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https://www.readbyqxmd.com/read/28545174/causes-and-clinical-outcomes-of-revision-total-knee-arthroplasty
#1
Dong-Hyun Lee, Seung-Hun Lee, Eun-Kyoo Song, Jong-Keun Seon, Hong-An Lim, Hong-Yeol Yang
Purpose: The purpose of this study was to evaluate causes and clinical outcomes of revision total knee arthroplasty (TKA) with a minimum 2-year follow-up. Materials and Methods: We performed a retrospective review on the records of 225 revision TKAs performed from 2003 to 2012 at a single institution. Finally, 206 cases were conducted. To evaluate clinical outcomes, we checked the range of motion (ROM), Knee Society (KS) score, Hospital for Special Surgery (HSS) score, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score preoperatively, 6 months postoperatively and yearly thereafter and complications after revision TKA...
June 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28543707/viable-bacteria-persist-on-antibiotic-spacers-following-two-stage-revision-for-periprosthetic-joint-infection
#2
Dongzhu Ma, Robert M Q Shanks, Charles M Davis, David W Craft, Thomas K Wood, Brian R Hamlin, Kenneth L Urish
Treatment in periprosthetic joint infection (PJI) remains challenging. The failure rate of two-stage revision and irrigation and debridement with component retention in PJI suggests that biofilm cells have a high tolerance to antibiotic chemotherapy. Previous work has demonstrated that biofilm cells have high antibiotic tolerance in vitro, but there is little clinical evidence to support these observations. The aim of this study was to determine if retrieved antibiotic spacers from two-stage revision total knee arthroplasty for PJI have evidence of remaining viable bacteria...
May 19, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28543702/microencapsulation-of-rifampicin-a-technique-to-preserve-the-mechanical-properties-of-bone-cement
#3
P Sanz-Ruiz, E Carbó-Laso, J C Del Real-Romero, F Arán-Ais, Y Ballesteros-Iglesias, E Paz-Jiménez, M Sánchez-Navarro, M A Pérez-Limiñana, J Vaquero-Martín
Two-stage exchange with antibiotic-loaded bone cement spacers remains the gold standard for chronic periprosthetic joint infection(PJI). Rifampicin is highly efficient on stationary-phase staphylococci in biofilm; however, its addition to PMMA to manufacture spacers prevents polymerization and reduces mechanical properties. Isolation of rifampicin during polymerization by microencapsulation could allow manufacturing rifampicin-loaded bone cement maintaining elution and mechanical properties. Microcapsules of rifampicin with alginate, polyhydroxybutyratehydroxyvalerate (PHBV), ethylcellulose and stearic acid (SA) were synthesized...
May 23, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28540150/brucella-melitensis-prosthetic-joint-infection
#4
Domenica Flury, Henrik Behrend, Parham Sendi, Matthias von Kietzell, Carol Strahm
Periprosthetic joint infection (PJI) due to Brucella spp. is rare. We report a case in a 75-year-old man and review 29 additional cases identified in a literature search. The diagnosis of Brucella PJI is challenging, in particular in non-endemic countries. Serological tests prior to joint aspiration or surgical intervention are reasonable. Involvement of infection control and timely information to laboratory personnel is mandatory upon diagnosis. There is no uniform treatment concept, neither with respect to surgical intervention nor for the duration of antimicrobials...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28540146/-combined-diagnostic-tool-application-to-a-retrospective-series-of-patients-undergoing-total-joint-revision-surgery
#5
Enrico Gallazzi, Lorenzo Drago, Andrea Baldini, Ian Stockley, David A George, Sara Scarponi, Carlo L Romanò
Background: Differentiating between septic and aseptic joint prosthesis may be challenging, since no single test is able to confirm or rule out infection. The choice and interpretation of the panel of tests performed in any case often relies on empirical evaluation and poorly validated scores. The "Combined Diagnostic Tool (CDT)" App, a smartphone application for iOS, was developed to allow to automatically calculate the probability of having a of periprosthetic joint infection, on the basis of the relative sensitivity and specificity of the positive and negative diagnostic tests performed in any given patient...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28537800/advanced-mri-techniques-for-the-hip-joint-focus-on-the-postoperative-hip
#6
Jennifer L Berkowitz, Hollis G Potter
OBJECTIVE: Imaging the hip joint with optimized MRI protocol parameters provides the radiologist with the ability to reliably diagnose complex hip abnormalities. The institution of appropriate metal artifact reduction techniques and dedicated sequences can enhance visualization of the periprosthetic bone and soft tissues and allow improved detection of the more frequently encountered total hip arthroplasty-related conditions, such as mechanical loosening, polyethylene wear, and adverse local tissue reactions...
May 24, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28534287/loading-with-vancomycin-does-not-decrease-gentamicin-elution-in-gentamicin-premixed-bone-cement
#7
Sebastian P Boelch, Martin C Jordan, Joerg Arnholdt, Maximilian Rudert, Martin Luedemann, Andre F Steinert
Antibiotic loaded bone cements are used as drug delivery systems for the treatment of periprosthetic joint infections. They can be loaded with antibiotics during industrial component production (premixing) and during cement preparation (manually blending). Although double premixed antibiotic loaded bone cements are available, manually blending of a gentamicin premixed antibiotic loaded bone cement with vancomycin is still popular. We compared in vitro antibiotic elution and compressive strength of 0.5 g gentamicin premixed bone cement (PALACOS® R + G), 0...
July 2017: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/28532409/variation-in-prosthetic-joint-infection-and-treatment-strategies-during-4-5%C3%A2-years-of-follow-up-after-primary-joint-arthroplasty-using-administrative-data-of-41397-patients-across-australian-european-and-united-states-hospitals
#8
Perla J Marang-van de Mheen, Ellie Bragan Turner, Susan Liew, Nora Mutalima, Ton Tran, Sten Rasmussen, Rob G H H Nelissen, Andrew Gordon
BACKGROUND: To identify best practices and quality improvement initiatives, we aimed to assess whether the incidence of Periprosthetic Joint Infection (PJI) and treatment strategies differed across patients treated in Australian, European and United States (US) hospitals. METHODS: Routinely collected administrative data for 41397 patients undergoing a primary total hip or knee arthroplasty between July 2007-December 2010 across 22 hospitals were included. Patients were followed for 2 years looking for PJI occurrence, defined as early (within 4 weeks) and late PJI, and surgical treatment during 2...
May 22, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28532408/bone-turnover-and-periprosthetic-bone-loss-after-cementless-total-hip-arthroplasty-can-be-restored-by-zoledronic-acid-a-prospective-randomized-open-label-controlled-trial
#9
Tsan-Wen Huang, Chao-Jan Wang, Hsin-Nung Shih, Yuhan Chang, Kuo-Chin Huang, Kuo-Ti Peng, Mel S Lee
BACKGROUND: Although the loss of bone mineral density (BMD) after total hip arthroplasty (THA) is a known problem, it remains unresolved. This study prospectively examined the effect of zoledronic acid (ZA) on bone turnover and BMD after cementless THA. METHODS: Between January 2010 and August 2011, 60 patients who underwent cementless THA were randomly assigned to receive either ZA infusion or placebo (0.9% normal saline only) postoperatively. ZA was administered at 2 day and 1 year postoperatively...
May 22, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28529862/therapeutic-use-of-antibiotic-loaded-bone-cement-in-the-treatment-of-hip-and-knee-joint-infections
#10
REVIEW
Konstantinos Anagnostakos
The use of antibiotic-loaded cement spacers is an established method in the management of periprosthetic hip and knee joint infections. Despite inconsistencies among published studies, data shows that infection control rates exceed 90% with two-stage exchange arthroplasty. The present work reviews the current literature about antibiotic-loaded cement spacers and concentrates on the indications for spacer implantation, spacer production details, antibiotic impregnation, pharmacokinetic properties, clinical success, mechanical complications, and systemic safety...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529859/treatment-of-periprosthetic-joint-infection-using-antimicrobials-dilute-povidone-iodine-lavage
#11
REVIEW
John A Ruder, Bryan D Springer
Periprosthetic joint infections (PJI) remain a challenge for the orthopaedic surgeon to treat and remain a leading cause of failure of both primary and revision total joint arthroplasty. Once a PJI develops, surgical treatment is generally indicated and includes an aggressive irrigation and debridement. One component of the irrigation and debridement involves the use of an antiseptic irrigating solution. In primary and revision TJA, dilute povidone-iodine lavage can be performed prior to wound closure. Approximately 17...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529108/a-3-to-18-year-follow-up-of-revision-total-hip-arthroplasty-with-impacted-bone-allografts-and-cemented-lubinus-sp-ii-stem-clinical-radiographic-and-survivorship-analysis-with-comparison-to-the-literature
#12
Hampus Stigbrand, Gösta Ullmark
BACKGROUND: We present the first medium- to long-term follow-up of revision total hip arthroplasty using impaction bone grafting (IBG) combined with the matte and collared Lubinus SP II stem for cases of severe osteolysis and stem loosening. METHODS: Sixty-nine femoral revisions were identified for 67 patients consecutively operated with revision femoral arthroplasty using IBG and a cemented Lubinus SP II stem. The mean age was 69 years (standard deviation, 9.9)...
April 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28526923/focal-articular-prosthetic-resurfacing-for-the-treatment-of-full-thickness-articular-cartilage-defects-in-the-knee-12-year-follow-up-of-two-cases-and-review-of-the-literature
#13
C Becher, E B Cantiller
INTRODUCTION: The rationale of focal articular prosthetic resurfacing used as a primary arthroplasty procedure in the treatment of articular cartilage defects is still under debate. Conflicting reports raise concern about high rates of re-operations and continued development of osteoarthritis, while others have reported good outcomes. The goal of this paper is to present the long-term results of two patients with a 12-year follow-up and to report the results of a literature review. MATERIALS AND METHODS: Two patients (male, 70 years; female 63 years) with a follow-up of 12 years were reviewed...
May 19, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28526202/capnocytophaga-canimorsus-an-underestimated-cause-of-periprosthetic-joint-infection
#14
Marcel Orth, Patrick Orth, Konstantinos Anagnostakos
BACKGROUND: Periprosthetic joint infection (PJI) is a major clinical problem in orthopedic surgery. Capnocytophaga canimorsus (C. canimorsus) is an unusual and hardly detectable bacterium. A review of the literature indicates that C. canimorsus affects mainly immunocompromised patients. It has not been reported to cause periprosthetic joint infections in immunocompetent patients so far. This case report aims to raise awareness of C. canimorsus in orthopedic surgery with special regard to joint arthroplasty...
May 16, 2017: Knee
https://www.readbyqxmd.com/read/28526166/transhumeral-anterior-radial-nerve-transposition-to-simplify-anticipated-future-humeral-reconstruction
#15
REVIEW
David A Muzykewicz, Reid A Abrams
Anterior transhumeral radial nerve transposition has been described in the treatment of humeral shaft fracture to protect the nerve from implant irritation or callus entrapment. Transposing the radial nerve through a facilitating humeral defect also simplifies revision surgery should nonunion result. Here we describe a surgical technique for anterior transhumeral radial nerve transposition for complex humeral reconstruction when subsequent revision surgery is anticipated. Three cases are used for illustration: (1) revision of a total elbow arthroplasty with periprosthetic fracture; (2) revision of a total elbow arthroplasty after aseptic loosening from an allograft/prosthesis composite; and (3) septic humeral nonunion with substantial bone loss...
May 16, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28526023/high-incidence-of-periprosthetic-joint-infection-with-propionibacterium-acnes-after-the-use-of-a-stemless-shoulder-prosthesis-with-metaphyseal-screw-fixation-a-retrospective-cohort-study-of-241-patients-propionibacter-infections-after-eclipse-tsa
#16
Lisa Johansson, Nils P Hailer, Hans Rahme
BACKGROUND: A stemless shoulder prosthesis with humeral metaphyseal screw fixation was introduced in order to save bone-stock and to facilitate reconstruction of biomechanics (Eclipse®). The aim of this study was to analyze whether the risk of infection is different with this implant compared to conventional shoulder prosthesis. METHODS: Two hundred and forty-one patients (54.8% females) were operated with a shoulder arthroplasty and followed for median 2.0 (0...
May 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28525482/artificial-cervical-disk-replacement-for-the-treatment-of-adjacent-segment-disease-after-anterior-cervical-decompression-and-fusion
#17
Sheng Bin, Huang Xiangwang, Xiao Sheng, Xiang Tiecheng, Liu Xiangyang, Zhang Yi, Liu Bin
STUDY DESIGN: Retrospective study. OBJECTIVE: To evaluate the outcome of artificial cervical disk replacement (ACDR) for the treatment of adjacent segment disease (ASD) after anterior cervical decompression and fusion (ACDF). SUMMARY OF BACKGROUND DATA: ACDF is the useful procedure for degenerative cervical diseases. However, studies have reported accelerated degeneration of functional spinal units adjacent to the fusion site after ACDF. MATERIALS AND METHODS: Between January 2004 and January 2011, 32 inpatients (18 male, 14 female; age, 38-61 y; mean, 48 y) underwent ACDR for the treatment of ASD after previous ACDF (single-level: n=12; 2-level: n=15; 3-level: n=5)...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28524620/clinical-performance-and-survivorship-of-navigated-floating-platform-mobile-bearing-total-knee-arthroplasty-a-minimum-10-year-follow-up
#18
Sang-Min Kim, Jai-Gon Seo, Seung-Jae Lim, Hyung-Tae Lim, Chang-Ho Cho, Young-Wan Moon
BACKGROUND: The purpose of this study is to report the outcome of navigation-assisted cruciate-retaining total knee arthroplasty (TKA) using one type of cemented, second-generation, floating-platform (FP), mobile-bearing system. METHODS: Forty-two patients who underwent cruciate retaining TKAs using e.motion-FP prostheses under navigational guidance were retrospectively reviewed. The preoperative diagnosis was osteoarthritis in all knees except one rheumatoid arthritis...
May 19, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/28522245/pin-site-complications-associated-with-computer-assisted-navigation-in-hip-and-knee-arthroplasty
#19
Eli Kamara, Zachary P Berliner, Matthew S Hepinstall, H John Cooper
BACKGROUND: There has been a great increase in the use of navigation technology in joint arthroplasty. In most types of navigation-assisted surgery, several temporary navigation pins are placed in the patient. Goals of this study are (1) to identify complications and (2) risk factors associated with placement of these pins. METHODS: This is a retrospective cohort study of all navigation-assisted hip and knee arthroplasty performed a single institution over a 3-year period...
April 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28521381/-time-in-the-or-outcome-and-surgeons-experience-the-use-of-patient-matched-instruments-in-arthroplasty-of-the-knee
#20
Christoph Schulze, Cem Kai Inan, Claudia Hacke, Alexander Kaltenborn, André Gutcke
Background Arthrosis of the knee is a common problem in Germany that is often treated with arthroplasty. To support the orthopaedic surgeon, person-matched instruments (PMI) are available from several providers. In this study we investigated the clinical and radiological outcome of the use of the PMI Visionaire(™) (Smith&Nephew). Furthermore, we investigated the influence of operative experience of the orthopaedic surgeon on the clinical and radiological results. Time in the operating room (OR) was identified as a parameter for cost effectiveness even during training to become an orthopaedic surgeon...
May 18, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
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