keyword
https://read.qxmd.com/read/38484939/in-vitro-elution-of-local-anesthetics-from-pmma-bone-cement
#1
JOURNAL ARTICLE
M Monfort-Mira, M Jornet-Gibert, C Yela-Verdú, P Torner-Pifarré, M Balaguer-Castro
Background and aim Currently, we do not have a gold standard for pain management after total knee arthroplasty. We may use one of more drug delivery systems, none of which are ideal. An ideal depot delivery system would provide therapeutic, nontoxic, doses of drug at the surgical side, especially during 72 h postoperatively. The bone cement used in arthroplasties has been used as a drug delivery system, especially antibiotics, since 1970. Based on this principle, we developed this study with the aim to characterize the elution profile of two local anaesthetics (lidocaine hydrochloride and bupivacaine hydrochloride) from PMMA (polymethilmethacrylate) bone cement...
March 12, 2024: Revista Española de Cirugía Ortopédica y Traumatología
https://read.qxmd.com/read/38479573/a-systematic-review-and-meta-analysis-of-antibiotic-loaded-bone-cement-for-prevention-of-deep-surgical-site-infections-following-primary-total-joint-replacement
#2
JOURNAL ARTICLE
Hideo Kato, Yukihiro Hamada, Shotaro Takano, Shinsuke Ikeda, Yoshinori Seto, Kazuhiko Matsushita, Koji Yamada, Katsufumi Uchiyama
BACKGROUND: The use of antibiotic-loaded bone cement (ALBC) as a mean for preventing deep surgical site infections (SSI) after total joint replacement is controversial. Therefore, we have conducted a meta-analysis to evaluate the prophylactic effect of ALBC for SSI prevention in patients undergoing arthroplasty. This study was conducted to revise treatment guidelines for MRSA infections in Japan. METHODS: PubMed (Medline), Scopus, Embase, Web of Science and Cochrane library were searched for relevant articles comparing preventive effect of ALBC for patients undergoing primary total joint arthroplasty by August 2022...
March 11, 2024: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://read.qxmd.com/read/38476757/case-report-hip-arthroplasty-after-fracture-related-joint-infection-caused-by-extensively-drug-resistant-klebsiella-pneumoniae
#3
Maximilian Fischer, Lars Nonnenmacher, Johannes C Reichert, Jürgen A Bohnert, Evgeny A Idelevich, Eyüp Doğan, Karsten Becker, Georgi I Wassilew
This case-report focuses on a 23-year-old soldier suffering from a fracture-related hip joint infection (FRI) due to extensively drug-resistant Klebsiella pneumoniae and S. epidermidis . The patient underwent multiple septic revision surgeries including the removal of remaining shrapnel accompanied by last-resort antimicrobial therapy with cefiderocol and colistin. Additionally, the surgeries included repeated tissue sampling for microbiological and histopathological analysis. An antibiotic-loaded cemented filler containing cefiderocol was used to improve local antimicrobial therapy...
2024: Frontiers in Surgery
https://read.qxmd.com/read/38450616/treatment-of-external-fixator-pin-tract-deep-infections-with-an-antibiotic-sparkler
#4
JOURNAL ARTICLE
Lee M Hlad, Jacob N Rizkalla, Eric So, John E Herzenberg
Pin tract infections are virtually universal complications with the use of external fixation. While most are superficial and respond to oral antibiotics and local care, septic loosening may occur at the bone-pin interface, which may lead to instability of the fixator, catastrophic failure, fracture, and long-term osteomyelitis. Classification systems and prevention protocols have been developed to address this ubiquitous complication. Treatment of severe pin tract infections often requires debridement, parenteral antibiotics, and removal of the offending pin or the entire external fixator...
March 7, 2024: Foot & Ankle Specialist
https://read.qxmd.com/read/38449938/cement-induced-chemical-burn-in-a-middle-aged-male-a-case-report-and-review-of-literature
#5
Hafsa Zahoor, Nismat Javed, Jacob K Epperson, Darshana Ganguly, Susan Chung, Misbahuddin Khaja
This case study reviews a 48-year-old Hispanic male working in construction who presented with left upper medial thigh pain, redness, and swelling after exposure to hazardous chemicals during cement processing. Initially diagnosed with cellulitis and adjacent myositis, the patient met sepsis criteria and received empiric antibiotics. However, negative cultures and an evolving wound appearance shifted the diagnosis towards bullous diseases and chemical injury. Occupational history and physical exam findings pointed towards injury secondary to chemical exposure, common in cement workers with inadequate protective gear...
February 2024: Curēus
https://read.qxmd.com/read/38448971/investigating-the-in-vitro-antibacterial-efficacy-of-composite-bone-cement-incorporating-natural-product-based-monomers-and-gentamicin
#6
JOURNAL ARTICLE
Yu-Chen Kan, Rui Guo, Yang Xu, Lu-Yang Han, Wen-Han Bu, Long-Xu Han, Jian-Jun Chu
OBJECTIVE: The objective of this study is to investigate the impact of four natural product extracts, namely, aloe-emodin, quercetin, curcumin, and tannic acid, on the in vitro bacteriostatic properties and biocompatibility of gentamicin-loaded bone cement and to establish an experimental groundwork supporting the clinical utility of antibiotic-loaded bone cements (ALBC). METHODS: Based on the components, the bone cement samples were categorized as follows: the gentamicin combined with aloe-emodin group, the gentamicin combined with quercetin group, the gentamicin combined with curcumin group, the gentamicin combined with tannic acid group, the gentamicin group, the aloe-emodin group, the quercetin group, the curcumin group, and the tannic acid group...
March 6, 2024: Journal of Orthopaedic Surgery and Research
https://read.qxmd.com/read/38447565/two-stage-treatment-protocol-of-fungal-periprosthetic-hip-and-knee-joint-infections-the-clinical-experience-from-a-single-center-experience
#7
JOURNAL ARTICLE
J Xu, W Sun, Y Wang, H Jiang, H Ding, Q Cheng, N Bao, J Meng
PURPOSE OF THE STUDY: To evaluate the clinical results and safety of fungal periprosthetic joint Infections (fPJIs) using two-stage treatment protocol. MATERIAL AND METHODS: 8 patients with fPJIs (3 hips and 5 knees) using two-stage revision were reviewed retrospectively and followed up at least 2 years. The preoperative demographic data, two-stage treatment protocol, results of microbiology and histologic workup and postoperative follow-up results (reimplantation success rate and infection free time) were recorded...
2024: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://read.qxmd.com/read/38417732/the-effect-of-different-antibiotic-combinations-in-calcium-sulfate-cement-on-the-growth-of-cutibacterium-acnes-and-staphylococcus-periprosthetic-shoulder-infection-isolates
#8
JOURNAL ARTICLE
Thomas Listopadzki, Allison Chowdhury, Kevin Kohut, Mohammad Nadir Haider, John K Crane, Thomas Duquin, Matthew DiPaola
BACKGROUND: Prosthetic joint infections (PJI) of the shoulder are a devastating complication of shoulder arthroplasty and are commonly caused by Staphylococcus and Cutibacterium acnes. Absorbable calcium sulfate beads are sometimes used for delivering antibiotics in PJI. This study evaluates the in vitro effect of different combinations of gentamicin, vancomycin, and ertapenem in beads made from calcium sulfate cement on the growth of C. acnes and coagulase-negative Staphylococcus strains...
February 26, 2024: Journal of Shoulder and Elbow Surgery
https://read.qxmd.com/read/38392594/medullary-sparing-antibiotic-cement-articulating-spacer-reduces-the-rate-of-mechanical-complications-in-advanced-septic-hip-arthritis-a-retrospective-cohort-study
#9
JOURNAL ARTICLE
Chun-Yen Chen, Chin-Ping Lin, Chun-Hao Tsai, Hui-Yi Chen, Hsien-Te Chen, Tsung-Li Lin
Antibiotic cement articulating spacers eradicate infection during a two-stage revision for advanced septic hip arthritis (ASHA); however, mechanical complications have been reported. We hypothesized that the rate of mechanical complications would be lower in medullary-sparing (MS) than in non-medullary-sparing (n-MS) articulating spacers. A retrospective study of ASHA using n-MS or MS spacers was conducted between 1999 and 2019. The rate of mechanical complications and reoperation and risk factors for mechanical complications were analyzed...
January 31, 2024: Journal of Personalized Medicine
https://read.qxmd.com/read/38391572/impact-of-anti-mycotic-drugs-on-the-osteogenic-response-of-bone-marrow-mesenchymal-stem-cells-in-vitro
#10
JOURNAL ARTICLE
Tim Niklas Bewersdorf, Jakob Hofmann, Sebastian Findeisen, Christian Schamberger, Thomas Lingner, Ulrike Sommer, Gerhard Schmidmaier, Tobias Grossner
The treatment of fungal bone infections and infected non-unions is a huge challenge in modern trauma and orthopedics, which normally contain the local and systemic administration of anti-fungal drugs. Although frequently used, little is known about the impact of systemic and locally administered fungicides on the osteogenic regenerative capabilities of infected bone tissue, especially upon the osteogenesis of human bone marrow mesenchymal stem cells (BM-hMSCs). This study evaluates the effects of the three most common fungicides for the systemic treatment of bone infections, Voriconazole (VOR), liposomal Amphotericin B (LAMB), and Fluconazole (FLU), as well as the effects of VOR and LAMB-loaded Polymethylmethacrylate (PMMA) cement chips in different concentrations upon the osteogenic response of BM-hMSCs in vitro...
February 15, 2024: Antibiotics
https://read.qxmd.com/read/38385716/effect-of-antibiotic-spacer-dosing-on-treatment-success-in-two-stage-exchange-for-periprosthetic-joint-infection
#11
JOURNAL ARTICLE
Hunter S Warwick, Timothy L Tan, Khuzaima Rangwalla, David N Shau, Jeffrey J Barry, Erik N Hansen
INTRODUCTION: In two-stage exchange for periprosthetic joint infection (PJI), adding antibiotics to cement spacers is the standard of care; however, little is known about optimal dosage. There is emphasis on using >3.6 g of total antibiotic, including ≥2.0 g of vancomycin, per 40 g of cement, but these recommendations lack clinical evidence. We examined whether recommended antibiotic spacer doses affect treatment success. METHODS: This was a retrospective review of 202 patients who underwent two-stage exchange for PJI from 2004 to 2020 with at least 1-year follow-up...
February 1, 2024: Journal of the American Academy of Orthopaedic Surgeons. Global Research & Reviews
https://read.qxmd.com/read/38334573/enhancing-bone-cement-efficacy-with-hydrogel-beads-synthesized-by-droplet-microfluidics
#12
JOURNAL ARTICLE
Zeyu Wang, Sherwin Yang, Chunjie He, Chaoqiang Li, Rong-Fuh Louh
Effective filling materials, typically bone cements, are essential for providing mechanical support during bone fracture treatment. A current challenge with bone cement lies in achieving continuous drug release and forming porous structures that facilitate cell migration and enhance osteoconductivity. We report a droplet microfluidics-based method for synthesizing uniform-sized gelatin hydrogel beads. A high hydrogel concentration and increased crosslinking levels were found to enhance drug loading as well as release performance...
February 1, 2024: Nanomaterials
https://read.qxmd.com/read/38316175/interim-use-of-antibiotic-loaded-cement-spacer-for-patients-with-infected-cervical-fusion
#13
JOURNAL ARTICLE
Yen-Chun Chiu, Shih-Chieh Yang, Yu-Hsien Kao, Yuan-Kun Tu
OBJECTIVE: The management of postoperative deep infection after anterior cervical discectomy and fusion (ACDF) remains challenging for spine surgeons. Our institution uses handmade antibiotic-loaded cement spacers to treat these complex cases. This study aimed to determine the efficacy and feasibility of this treatment. METHODS: This study included four patients with deep cervical spine infections after ACDF who underwent our treatment between March 2012 and January 2022...
February 3, 2024: World Neurosurgery
https://read.qxmd.com/read/38312906/systemic-absorption-resulting-from-tobramycin-loaded-antibiotic-cement-spacers-used-in-the-treatment-of-prosthetic-joint-infection
#14
JOURNAL ARTICLE
James D Como, Rasha Abdulmassih, Anthony J Guarascio, Timothy Sauber, Jeffrey Sewecke, Edward Westrick, Nitin Bhanot
PURPOSE: Antimicrobial cement spacer (ACS) placement has been a cornerstone of two-stage management of prosthetic hip and knee infection. Pharmacokinetic modelling has described peak systemic antibiotic concentrations within the first 24-48 h post-operatively, followed by rapid clearance. A few studies have, however, identified detectable tobramycin levels in patients with a post-operative decline in creatinine clearance. Our study sought to determine how frequently detectable serum tobramycin levels occurred within the first 72 h following ACS placement in all patients regardless of baseline or subsequent changes in renal function, whether these levels correlated with tobramycin spacer dosage, creatinine clearance, or potential nephrotoxicity risk factors, and whether any patients developed acute kidney injury within the 14-day post-operative period...
February 2024: Indian Journal of Orthopaedics
https://read.qxmd.com/read/38312269/can-pyrocarbon-be-used-as-a-functional-spacer-for-the-treatment-of-recalcitrant-shoulder-infections
#15
JOURNAL ARTICLE
Hugo Barret, Pascal Boileau
BACKGROUND: The most common treatment approach in periprosthetic joint infection (PJI) and chronic shoulder joint infection (SJI) is a two-stage revision involving interval placement of an antibiotic cement spacer or a resection arthroplasty. Knowing that Pyrocarbon has a smooth surface that prevents pathogen adhesion, the question arises whether it could be used as a temporary or permanent functional spacer? PURPOSE: The primary objective of the present study was to assess the rate of infection eradication after temporary or definitive implantation of Pyrocarbon Interposition Shoulder Arthroplasty (PISA) in patients with recalcitrant PJI or SJI...
January 2024: JSES international
https://read.qxmd.com/read/38309798/diagnosing-and-managing-infection-in-total-ankle-replacement
#16
REVIEW
Markus Walther, Veit Krenn, Kathrin Pfahl
Infections after total ankle replacement (TAR) within the first 4 weeks after implantation can be managed successfully with 1 or several debridements, irrigation, and a change of polyethylene inlay. Late infections require implant removal. Low-grade infections might be an underestimated problem so far. Although single-surgery revisions are reported in the literature, the authors' experience with 2-stage revisions using an antibiotics-loaded bone cement spacer is better. Additional antibiotics are used to support the surgical treatment...
March 2024: Foot and Ankle Clinics
https://read.qxmd.com/read/38307930/regulation-of-the-antibiotic-elution-profile-from-tricalcium-phosphate-bone-cement-by-addition-of-bioactive-glass
#17
JOURNAL ARTICLE
H K Abd El-Hamid, Mohammad M Farag, Mohamed Abdelraof, R L Elwan
This work aimed at tailoring of different properties of antibacterial drug delivery Ca-phosphate cements by incorporation of bioactive glass (BG). The cements were prepared from beta-tricalcium phosphate cement (β-TCP) and BG based on 50 SiO2 -20 CaO-15 Na2 O-7 B2 O3 -4 P2 O5 -4 Al2 O3  wt% with different percentages of BG [5, 10, 15, and 20% (w/w)]. The composite cements were characterized by XRD, FTIR, and TEM. Moreover, in vitro bioactivity and biodegradation were evaluated in the simulated body fluid (SBF) at 37 °C...
February 2, 2024: Scientific Reports
https://read.qxmd.com/read/38304243/point-of-care-coating-of-revision-femoral-stems-with-antibiotic-loaded-calcium-sulfate-reduction-in-infection-after-2nd-stage-reimplantation-but-not-with-aseptic-revisions
#18
JOURNAL ARTICLE
Edward J McPherson, Brooke M Crawford, Steven G Kenny, Matthew V Dipane, Shahrzad Salarkia, Alexandra I Stavrakis, Madhav Chowdhry
BACKGROUND: Infection rates in revision total hip arthroplasty are lower when antibiotic loaded cemented stems are utilized. Inspired by this technique, a point-of-care coating of antibiotic-loaded calcium sulfate (CaSO4 ) was applied to cementless revision stems in aseptic revision and 2nd stage reimplantation total hip arthroplasty. METHODS: One hundred eleven consecutive femoral stems were coated. Just prior to insertion, 10 cc of CaSO4 was mixed with 1 g vancomycin and 240 mg tobramycin with the paste applied to the stem...
February 2024: Arthroplasty Today
https://read.qxmd.com/read/38299852/cathodic-voltage-controlled-electrical-stimulation-and-betadine-decontaminate-nosocomial-pathogens-from-implant-surfaces
#19
JOURNAL ARTICLE
Tripti Thapa Gupta, Bernadette Zumpano, Jacob Opalinski, Riley Ritchey, Nathan Winter, Scott R Nodzo, Mary Canty
Periprosthetic joint infection (PJI) after total joint arthroplasty is a major concern requiring multiple surgeries and antibiotic interventions. Staphylococcus aureus , Pseudomonas aeruginosa , and Escherichia coli are the predominant causes of these infections. Due to biofilm formation, antibiotic treatment for patients with PJI can prolong resistance, further complicating the use of current treatments. Previous research has shown that cathodic voltage-controlled electrical stimulation (CVCES) is an effective technique to prevent/treat implant-associated biofilm infections on titanium (Ti) surfaces...
February 1, 2024: MSphere
https://read.qxmd.com/read/38298291/advanced-erosive-gouty-arthropathy-of-the-knee
#20
Alexei Buruian, Susana Angelo, Emanuel Seiça, Fábio Fernandes, António Mendes
A 57-year-old male, with chronic bilateral knee pain and a history of poorly controlled hyperuricemia leading to gouty attacks, underwent orthopedic assessment. Radiographic and MRI findings confirmed chronic gouty arthropathy with erosive bony defects, the most significant on the right proximal tibia. Total knee arthroplasty (TKA) was performed without any complications, addressing the bony defect with cement and a semi-constrained prosthesis. However, a gouty attack led to prolonged wound discharge and periprosthetic infection postoperatively, prompting revision surgery with debridement, antibiotics, and implant retention (DAIR)...
January 2024: Curēus
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