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https://www.readbyqxmd.com/read/28819592/insufficiency-fractures-of-the-distal-tibia-and-fibula-following-total-hip-arthroplasty-a-case-report
#1
Ryu Kojima, Toshiki Miura, Eisei Fukatani
INTRODUCTION: Although periprosthetic fractures of the femur have been well documented, insufficiency fractures following total hip arthroplasty (THA) have been rarely described. We report a case of an insufficiency fracture in the distal tibia and fibula that occurred after THA. CASE REPORT: A 54-year-old woman presented with severe pain in the bilateral hip joints and was diagnosed with end-stage osteoarthritis. She underwent THA on the right side. Although the postoperative course was uneventful, she suddenly experienced severe pain and swelling in the right leg without any history of trauma 22 weeks after the surgery...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28818359/environment-of-care-is-it-time-to-reassess-microbial-contamination-of-the-operating-room-air-as-a-risk-factor-for-surgical-site-infection-in-total-joint-arthroplasty
#2
REVIEW
Javad Parvizi, Sue Barnes, Noam Shohat, Charles E Edmiston
In the modern operating room (OR), traditional surgical mask, frequent air exchanges, and architectural barriers are viewed as effective in reducing airborne microbial populations. Intraoperative sampling of airborne particulates is rarely performed in the OR because of technical difficulties associated with sampling methodologies and a common belief that airborne contamination is infrequently associated with surgical site infections (SSIs). Recent studies suggest that viable airborne particulates are readily disseminated throughout the OR, placing patients at risk for postoperative SSI...
August 14, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28813499/staphylococcus-aureus-biofilm-elicits-the-expansion-activation-and-polarization-of-myeloid-derived-suppressor-cells-in-vivo-and-in-vitro
#3
Kuo-Ti Peng, Ching-Chuan Hsieh, Tsung-Yu Huang, Pei-Chun Chen, Hsin-Nung Shih, Mel S Lee, Pey-Jium Chang
Staphylococcus aureus (S. aureus) is one of the most common causes of biofilm infections in periprosthetic joint infections (PJIs). Accumulating evidence has shown that the immunosuppressive environment established by S. aureus biofilm infection in PJIs involves the presence of myeloid-derived suppressor cells (MDSCs) and M2-macrophages. Due to the diversity of MDSCs, little is known about whether S. aureus biofilm preferentially expands specific MDSC subsets or whether MDSCs can further differentiate into M2-macrophages during S...
2017: PloS One
https://www.readbyqxmd.com/read/28811108/methylene-blue-guided-debridement-as-an-intraoperative-adjunct-for-the-surgical-treatment-of-periprosthetic-joint-infection
#4
Jeremy D Shaw, Steve Miller, Anna Plourde, Daniel L Shaw, Rosanna Wustrack, Erik N Hansen
BACKGROUND: Current methods to identify infected tissue in periprosthetic joint infection (PJI) are inadequate. The purpose of this study was (1) to assess methylene blue-guided surgical debridement as a novel technique in PJI using quantitative microbiology and (2) to evaluate clinical success based on eradication of infection and infection-free survival. METHODS: Sixteen total knee arthroplasty patients meeting Musculoskeletal Infection Society criteria for PJI undergoing the first stage of 2-stage exchange arthroplasty were included in this prospective study...
July 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28808626/acetabular-revisions-using-porous-tantalum-components-a-retrospective-study-with-5-10-years-follow-up
#5
Francesco Roberto Evola, Luciano Costarella, Giuseppe Evola, Martina Barchitta, Antonella Agodi, Giuseppe Sessa
AIM: To evaluate the clinical and X-ray results of acetabular components and tantalum augments in prosthetic hip revisions. METHODS: Fifty-eight hip prostheses with primary failure of the acetabular component were reviewed with tantalum implants. The clinical records and X-rays of these cases were retrospectively reviewed. Bone defect evaluations were based on preoperative CT scans and classified according to Paprosky criteria of Radiolucent lines and periprosthetic gaps; implant mobilization and osteolysis were evaluated by X-ray...
July 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28808616/periprosthetic-hip-joint-infection-with-aspergillus-terreus-a-clinical-case-and-a-review-of-the-literature
#6
Rachel Bartash, Yi Guo, John B Pope, Michael H Levi, Wendy Szymczak, Nidhi Saraiya, Priya Nori
Fungal periprosthetic joint infections due to Aspergillus species are rare but are associated with significant cost and morbidity. We present a case of Asperigillus terreus prosthetic joint infection of the hip. The patient was successfully treated with a prolonged course of systemic antifungals along with surgical management.
December 2017: Medical Mycology Case Reports
https://www.readbyqxmd.com/read/28800858/diagnostic-value-of-synovial-white-blood-cell-count-and-serum-c-reactive-protein-for-acute-periprosthetic-joint-infection-after-knee-arthroplasty
#7
Sang-Gyun Kim, Jae-Gyoon Kim, Ki-Mo Jang, Seung-Bum Han, Hong-Chul Lim, Ji-Hoon Bae
BACKGROUND: The diagnosis of periprosthetic joint infection (PJI) remains difficult, particularly in acute postoperative stage. The purpose of this study was to investigate the optimal cutoff value of synovial white blood cell (WBC) count, percentage of polymorphonuclear cells, erythrocyte sedimentation rate, and C-reactive protein (CRP) for diagnosing early postoperative infection after knee joint arthroplasty. METHODS: We retrospectively reviewed primary total knee arthroplasties and unicompartmental knee arthroplasties, with a knee aspiration within 3 weeks of surgery, from January 2006 to November 2016...
July 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28797879/using-a-non-invasive-secure-skin-closure-following-total-knee-arthroplasty-leads-to-fewer-wound-complications-and-no-patient-home-care-visits-compared-to-surgical-staples
#8
Alberto V Carli, Sara Spiro, Brian T Barlow, Steven B Haas
BACKGROUND: Superficial wound complications occur in up to 10% of total knee arthroplasty (TKA) procedures and have been associated with periprosthetic joint infection. The ideal material for TKA closure should offer: 1) fast intraoperative application, 2) minimal wound complications and 3) removable by patients without assistance. We evaluated a novel, non-invasive, removable skin closure system for TKA to determine its effect on wound complications. METHODS: We prospectively evaluated 221 consecutive TKA patients who received skin closure using a non-invasive zipper-like system ('Zip'; Zip 16 Surgical Skin Closure System; Zipline Medical)...
August 7, 2017: Knee
https://www.readbyqxmd.com/read/28797875/success-rates-characteristics-and-costs-of-articulating-antibiotic-spacers-for-total-knee-periprosthetic-joint-infection
#9
Scott R Nodzo, Keely K Boyle, Sara Spiro, Allina A Nocon, Andy O Miller, Geoffrey H Westrich
BACKGROUND: The optimal type, characteristics, and success rates of articulating antibiotic spacers used during total knee arthroplasty (TKA) periprosthetic joint infection (PJI) have not been well defined in a single series. We sought to (1) determine the success rate for three unique spacer constructs and (2) evaluate any microbiological, surgical, or patient characteristics that would influence the success rate. METHODS: We retrospectively reviewed patients who underwent a two-stage exchange for a TKA PJI with a prefabricated spacer (PREFAB), home-made mold (MOLD), or autoclaved femoral component (AUTOCL)...
August 8, 2017: Knee
https://www.readbyqxmd.com/read/28795083/mechanical-instability-and-titanium-particles-induce-similar-transcriptomic-changes-in-a-rat-model-for-periprosthetic-osteolysis-and-aseptic-loosening
#10
Mehdi Amirhosseini, Göran Andersson, Per Aspenberg, Anna Fahlgren
Wear debris particles released from prosthetic bearing surfaces and mechanical instability of implants are two main causes of periprosthetic osteolysis. While particle-induced loosening has been studied extensively, mechanisms through which mechanical factors lead to implant loosening have been less investigated. This study compares the transcriptional profiles associated with osteolysis in a rat model for aseptic loosening, induced by either mechanical instability or titanium particles. Rats were exposed to mechanical instability or titanium particles...
December 2017: Bone Reports
https://www.readbyqxmd.com/read/28791884/added-value-of-18f-fdg-pet-ct-in-diagnosing-infected-hip-prosthesis
#11
Robert M Kwee, Wouter Am Broos, Boudewijn Brans, Geert Him Walenkamp, Jan Geurts, René E Weijers
Background The diagnosis of infected hip prosthesis is frequently not straightforward yet very important as it changes treatment. Purpose To retrospectively investigate the added value of 18F-FDG PET/CT to conventional tests including radiography, erythrocyte sedimentation rate (ESR)/C-reactive protein (CRP) testing, and joint aspiration, in diagnosing infected hip prosthesis. Material and Methods Seventy-eight hip prostheses of 78 patients (55% men; mean age = 66.5 years; age range = 30-85 years) with non-specific clinical presentation, i...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28790473/longitudinal-followup-of-incidentally-detected-pseudotumors-in-patients-with-metal-on-metal-implants-a-retrospective-study
#12
Khushboo Pilania, Bhavin Jankharia
BACKGROUND: This study describes the significance and temporal evolution of incidentally detected, presumed, metal-induced reactive periprosthetic masses in patients with metal on metal (MoM) hip arthroplasty and its management. The literature concerning the temporal evolution of these lesions is meagre and so it is still unclear, whether asymptomatic patients with periprosthetic collections should undergo revision. MATERIALS AND METHODS: Patients with MoM hip replacements fitted with a recalled implant (ASR, DuPuy) often undergo magnetic resonance imaging with metal artifact reduction sequences to look for complications...
July 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28790468/management-of-the-infected-total-hip-arthroplasty
#13
D'jon Lopez, Isabel Leach, Elinor Moore, Alan R Norrish
In the United Kingdom approximately 80,000 total hip arthroplasties are undertaken on an average each year. The popularity and demand for this operation are continually increasing. Our understanding of arthroplasty surgery and its complications has evolved greatly, and as a result infection rates are undeniably at an all-time low. The increasing volume of operations being performed does, however, mean that we still continue to see an increased number of cases of infection. There is no doubt that periprosthetic joint infection (PJI) poses a complex clinical and diagnostic predicament to clinicians...
July 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28782280/orthopaedic-wear-particle-induced-bone-loss-and-exogenous-macrophage-infiltration-is-mitigated-by-local-infusion-of-nf-%C3%AE%C2%BAb-decoy-oligodeoxynucleotide
#14
Tzuhua Lin, Jukka Pajarinen, Akira Nabeshima, Luis A Córdova, Florence Loi, Emmanuel Gibon, Laura Lu, Karthik Nathan, Eemeli Jämsen, Zhenyu Yao, Stuart B Goodman
Excessive production of wear particles from total joint replacements (TJRs) induces chronic inflammation, macrophage infiltration, and consequent bone loss (periprosthetic osteolysis). This inflammation and bone remodeling are critically regulated by the transcription factor NF-κB. We previously demonstrated that inhibition of NF-κB signaling by using the decoy oligodeoxynucleotide (ODN) mitigates polyethylene wear particle-induced bone loss using in vitro and in vivo models. However, the mechanisms of NF-κB decoy ODN action, and in particular its impact on systemic macrophage recruitment, remain unknown...
August 7, 2017: Journal of Biomedical Materials Research. Part A
https://www.readbyqxmd.com/read/28781018/high-early-major-complication-rate-after-revision-for-mechanically-assisted-crevice-corrosion-in-metal-on-polyethylene-total-hip-arthroplasty
#15
Brian J McGrory, Anna H Jorgensen
BACKGROUND: Failed total hip arthroplasty caused by mechanically assisted crevice corrosion (MACC) has serious consequences such as adverse local tissue reaction. Revision is currently indicated for significant hip pain, stiffness, and dysfunction; hip instability; progressive bone loss; and soft tissue destruction. Outcomes of this revision surgery are not yet completely understood. METHODS: We examined the surgical outcomes at a minimum of 6 months (average, 25; range, 7-68 months) in a cohort of 27 consecutive patients who underwent revision total hip arthroplasty for MACC associated with a single implant vendor and taper type...
July 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28773099/the-impact-of-metal-ion-exposure-on-the-cellular-behavior-of-human-osteoblasts-and-pbmcs-in-vitro-analyses-of-osteolytic-processes
#16
Anika Jonitz-Heincke, Jenny Tillmann, Annett Klinder, Simone Krueger, Jan Philippe Kretzer, Paul Johan Høl, Alexander C Paulus, Rainer Bader
Osteolysis in the periprosthetic tissue can be caused by metallic wear particles and ions that can originate from implant surface corrosion. These products influence cellular behavior and stimulate the expression of proinflammatory cytokines. The purpose of this study was to evaluate the impact of CoCr29Mo6 ions on cell survival, differentiation, and cytokine expression in human osteoblasts and peripheral blood mononuclear cells (PBMCs). Thus, we exposed cells with a mixture of 200 µg/L ion solution and determined cell viability and apoptosis/necrosis...
July 3, 2017: Materials
https://www.readbyqxmd.com/read/28768571/a-double-plating-approach-to-distal-femur-fracture-a-clinical-study
#17
Ely L Steinberg, Jacov Elis, Yohai Steinberg, Moshe Salai, Tomer Ben-Tov
BACKGROUND: Locked plating is one of the latest innovative options for treating supracondylar femur fractures with relatively low failure rates. Single lateral plating was often found to have a relative higher failure rate. No clinical studies of double-plating distal femur fixation have thus far been reported. The aim of this study is to present our clinical experience with this surgical approach. PATIENTS AND METHODS: Thirty-two patients (26 females and 6 males, mean age 76 years, range 44-101) were included in the study...
July 25, 2017: Injury
https://www.readbyqxmd.com/read/28763892/-efficacy-and-safety-of-drainage-after-total-knee-arthroplasty
#18
F Jing, H M Li, X D Yang, B Li, J Ji, Y L Li, C J Sun
Objective: To determine whether suction drainage is safe and effective compared with no-drainage in total knee arthroplasty. Methods: The literature search was based on PubMed, MEDLINE, EMBASE, Highwire, the Cochrane Library, CBM, CNKI, VIP and WFSD.The data were analysed using RevMan 5.3.Fourteen randomised controlled trials involving 1 009 knees were included in our analysis. Results: Suction drainage increases the rate and volume of blood transfusion.No-drainage group increases the rate of wound problems (OR=1...
July 18, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28760844/inhibitory-effect-ofquercetinon-titaniumparticle-inducedendoplasmic-reticulum-stress-ers-related-apoptosisandin-vivoosteolysis
#19
Laibo Zhang, Zhoubin Tian, Wei Li, Xianquan Wang, Zhentao Man, Shui Sun
Wear particle-induced periprosthetic osteolysis is the main cause of aseptic loosening of orthopaedic implants. The aim of this study is to determine the protective effect of quercetin (QUE) against titanium (Ti) particle-induced ERS-related apoptosis and osteolysis. In this study, RAW264.7 cells were pretreated with different concentrations (40, 80, and 160 μmol/l) of QUE for 30 min and then treated with Ti particle (5 mg/ml) for 24 h. Cell viability and apoptosis were determined using MTT assay and Annexin V-FITC apoptosis detection kit, respectively...
July 31, 2017: Bioscience Reports
https://www.readbyqxmd.com/read/28760710/the-impact-of-preoperative-bacteriuria-on-the-risk-of-periprosthetic-joint-infection-after-primary-knee-or-hip-replacement-a-retrospective-study-with-a-one-year-follow-up
#20
Meeri Honkanen, Esa Jämsen, Matti Karppelin, Reetta Huttunen, Heini Huhtala, Antti Eskelinen, Jaana Syrjänen
OBJECTIVES: Patients who undergo elective joint replacement are traditionally screened and treated for preoperative bacteriuria in order to prevent periprosthetic joint infection (PJI). More recently, this practice has been questioned. The purpose of this study was to determine whether preoperative bacteriuria is associated with an increased risk of PJI. METHODS: Patients who had undergone a primary hip or knee replacement in a tertiary care hospital between September 2002 and December 2013 were identified from the hospital database (23 171 joint replacements, 10 200 hips, and 12 971 knees)...
July 28, 2017: Clinical Microbiology and Infection
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