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https://www.readbyqxmd.com/read/28221245/an-articulating-antibiotic-cement-spacer-for-first-stage-reconstruction-for-infected-total-elbow-arthroplasty
#1
Kanishka E Williams, Simon MacLean, Jesse Jupiter, Gregory I Bain
Management of an infected total elbow replacement is a significant clinical challenge. Although preservation of the prosthesis is ideal, a 2-stage revision is often necessary. Unlike lower limb arthroplasty, antibiotic spacers are not commercially available. Monoblock cement spacers do not allow elbow movements and are therefore associated with severe stiffness and scarring, leading to poor clinical outcomes. In our paper we present a simple and novel technique for constructing an articulating antibiotic-impregnated spacer for use as an implant for a 1-stage revision of an infected elbow arthroplasty...
February 17, 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28218376/relationship-between-femoral-offset-and-dislocation-in-preformed-antibiotic-loaded-cement-spacers-spacer-g%C3%A2
#2
Ignacio Molinas, Ester Garcia-Oltra, Jenaro A Fernández-Valencia, Xavier Tomas, Xavier Gallart, Josep Riba, Andreu Combalia, Guillem Bori
PURPOSE: A reduction in femoral offset may decrease muscle tension and lead to spacer dislocations even though proximal femur, musculature and acetabulum remain intact. In this study, we aimed to determine whether postoperative lateral femoral offset (LFO) and modified vertical femoral offset (MVFO) values affect the risk of dislocation of a hip spacer. MATERIALS AND METHODS: We measured LFO and MVFO in properly centred, postoperative, anteroposterior radiographs of the pelvis in 66 patients (71 spacers)...
February 8, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28197990/a-chlorhexidine-releasing-epoxy-based-coating-on-titanium-implants-prevents-staphylococcus-aureus-experimental-biomaterial-associated-infection
#3
M Riool, A J Dirks, V Jaspers, L de Boer, T J Loontjens, C M van der Loos, S Florquin, I Apachitei, L N Rijk, H A Keul, S A Zaat
Prevention of biomaterial-associated infections (BAI) remains a challenging problem, in particular due to the increased risk of resistance development with the current antibiotic-based strategies. Metallic orthopaedic devices, such as non-cemented implants, are often inserted under high mechanical stress. These non-cemented implants cannot be protected by e.g. antibioticreleasing bone cement or other antimicrobial approaches, such as the use of bioactive glass. Therefore, in order to avoid abrasion during implantation procedures, we developed an antimicrobial coating with great mechanical stability for orthopaedic implants, to prevent Staphylococcus aureus BAI...
February 14, 2017: European Cells & Materials
https://www.readbyqxmd.com/read/28169939/precise-measurement-of-the-outer-diameters-of-antibiotic-laden-cement-nails-produced-by-various-sized-thoracostomy-catheter-molds
#4
Cory M Czajka, Ian N Bauer, Stephen J Warner, Robin N Goytia, Mark R Brinker
OBJECTIVES: At our institution, custom made antibiotic-laden cement nails fabricated during surgery using a thoracostomy catheter as a mold is commonly employed to treat long bone infection. As the outer diameter of the nails produced has not previously been described, we designed a study to measure the outer diameter of antibiotic-laden cement nails fashioned using commercially available and commonly utilized thoracostomy catheters of various sizes. METHODS: Six thoracostomy catheters from two different manufactures (Argyle™ PVC Thoracic Catheters, Covidien Ltd...
January 24, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28161774/outcome-following-subluxation-of-mobile-articulating-spacers-in-two-stage-revision-total-knee-arthroplasty
#5
Brent A Lanting, Adrian Lau, Matthew G Teeter, James L Howard
INTRODUCTION: Infection after total knee arthroplasty (TKA) is a severe complication. It is usually treated with two-stage revision and implantation of a cement spacer. Few studies describe the complications associated with a mobile articulating spacer. This study examined the subluxation of articulating antibiotic spacers in knees and correlated it with prospectively collected early outcome scores after implantation of a revision prosthesis. METHODS: Staged revisions for 72 infected primary total knee arthroplasties between 2004 and 2012 were examined...
February 4, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28145953/vancomycin-and-ceftazidime-in-bone-cement-as-a-potentially-effective-treatment-for-knee-periprosthetic-joint-infection
#6
Yung-Heng Hsu, Chih-Chien Hu, Pang-Hsin Hsieh, Hsin-Nung Shih, Steve W N Ueng, Yuhan Chang
BACKGROUND: The aim of this study was to determine the optimal formulation of antibiotic-loaded bone cement for knee periprosthetic joint infection. We used both in vitro and in vivo models incorporating various broad-spectrum antibiotics and tested their efficacy against gram-positive and gram-negative bacteria. METHODS: Bone cement specimens loaded with 4 g of either vancomycin or teicoplanin and 4 g of ceftazidime, imipenem, or aztreonam were studied to measure their in vitro antibiotic release characteristics and antibacterial capacities against methicillin-susceptible Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, and Escherichia coli...
February 1, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28135373/elution-profiles-of-two-methods-of-antibiotic-tibial-nail-preparations
#7
Matthew R Karek, Nancy M Jackson, Jeffrey C Flynn, Rahul Vaidya, David C Markel
Interlocking nails coated with antibiotic-supplemented cement provide effective treatment of infected long bone nonunion, but the thicker coating on guidewires may provide greater antibacterial activity. This study compared the properties of cement cured on each construct by evaluating 2-cm segments of 8-mm interlocking nails and 3.5-mm guidewires coated with antibiotic-supplemented cement. Each construct (n=7 for each group) was coated with polymethylmethacrylate cement (Simplex; Stryker Orthopaedics, Mahwah, New Jersey) containing either 1 g tobramycin or 1 g vancomycin powder plus 2...
January 30, 2017: Orthopedics
https://www.readbyqxmd.com/read/28116272/management-of-large-bone-defects-in-diaphyseal-fractures-by-induced-membrane-formation-by-masquelet-s-technique
#8
R Sivakumar, M Gulam Mohideen, M Chidambaram, T Vinoth, Prahalad Kumar Singhi, V Somashekar
INTRODUCTION: Management of the large gap in long bone fractures is a challenging problem after compound injuries. A novel technique called as Masquelet's technique of "induced membrane formation", is used to bridge a gap of more than 5 cm using bone cement as a spacer in first stage and autologous cancellous bone graft to fill the gap in second stage. CASE PRESENTATION: We present two different and difficult cases with bone defects after open injuries associated with long bone fractures in this paper...
July 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28114929/induced-membrane-technique-for-the-treatment-of-chronic-hematogenous-tibia-osteomyelitis
#9
Xiaohua Wang, Zhen Wang, Jingshu Fu, Ke Huang, Zhao Xie
BACKGROUND: Chronic hematogenous osteomyelitis often results from the improper treatment of acute hematogenous osteomyelitis. At present, there is lack of uniform standards for the treatment, and the clinical features of the disease are unclear. The purpose of this study was to explore the clinical efficacy and complications of chronic hematogenous tibia osteomyelitis treated with the induced membrane technique. METHODS: A retrospective analysis of the chronic hematogenous tibia osteomyelitis patients in our department admitted from January 2013 to February 2014 and treated with the induced membrane two-stage surgical technique was performed...
January 23, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28111125/superficial-vancomycin-coating-of-bone-cement-in-orthopedic-revision-surgery-a-safe-technique-to-enhance-local-antibiotic-concentrations
#10
Florian Amerstorfer, Stefan Fischerauer, Patrick Sadoghi, Gerold Schwantzer, Klaus Dieter Kuehn, Andreas Leithner, Mathias Glehr
BACKGROUND: The use of antibiotic-loaded cement has become a well-accepted method to develop high local antibiotic concentrations in revision surgery of infected arthroplasty. A new surgical technique has been established to further increase the local antibiotic concentration and thereby minimizes the risk of reinfection. Our study aim was to investigate the safety of additional superficial vancomycin coating (SVC) by analyzing postoperative joint and serum vancomycin concentrations, as well as the creatinine levels of patients with orthopedic revision surgery...
December 1, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28089125/long-term-outcomes-of-permanent-cement-spacers-in-the-infected-foot
#11
Tammer Elmarsafi, Noah G Oliver, John S Steinberg, Karen K Evans, Christopher E Attinger, Paul J Kim
When osteomyelitis occurs in the infected foot, cement spacers have been used as a limb salvage tool. The aim of the present study was to assess the longevity and outcomes in high-risk, low-demand patients who have undergone resection of bone and subsequent placement of permanent antibiotic-eluting cement spacers in the foot. A retrospective review case series of 30 patients who had undergone placement of a permanent antibiotic-eluting cement spacer in the foot were evaluated for retention, spacer exchange, removal, amputation, and functional status...
January 6, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28087408/effects-of-loading-concentration-blood-and-synovial-fluid-on-antibiotic-release-and-anti-biofilm-activity-of-bone-cement-beads
#12
Devendra H Dusane, Scott M Diamond, Cory S Knecht, Nicholas R Farrar, Casey W Peters, Robert P Howlin, Matthew C Swearingen, Jason H Calhoun, Roger D Plaut, Tanya M Nocera, Jeffrey F Granger, Paul Stoodley
Antibiotic loaded cement beads are commonly used for the treatment of biofilm related orthopaedic periprosthetic infections; however the effects of antibiotic loading and exposure of beads to body fluids on release kinetics are unclear. The purpose of this study was to determine the effects of (i) antibiotic loading density (ii) loading amount (iii) material type and (iv) exposure to body fluids (blood or synovial fluid) on release kinetics and efficacy of antibiotics against planktonic and lawn biofilm bacteria...
January 10, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/28057476/operative-treatment-of-early-infection-after-internal-fixation-of-limb-fractures-exclusive-of-severe-open-fractures
#13
REVIEW
P Bonnevialle
Early infection after open reduction and internal fixation (ORIF) of a limb bone is defined as bacteriologically documented, deep and/or superficial surgical-site infection (SSI) diagnosed within 6months after the surgical procedure. This interval is arbitrarily considered sufficient to obtain fracture healing. The treatment of early infection after ORIF should be decided by a multidisciplinary team. The principles are the same as for revision arthroplasty. Superficial SSIs should be differentiated from deep SSIs, based on the results of bacteriological specimens collected using flawless technique...
January 2, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28053381/a-simple-method-for-fashioning-an-antibiotic-impregnated-cemented-rod-for-intramedullary-placement-in-infected-non-union-of-long-bones
#14
Ajay Bharti, Umesh Kumar Saroj, Vineet Kumar, Sanjay Kumar, Balram Ji Omar
The intramedullary insertion of antibiotic impregnated PMMA rods, beads or nails are widely used and accepted modality of treatment for chronic osteomyelitis of long bones. But at times it becomes difficult to insert and remove these antibiotic delivery systems owing to narrowed medullary canals. Here we present a technique for preparing PMMA rods with diameter ranging from 6 mm to 3 mm. These rods could easily be placed in narrow intramedullary canal of long bones with chronic osteomyelitis or infected non-union...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28053260/comparison-of-the-elution-properties-of-commercially-available-gentamicin-and-bone-cement-containing-vancomycin-with-home-made-preparations
#15
COMPARATIVE STUDY
N M Frew, T Cannon, T Nichol, T J Smith, I Stockley
AIMS: Vancomycin is commonly added to acrylic bone cement during revision arthroplasty surgery. Proprietary cement preparations containing vancomycin are available, but are significantly more expensive. We investigated whether the elution of antibiotic from 'home-made' cement containing vancomycin was comparable with more expensive commercially available vancomycin impregnated cement. MATERIALS AND METHODS: A total of 18 cement discs containing either proprietary CopalG+V; or 'home-made' CopalR+G with vancomycin added by hand, were made...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28002924/quantitative-study-on-vancomycin-release-from-cement-in-3-different-formulations-preliminary-results-and-antimicrobial-activity
#16
D Fenga, M Currò, M Rosi, D J Ortolà, A Cantivalli, R Ientile, M A Rosa
The purpose of this study is to investigate the best preparation method of the cement powder mixture, solvent and antibiotic in order to obtain the greatest amount of antibiotic in the joint for the longest time as possible. At time T0 the three samples, packed in a sterile environment in different formulations, were placed in sterile tubes, adding to each one 5 ml of saline phosphate buffer solution (PBS) and put in a stove at 37°C for 24 h. A sample of PBS without cement (T control) was also created. Qualitative and quantitative assessment of the incubated liquid with cement was performed along with biochemical analysis with High Performance Liquid Chromatography (HPLC)...
October 2016: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/27993444/two-stage-revisions-for-culture-negative-infected-total-knee-arthroplasties-a-five-year-outcome-in-comparison-with-one-stage-and-two-stage-revisions-for-culture-positive-cases
#17
Heng Li, Ming Ni, Xiang Li, Qingmeng Zhang, Xin Li, Jiying Chen
BACKGROUND: Culture-negative periprosthetic joint infection (PJI) is very intractable when dealing with an infected total knee arthroplasty (TKA) patient. Two-stage revision has been proved to be a reliable solution for PJI patients. Whether it is still credible for culture-negative infected patients remains uncertain. METHODS: Our group retrospectively reviewed all total knee revision patients from January 2003 to January 2014, 145 PJI patients were diagnosed as infection with the PJI diagnostic criteria and 129 patients were successfully followed...
December 16, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/27989720/prevention-of-propionibacterium-acnes-biofilm-formation-in-prosthetic-infections-in-vitro
#18
Robert P Howlin, Christopher Winnard, Elizabeth M Angus, Connor J Frapwell, Jeremy S Webb, John J Cooper, Sean S Aiken, Julie Y Bishop, Paul Stoodley
BACKGROUND: The role of Propionibacterium acnes in shoulder arthroplasty and broadly in orthopedic prosthetic infections has historically been underestimated, with biofilm formation identified as a key virulence factor attributed to invasive isolates. With an often indolent clinical course, P acnes infection can be difficult to detect and treat. This study investigates absorbable cements loaded with a broad-spectrum antibiotic combination as an effective preventive strategy to combat P acnes biofilms...
December 15, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27955626/antibiotics-and-antiseptics-for-preventing-infection-in-people-receiving-revision-total-hip-and-knee-prostheses-a-systematic-review-of-randomized-controlled-trials
#19
Jeffrey Voigt, Michael Mosier, Rabih Darouiche
BACKGROUND: Infection rates in revision (second and subsequent) major joint arthroplasty continues to be a significant issue with rates 2-3 times those of primary procedures. The effect of antibiotic and antiseptic prophylaxis on outcomes for this type of surgery has not been adequately reviewed. METHODS: A systematic search of the main databases for randomized controlled trials (RCTs) evaluating antibiotics and antiseptics was conducted to evaluate the predetermined endpoints of infection...
December 12, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27941638/bronchiectasis-in-the-last-five-years-new-developments
#20
REVIEW
Jun Keng Khoo, Victoria Venning, Conroy Wong, Lata Jayaram
Bronchiectasis, a chronic lung disease characterised by cough and purulent sputum, recurrent infections, and airway damage, is associated with considerable morbidity and mortality. To date, treatment options have been limited to physiotherapy to clear sputum and antibiotics to treat acute infections. Over the last decade, there has been significant progress in understanding the epidemiology, pathophysiology, and microbiology of this disorder. Over the last five years, methods of assessing severity have been developed, the role of macrolide antibiotic therapy in reducing exacerbations cemented, and inhaled antibiotic therapies show promise in the treatment of chronic Pseudomonas aeruginosa infection...
December 8, 2016: Journal of Clinical Medicine
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