debridement with prosthesis retention between January 2011 and January 2015 were collected and analyzed...
June 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
https://www.readbyqxmd.com/read/29904419/value-of-procalcitonin-for-diagnosing-perioperative-pneumonia-urinary-infections-and-superficial-surgical-site-infections-in-patients-undergoing-primary-hip-and-knee-arthroplasty
#8
Lixuan Zhang, Daozhang Cai, Hanming Guo
Serum procalcitonin (PCT) levels may be helpful for the diagnosis of infections during the perioperative period of arthroplasty. However, there is much debate in the literature regarding the appropriate cut-off value for different types of surgery and local bacterial infection. The present study aimed to evaluate serum PCT levels in patients undergoing arthroplasty and to determine the cut-off value that may represent perioperative pneumonia, urinary infections and superficial surgical site infections. The present retrospective study included a total of 500 patients treated between July 2014 and August 2015...
June 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29903458/the-bundle-busters-incidence-and-costs-of-postacute-complications-following-total-joint-arthroplasty
#9
Andrew J Luzzi, Andrew N Fleischman, Christopher N Matthews, Meredith P Crizer, John Wilsman, Javad Parvizi
BACKGROUND: Recently, a bundled payment model was implemented in the United States to improve quality and reduce costs. While hospitals may be rewarded for lowering costs, they may be financially exposed by high cost complications, the so-called bundle busters. We aimed at determining the incidence, etiology, and costs of postacute complications after total joint arthroplasty (TJA). METHODS: A retrospective study was conducted using a prospectively collected database of patients who underwent primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) from January 2015 to April 2016...
June 11, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29902831/the-effect-of-antiseptics-in-the-prophylaxis-of-infection-in-orthopaedic-surgery
#10
Martin Lüdemann, Pablo Munoz, Martin Wagner, Uwe Malzahn, Konstantin Horas, Peter Heuschmann, Maximilian Rudert
INTRODUCTION: Over the past decade, the incidence of revision arthroplasty has increased substantially. One of the main reasons for revision arthroplasty is periprosthetic joint infection, often resulting in multiple surgical interventions with variable success and poor clinical outcome. Intraoperative wound irrigation has been proposed to reduce bacterial contamination and thus the risk of periprosthetic infection. However, there is currently no widely accepted recommendation for the use of topical antiseptics within the operative setting for primary implantation...
June 14, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29901604/skin-avulsion-injuries-caused-by-the-application-of-adhesive-drapes-during-total-knee-arthroplasty-a-case-report
#11
Bin Yang, Chuanzhi Xiong, Zhihua Lu, Jingcheng Wang
RATIONALE: The use of adhesive drapes has decreased the incidence of surgical-site infections. PATIENT CONCERNS: Despite the obvious benefits of the proper use of drapes, there remain many potential risks. DIAGNOSE: A 66-year-old man with a history of left knee osteoarthritis and varus deformity underwent total knee arthroplasty at our hospital, upon removal of the adhesive drape by delicate peeling and warm saline lavage, a large area of the skin avulsion happened...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29896561/short-term-safety-and-effectiveness-of-a-second-generation-motion-guided-total-knee-system
#12
Adam I Harris, Tianyi David Luo, Jason E Lang, Branko Kopjar
Background: Modern knee prostheses are designed to more closely replicate normal knee kinematics. The JOURNEY II Bi-Cruciate Stabilized Total Knee System (Smith & Nephew Inc., Memphis, TN) is a second-generation motion-guided knee system that demonstrates axial rotation patterns during flexion, which resemble those of the normal knee. The aim of this study was to assess the short-term safety and effectiveness of this system in standard clinical practice. Methods: A total of 186 subjects (209 primary total knee arthroplasties [TKAs]) were enrolled at 12 U...
June 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29896556/are-patients-being-evaluated-for-periprosthetic-joint-infection-prior-to-referral-to-a-tertiary-care-center
#13
Matthew W Tetreault, Kenneth A Estrera, Erdan Kayupov, Caroline Brander, Craig J Della Valle
Background: Patients with a painful or failed total joint arthroplasties should be evaluated for periprosthetic joint infection (PJI). The purpose of this study is to determine if patients referred to a tertiary care center had been evaluated for PJI according to the American Academy of Orthopaedic Surgeons (AAOS) clinical practice guidelines. Methods: One hundred thirteen patients with painful hip (43) or knee (70) arthroplasties were referred to a single provider by orthopaedic surgeons outside our practice between 2012 and 2014...
June 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29896551/external-fixator-immobilization-after-extensor-mechanism-reconstruction-in-total-knee-arthroplasty
#14
Colin D Canham, Christopher Walsh, Stephen J Incavo
Extensor mechanism disruption after total knee arthroplasty is a complicated problem that typically requires surgical reconstruction. After extensor mechanism failure, reconstruction is typically indicated to restore active knee extension and provide a stable limb for ambulation. Immobilization of the knee in extension is vital in the initial postoperative period after extensor mechanism reconstruction. We describe a series of 4 patients who underwent extensor mechanism reconstruction followed by external fixator application to maintain the knee extended in the initial postoperative period...
June 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29896545/lyme-periprosthetic-joint-infection-in-total-knee-arthroplasty
#15
Murillo Adrados, Daniel Howard Wiznia, Marjorie Golden, Richard Pelker
Lyme arthritis, caused by the spirochete Borrelia burgdorferi sensu stricto, is a common tick-borne illness in New England and the upper Midwest. Most often, the disease affects the knee and has typically been reported as a cause of native joint infection. There has been only 1 case of Lyme periprosthetic joint infection (associated with a total knee arthroplasty) reported in the literature, and to our knowledge, no other reported cases of Lyme periprosthetic joint infections exist. In this article, we report on 2 patients diagnosed with prosthetic joint infections who were subsequently found to have Lyme prosthetic joint infections, with B burgdorferi as the infectious organism...
June 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29896461/sequential-bilateral-rapid-destructive-inflammatory-coxarthrosis-in-a-patient-with-human-immunodeficiency-virus
#16
Hyeon Jun Kim, Sung Soo Kim, Su Jin Kim, Kyung Ho Lee
The diagnostic criteria for sequential rapidly destructive coxarthrosis remain unclear and this condition is rarely reported in patients with human immunodeficiency virus (HIV). Here, we report a case of an HIV-infected 73-year old female who experienced hip joint destruction. The patient was diagnosed with HIV in 2012 (at age 68 years) and began continuous treatment with nucleoside reverse transcriptase and protease inhibitors. Twenty-nine months after her HIV diagnosis, the patient experienced osteonecrosis of the right hip and underwent a total hip arthroplasty (THA)...
June 2018: Hip & Pelvis
https://www.readbyqxmd.com/read/29896460/an-uncommon-case-of-bilateral-pathologic-hip-fractures-antiviral-drug-induced-osteomalacia-in-a-patient-with-hepatitis-b
#17
Nam Hoon Moon, Won Chul Shin, Min Uk Do, Hyung Joon Cho, Kuen Tak Suh
The long-term use of adefovir and tenofovir-antiviral medications commonly used to treat chronic hepatitis B-can be associated with proximal renal tubular dysfunction resulting in significant hypophosphatemic osteomalacia. However, there have been few reports about pathological fractures requiring surgical stabilization in cases of antiviral drug-induced hypophosphatemic osteomalacia. We present the case of a 51-year-old man who sustained bilateral pathological hip fractures associated with antiviral drug-induced hypophosphatemic osteomalacia...
June 2018: Hip & Pelvis
https://www.readbyqxmd.com/read/29893777/particulate-wear-debris-osteolysis-acute-urinary-retention-and-delirium-as-late-complications-of-hip-arthroplasty
#18
Carmen Benitez, Javier Pérez-Jara, Luis Garcia-Paino, Teresa Montenegro, Encarnacion Martin, Arturo Vilches-Moraga
Intrapelvic mass formation as a result of particulate wear debris induced osteolysis is a recognised late complication of cementless total hip arthroplasty. Clinical presentation typically involves hip and/or leg pain resulting in functional impairment, and obstructive urinary symptoms developing 3-20 years after surgery. An acute confusional state has never been described in this scenario. We report the case of an 86-year-old gentleman with a diagnosis of dementia brought to our emergency department with an acute confusional state...
June 8, 2018: Age and Ageing
https://www.readbyqxmd.com/read/29891399/treatment-of-periprosthetic-knee-infection-with-concurrent-rotational-muscle-flap-coverage-is-associated-with-high-failure-rates
#19
Shay I Warren, Taylor S Murtaugh, Akshay Lakra, Luke A Reda, Roshan P Shah, Jeffrey A Geller, H John Cooper
BACKGROUND: Soft-tissue deficiency is a potentially devastating complication of the infected total knee arthroplasty (TKA). Rotational muscle flaps are commonly used to address these defects. However, reported success rates vary widely. METHODS: We reviewed 26 consecutive patients who underwent rotational muscle flap surgery for full-thickness anterior soft-tissue defect during treatment of an infected TKA. Twenty-four cases used a medial gastrocnemius rotational flap, 1 used a lateral gastrocnemius flap, and 1 used a rectus femoris-vastus intermedius flap...
May 23, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29890859/narcotic-use-and-total-hip-arthroplasty
#20
Surajudeen Bolarinwa, Aaron A Casp, Jourdan M Cancienne, Brian C Werner, James A Browne
BACKGROUND: The purpose of this study is to: (1) characterise risk factors for prolonged narcotic use following total hip arthroplasty (THA); (2) examine preoperative and prolonged postoperative narcotic use as independent risk factors for complications following THA. METHODS: A national database identified primary THA patients from 2007-2015. Preoperative (POU) and prolonged postoperative narcotics users (PPU) were identified. A multivariable logistic regression analysis was utilised to identify any patient-related risk factors for prolonged use, and examined POU and PPU as risk factors for complications following THA...
June 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
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