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Infection knee arthroplasty

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https://www.readbyqxmd.com/read/29776853/outcomes-of-a-fixed-bearing-medial-cemented-unicondylar-knee-arthroplasty-design-survival-analysis-and-functional-score-of-460-cases
#1
Philip Winnock de Grave, Justine Barbier, Thomas Luyckx, Alexander Ryckaert, Paul Gunst, Luc Van den Daelen
BACKGROUND: Unicompartmental knee arthroplasty (UKA) is an alternative to total knee arthroplasty in isolated medial osteoarthritis (OA). However, despite satisfactory reports on the clinical performance, UKA revision rates are still concerning. This retrospective study reports on the long-term survivorship, functional outcomes, and reasons for revision in fixed-bearing UKA implant. METHODS: Between 2005 and 2013, 460 consecutive patients were treated with medial UKA in one center using a fixed-bearing UKA system...
April 24, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29776813/unicompartmental-knee-arthroplasty-for-spontaneous-osteonecrosis-of-the-medial-tibial-plateau
#2
Tomoyuki Kamenaga, Takafumi Hiranaka, Yuichi Hida, Takaaki Fujishiro, Koji Okamoto
BACKGROUND: There have been very few reports on isolated medial tibial plateau osteonecrosis, and the condition has not been clearly described. Unicompartmental knee arthroplasty (UKA) may be an appropriate treatment method for this condition. The aims of this study were to report our experience of using mobile-bearing knee implants for osteonecrosis of the medial tibial plateau and to discuss the etiology and treatment of this type of osteonecrosis. METHODS: This study included six consecutive patients with isolated medial tibial plateau osteonecrosis treated with an Oxford mobile-bearing knee implant...
May 16, 2018: Knee
https://www.readbyqxmd.com/read/29775976/-are-there-any-differences-in-quality-or-complication-rate-in-total-knee-arthroplasty-after-establishing-a-centre-for-endoprosthesis
#3
Muzaffer Düzgünoglu, Wolfgang Hönle, Alexander Scheller, Alexander Schuh
BACKGROUND: The aim of the study is to show whether there are any changes in quality or incidence of complications in total knee arthroplasty (TKA) after establishing a centre for endoprothesis (EPZ). MATERIAL AND METHODS: We conducted a retrospective study comparing 100 TKAs one year before establishing an EPZ (Group I) with 100 TKAs one year after establishing an EPZ (group II). Data were collected by analysing our electronic documentation system, and the report of the rehabilitation hospital...
May 18, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29772995/bilateral-spontaneous-quadriceps-tendon-ruptures-after-staged-bilateral-total-knee-arthroplasties-a-case-report
#4
Marine Coste, Jared M Newman, Neil V Shah, Ahmed M Eldib, Preston W Grieco, Aditya V Maheshwari
Quadriceps tendon ruptures are rare complications of total knee arthroplasty (TKA) and may be associated with preexisting tendon degeneration, vascular injuries during surgery, damage to the quadriceps tendon with over resection of the patella, or incomplete healing after a particular surgical approach. Moreover, postoperative causes include tissue necrosis due to component malalignment, trauma, and infection. Patient factors such as chronic systemic diseases, medications, increased body weight, and sedentary lifestyle could also be responsible...
2018: Journal of Long-term Effects of Medical Implants
https://www.readbyqxmd.com/read/29772993/shoulder-lesion-in-a-69-year-old-woman
#5
Andrew J Hayden, Srinivas Kolla, Adele L Boskey, Steven Burekhovich, Chuanyong Lu, Michael Stracher, Aditya V Maheshwari
Milwaukee Shoulder Syndrome (MSS) is a painful progressive arthropathy in which hydroxyapatite crystal deposition in synovial tissue induces lysosomal release of collagenase and neutral proteases. These enzymes are destructive to periarticular tissue, including the synovium, articular cartilage, rotator cuff muscles, and the intrasynovial cortical bone. MSS predominantly occurring in women (90%) over the age of 70 years of age with a clinical history marked by recurrent joint effusions and pain, which classically worsens at night...
2018: Journal of Long-term Effects of Medical Implants
https://www.readbyqxmd.com/read/29770589/short-term-follow-up-of-antibiotic-loaded-articulating-cement-spacers-in-two-stage-revision-of-infected-total-knee-arthroplasty-a-case-series
#6
Meng-Qiang Tian, Xian-Teng Yang, Xiao-Bin Tian, Yun-Bo Sun, Yuan-Hui Duan, Li Sun
OBJECTIVE: Infection of total knee arthroplasty (TKA) is a rare but devastating complication. Two-stage revision is an effective treatment for late infected TKA. This study aimed to assess the short-term results of two-stage revision using articulating antibiotic-loaded spacers. METHODS: Twenty-five patients (10 men and 15 women) were diagnosed with late infections after TKA and treated with two-stage revision from April 2006 to August 2010; 19 of these patients had TKA for osteoarthritis and 6 for rheumatoid arthritis...
May 17, 2018: Orthopaedic Surgery
https://www.readbyqxmd.com/read/29769140/local-infiltration-anesthesia-versus-epidural-analgesia-for-postoperative-pain-control-in-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#7
Chen Li, Ji Qu, Su Pan, Yang Qu
BACKGROUND: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy and safety of local infiltration anesthesia (LIA) versus epidural analgesia (EPA) for postoperative pain control in total knee arthroplasty (TKA). METHODS: In December 2017, a systematic computer-based search was conducted in Pubmed, EMBASE, Web of Science, and Cochrane Database of Systematic Reviews. RCTs of patients prepared for spine surgery that compared LIA versus EPA for postoperative pain control in TKA were retrieved...
May 16, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29763476/drug-induced-linear-iga-bullous-dermatosis-in-a-patient-with-a-vancomycin-impregnated-cement-spacer
#8
Kelsie Riemenschneider, Daren A Diiorio, John A Zic, Matthew R Livingood, Jo-David Fine, Jennifer G Powers, Jeffrey P Zwerner, Eric Tkaczyk
Linear IgA bullous dermatosis (LABD) is an autoimmune blistering rash caused by IgA autoantibodies against the epidermal basement membrane zone. It commonly is drug induced, often in association with systemic vancomycin. We report a case of a previously healthy 77-year-old man who developed a diffuse macular rash and hemorrhagic bullae on the left leg 10 days after placement of a vancomycin-impregnated cement spacer (VICS) during a revision knee arthroplasty and initiation of postoperative treatment with intravenous (IV) vancomycin...
April 2018: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/29752506/examination-of-intra-operative-core-temperature-in-joint-arthroplasty-a-single-institution-prospective-observational-study
#9
Jennifer R Matos, Julie R McSwain, Bethany J Wolf, J Wesley Doty, Sylvia H Wilson
PURPOSE: Peri-operative hypothermia is associated with increased blood loss, delayed wound healing, and surgical site infections. However, it is not known when or how rapidly hypothermia develops during arthroplasty. This study observed patients undergoing lower extremity arthroplasty to identify the times of greatest heat loss or gain. METHODS: This single-institution prospective observational study enrolled 120 patients undergoing elective knee or hip arthroplasty for peri-operative temporal temperature measurements at ten prespecified intervals...
May 11, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29744425/preliminary-focus-on-the-mechanical-and-antibacterial-activity-of-a-pmma-based-bone-cement-loaded-with-gold-nanoparticles
#10
T Russo, A Gloria, R De Santis, U D'Amora, G Balato, A Vollaro, O Oliviero, G Improta, M Triassi, L Ambrosio
In total knee arthroplasty (TKA) and total hip replacement (THR) the restoration of the normal joint function represents a fundamental feature. A prosthetic joint must be able to provide motions and to transmit functional loads. As reported in the literature, the stress distribution may be altered in bones after the implantation of a total joint prosthesis. Some scientific works have also correlated uncemented TKA to a progressive decrease of bone density below the tibial component. Antibiotic-loaded bone cements are commonly employed in conjunction with systemic antibiotics to treat infections...
September 2017: Bioactive Materials
https://www.readbyqxmd.com/read/29731320/the-largest-survivorship-and-clinical-outcomes-study-of-the-fixed-bearing-stryker-triathlon-partial-knee-replacement-a-multi-surgeon-single-centre-cohort-study-with-a-minimum-of-two-years-of-follow-up
#11
S W F Middleton, P J Schranz, V I Mandalia, A D Toms
BACKGROUND: The surgical management of isolated medial compartment degenerative disease of the knee causes debate. Unicompartmental arthroplasty options include fixed and mobile bearing implant designs with fixed bearing becoming increasingly popular. We present the largest cohort of a fixed bearing single radius design, Stryker Triathlon Partial Knee Replacement (PKR). METHODS: We prospectively collected demographic data and patient reported outcome measures (PROMs) on our cohort of PKR implants since its adoption in our unit, 2009 until March 2015...
May 3, 2018: Knee
https://www.readbyqxmd.com/read/29729819/one-year-after-proximal-or-distal-periprosthetic-fracture-of-the-femur-two-conditions-with-divergent-outcomes
#12
D Eschbach, B Buecking, H Kivioja, M Fischer, T Wiesmann, R Zettl, L Oberkircher, J Barthel, R Aigner, S Ruchholtz, C Bliemel
INTRODUCTION: Arthroplasty of the hip and knee is 1 of the 20 most frequent operations in Germany. Periprosthetic fracture is one of the most feared complications following primary or revision arthroplasty. Present publication aims to analyse differences between patients with periprosthetic fracture around total knee arthroplasty (PFTKA) and patients with periprosthetic fracture around total hip arthroplasty (PFTHA) concerning demographics, clinical course, complications and return to pre-fracture mobility...
April 24, 2018: Injury
https://www.readbyqxmd.com/read/29715553/development-and-validation-of-baseline-perioperative-and-at-discharge-predictive-models-for-postsurgical-prosthetic-joint-infection
#13
María Dolores Del Toro, Cecilia Peñas, Ana Conde Albarracín, Julián Palomino, Francisco Brun, Santiago Sánchez, Jesús Rodríguez-Baño
OBJECTIVES: To develop and validate baseline, perioperative and at-discharge risk-scoring systems for postsurgical prosthetic joint infection (PJI) in patients undergoing arthroplasty. PATIENTS AND METHODS: A multicentre, prospective cohort study of patients undergoing hip and knee arthroplasty was performed. Patients were randomly assigned (2:1) to a derivation cohort (DC) or a validation cohort (VC). Multivariable predictive models of PJI were constructed at baseline (preoperative period), perioperative (adding perioperative variables), and at-discharge (adding wound state at-discharge)...
April 28, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29715226/development-and-evaluation-of-a-preoperative-risk-calculator-for-periprosthetic-joint-infection-following-total-joint-arthroplasty
#14
Timothy L Tan, Mitchell G Maltenfort, Antonia F Chen, AliSina Shahi, Carlos A Higuera, Marcelo Siqueira, Javad Parvizi
BACKGROUND: Preoperative identification of patients at risk for periprosthetic joint infection (PJI) following total hip arthroplasty (THA) or total knee arthroplasty (TKA) is important for patient optimization and targeted prevention. The purpose of this study was to create a preoperative PJI risk calculator for assessing a patient's individual risk of developing (1) any PJI, (2) PJI caused by Staphylococcus aureus, and (3) PJI caused by antibiotic-resistant organisms. METHODS: A retrospective review was performed of 27,717 patients (12,086 TKAs and 31,167 THAs), including 1,035 with confirmed PJI, who were treated at a single institution from 2000 to 2014...
May 2, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29715222/alpha-defensin-lateral-flow-test-for-diagnosis-of-periprosthetic-joint-infection-not-a-screening-but-a-confirmatory-test
#15
Nora Renz, Katsiaryna Yermak, Carsten Perka, Andrej Trampuz
BACKGROUND: Determination of alpha defensin in synovial fluid has shown promising results for diagnosing periprosthetic joint infection (PJI). The purposes of our study were to assess the performance of alpha defensin lateral flow (ADLF) test for the diagnosis of acute and chronic PJI using 3 classification systems and to compare its performance with the synovial fluid leukocyte count. METHODS: Patients in whom aspiration of a prosthetic hip or knee joint was performed before revision arthroplasty were prospectively included...
May 2, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29709393/validity-of-administrative-data-in-identifying-complex-surgical-site-infections-from-a-population-based-cohort-after-primary-hip-and-knee-arthroplasty-in-alberta-canada
#16
Elissa Rennert-May, Braden Manns, Stephanie Smith, Shannon Puloski, Elizabeth Henderson, Flora Au, Kathryn Bush, John Conly
BACKGROUND: Surgical site infections (SSIs) are a substantial burden to healthcare systems in North America. Administrative data is one method though which these may be identified, but the accuracy of using such data is uncertain. METHODS: We followed a population-based cohort of patients who received primary hip/knee arthroplasty in Alberta, Canada, for whom a comprehensive Infection Prevention and Control (IPC) prospective surveillance methodology was used to track SSIs...
April 27, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29708568/preoperative-vitamin-d-deficiency-is-associated-with-higher-postoperative-complication-rates-in-total-knee-arthroplasty
#17
Vishal Hegde, Armin Arshi, Christopher Wang, Zorica Buser, Jeffrey C Wang, Andrew R Jensen, John S Adams, Erik N Zeegen, Nicholas M Bernthal
The purpose of this study was to determine the relative incidence of postoperative complications in 25-hydroxyvitamin D (25D)-deficient and -sufficient patients undergoing total knee arthroplasty (TKA). Patients who were either serum 25D deficient (25D <20 ng/mL) or 25D sufficient (25D ≥20 ng/mL) 90 days prior to primary TKA from 2007 to 2016 were identified using the Humana administrative claims registry. The incidence of postoperative medical and surgical complications was determined by querying for relevant International Classification of Diseases, Ninth Revision and Current Procedural Terminology codes...
April 27, 2018: Orthopedics
https://www.readbyqxmd.com/read/29706257/primary-total-knee-arthroplasty-in-patients-with-neuropathic-charcot-arthropathy-contemporary-results
#18
Meagan E Tibbo, Brian P Chalmers, Daniel J Berry, Mark W Pagnano, David G Lewallen, Matthew P Abdel
BACKGROUND: Total knee arthroplasty (TKA) for neuropathic (Charcot) arthropathy is technically challenging with higher complication rates than primary TKA for osteoarthritis. There is a paucity of data regarding outcomes of TKA in contemporary cohorts with modern implants, techniques, and indications. Our study aimed to determine the (1) survivorship of implants, (2) rates and types of complications, (3) clinical outcomes, and (4) radiographic outcomes in patients treated with primary TKA for Charcot arthropathy...
April 9, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29705681/midlevel-constraint-without-stem-extensions-in-primary-total-knee-arthroplasty-provides-stability-without-compromising-fixation
#19
David A Crawford, Jesua I Law, Adolph V Lombardi, Keith R Berend
BACKGROUND: Many total knee arthroplasty (TKA) systems allow for so-called midlevel constraint (MLC) articular bearings that can be used with primary implants. The purpose of this study is to report the early outcomes with MLC bearings in primary TKA. MATERIALS/METHODS: From December 2005 to June 2015, minimum 2-year follow-up was available on 96 patients (103 TKA) who underwent primary TKA with an MLC bearing using the Vanguard Total Knee System. Outcomes included pain, Knee Society clinical and functional score, range of motion, and need for revision...
April 9, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29699825/chronic-obstructive-pulmonary-disease-is-associated-with-short-term-complications-following-total-knee-arthroplasty
#20
George A Yakubek, Gannon L Curtis, Anton Khlopas, Mhamad Faour, Alison K Klika, Michael A Mont, Wael K Barsoum, Carlos A Higuera
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major global health issue and a leading cause of morbidity and mortality. Patients with COPD are at increased risk of complications following surgery. The purpose of this study is to evaluate the postoperative total knee arthroplasty (TKA) outcomes in these patients in comparison to a non-COPD matching cohort. Specifically, we asked the following questions: (1) "Is COPD associated with adverse perioperative outcomes?" and (2) "Does COPD increase the risk of short-term complications following TKA?" METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was used to identify 111,168 patients who underwent TKA between 2008 and 2014...
March 15, 2018: Journal of Arthroplasty
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