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antibiotics and cements

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https://www.readbyqxmd.com/read/28894615/chronic-osteomyelitis-of-the-distal-femur-treated-with-resection-and-delayed-endoprosthetic-reconstruction-a-report-of-three-cases
#1
Sean Ryan, William Eward, Brian Brigman, Robert Zura
Chronic osteomyelitis involving the distal femur often results in amputation or arthrodesis. This article presents three cases of chronic osteomyelitis treated with a staged approach culminating in endoprosthetic reconstruction. Stage one involved resection of infected bone and placement of an intramedullary nail spanning the bony defect between proximal femur and tibia, with antibiotic cement packed around the nail. Patients were then placed on long-term IV +/- oral antibiotics to clear the infection. A "cooldown" period was then used between stages where patients were off antibiotics and inflammatory markers were monitored for signs of remaining infection...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28876459/antibiotic-elution-from-acrylic-bone-cement-loaded-with-high-doses-of-tobramycin-and-vancomycin
#2
Joshua Slane, Bradley Gietman, Matthew Squire
Two-stage revision treatment of prosthetic joint infection (PJI) frequently employs the use of a temporary bone cement spacer loaded with multiple antibiotic types. Tobramycin and vancomycin are commonly used antibiotics in cement spacers, however, there is no consensus on the relative concentrations and combinations that should be used. Therefore, the purpose of this study was to investigate the influence of dual antibiotic loading on the total antibiotic elution and compressive mechanical properties of acrylic bone cement...
September 6, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28866230/strontium-doped-injectable-bone-cement-for-potential-drug-delivery-applications
#3
Ali Taha, Muhammad Akram, Zaidoon Jawad, Ammar Z Alshemary, Rafaqat Hussain
Microwave assisted wet precipitation method was used to synthesize calcium deficient strontium doped β-tricalcium phosphate (Sr-βTCP) with a chemical formula of Ca2.96-xSrx(PO4)2. Sr-βTCP was reacted with monocalcium phosphate monohydrate [Ca(H2PO4)2.H2O, MCPM] in presence of water to furnish corresponding Sr containing brushite cement (Sr-Brc). The samples were characterized by using X-ray diffractometry (XRD), Fourier transform infrared spectroscopy (FTIR) and field emission scanning electron microscopy (FESEM)...
November 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28865450/elution-kinetics-of-vancomycin-and-gentamicin-from-carriers-and-their-effects-on-mesenchymal-stem-cell-proliferation-an-in-vitro-study
#4
Tomas Kucera, Lenka Ryskova, Tomas Soukup, Jana Malakova, Eva Cermakova, Pavel Mericka, Jakub Suchanek, Pavel Sponer
BACKGROUND: Musculoskeletal infections remain a major complication in orthopedic surgery. The local delivery of antibiotics provides the high levels required to treat an infection without systemic toxicity. However, the local toxicity of antibiotic carriers to the mesenchymal stem cells, as a result of both the peak concentrations and the type of carrier, may be significant. METHODS: To address this concern, the elution kinetics of vancomycin and gentamicin from several commercially available antibiotic carriers and several carriers impregnated by a surgeon (10 ml of each sterile carrier were manually mixed with a 500 mg vancomycin and an 80 mg gentamicin solution, and the duration of impregnation was 30 min) were assessed...
September 2, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28861853/corr-insights-%C3%A2-how-long-does-antimycobacterial-antibiotic-loaded-bone-cement-have-in-vitro-activity-for-musculoskeletal-tuberculosis
#5
Enrico Pola
No abstract text is available yet for this article.
August 31, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28853767/a-large-animal-model-for-a-failed-two-stage-revision-of-intramedullary-nail-related-infection-by-methicillin-resistant-staphylococcus-aureus
#6
T F Moriarty, T Schmid, V Post, E Samara, S Kates, E M Schwarz, S Zeiter, R G Richards
The treatment of chronic orthopaedic device-associated infection (ODRI) often requires multiple surgeries and prolonged antibiotic therapy. Despite this extensive treatment protocol, the procedure is associated with significant failure rates. Currently, no large animal model is available that recapitulates a failed revision. Therefore, our aim was to establish a large animal model for failed treatment of an ODRI in order to serve as a testbed for future interventional strategies. Adult Swiss Alpine sheep received an intramedullary nail in the tibia and a localised inoculum of either a methicillin-sensitive or methicillin-resistant Staphylococcus aureus (MSSA, MRSA respectively)...
August 30, 2017: European Cells & Materials
https://www.readbyqxmd.com/read/28853591/introduction-of-antibiotic-loaded-cement-during-hip-hemiarthroplasty-washout-to-reduce-the-need-for-full-revision-surgery
#7
C J O'Dowd-Booth, S F Bellringer, C Gee, P Stott
No abstract text is available yet for this article.
September 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28851574/levofloxacin-loaded-bone-cement-delivery-system-highly-effective-against-intracellular-bacteria-and-staphylococcus-aureus-biofilms
#8
Magda Ferreira, Olena Rzhepishevska, Liliana Grenho, Danila Malheiros, Lídia Gonçalves, António J Almeida, Luisa Jordão, Isabel A Ribeiro, Madeleine Ramstedt, Pedro Gomes, Ana Bettencourt
Staphylococcus aureus is a major pathogen in bone associated infections due to its ability to adhere and form biofilms on bone and/or implants. Moreover, recrudescent and chronic infections have been associated with S. aureus capacity to invade and persist within osteoblast cells. With the growing need of novel therapeutic tools, this research aimed to evaluate some important key biological properties of a novel carrier system composed of acrylic bone cement (polymethylmethacrylate - PMMA), loaded with a release modulator (lactose) and an antibiotic (levofloxacin)...
August 26, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28835000/-therapy-of-periprosthetic-shoulder-infection
#9
Bernd Fink, Florian Sevelda
There are several therapeutic options for the treatment of periprosthetic joint infections of shoulder arthroplasties. In acute infections, the implant can remain in place with open debridement, septic lavage with antibacterial solutions such as octinedine or polyhexanide solution and exchange of all mobile components. In late infections, the therapeutic options after removal of the infected implant are: permanent spacer, resection arthroplasty, one stage revision and two stage revision with or without a temporary spacer...
August 23, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28802424/can-antibiotic-impregnated-cement-nail-achieve-both-infection-control-and-bony-union-in-infected-diaphyseal-femoral-non-unions
#10
Chetan Pradhan, Atul Patil, Chetan Puram, Dheeraj Attarde, Parag Sancheti, Ashok Shyam
BACKGROUND: Infected non-union is complex and debilitating disorder affecting orthopaedic surgeon and patient in terms of cost and time. Many methods are described in the literature for treatment of infected non-union. Local high concentration of antibiotic and mechanical stability of antibiotic cement impregnated intramedullary nail (ACIIN) proves cost and time effective. Recently it was suggested that ACIIN can achieve both union and infection control in infected non-unions with bone gap less than 4cm...
August 2017: Injury
https://www.readbyqxmd.com/read/28797875/success-rates-characteristics-and-costs-of-articulating-antibiotic-spacers-for-total-knee-periprosthetic-joint-infection
#11
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/28795294/how-long-does-antimycobacterial-antibiotic-loaded-bone-cement-have-in-vitro-activity-for-musculoskeletal-tuberculosis
#12
Jae Hoo Lee, Chang Dong Han, Sang-Nae Cho, Ick Hwan Yang, Woo Suk Lee, Seung-Hun Baek, Jae Won Shin, Khalid Elfadil Ibrahim Husein, Kwan Kyu Park
BACKGROUND: Antibiotic-loaded bone cement is accepted as an effective treatment modality for musculoskeletal tuberculosis. However, comparative information regarding combinations and concentrations of second-line antimycobacterial drugs, such as streptomycin and amoxicillin and clavulanic acid, are lacking. QUESTIONS/PURPOSES: (1) In antibiotic-loaded cement, is there effective elution of streptomycin and Augmentin(®) (amoxicillin and clavulanic acid) individually and in combination? (2) What is the antibacterial activity duration for streptomycin- and amoxicillin and clavulanic acid -loaded cement? METHODS: Six different types of bone cement discs were created by mixing 40 g bone cement with 1 or 2 g streptomycin only, 0...
August 9, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28762237/aminoglycoside-impregnated-cement-spacer-precipitating-acute-kidney-injury-requiring-hemodialysis
#13
Sohail Abdul Salim, Jessica Everitt, Aaron Schwartz, Mohit Agarwal, Jorge Castenada, Tibor Fülöp, Luis A Juncos
The current standard of care for prosthetic joint infection includes two-stage arthroplasty, with antibiotic-impregnated cement spacers (ACS) utilized between the stages. We report a 75-year-old woman with previously normal renal function, who developed acute kidney injury (AKI) secondary to biopsy-proven acute tubular necrosis and acute interstitial nephritis after ACS placement containing tobramycin and vancomycin. Peak tobramycin level measured 25.3 mcg/mL, the highest value reported in the literature after ACS placement...
July 31, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28760126/simple-method-for-increasing-drug-elution-from-polymethylmethacrylate-bone-cement
#14
Ahmet Issın, Nizamettin Koçkara
OBJECTIVES: This study aims to investigate the effects of the use of citric acid and sodium bicarbonate mixture as an effervescent in polymethylmethacrylate bone cement in terms of better drug elution. PATIENTS AND METHODS: Multiple cylinder cement blocks each containing 10 g of glucose and different amounts of effervescent (E), with different numbers of pieces (P), surface areas, volumes, and porosities were prepared. Physical properties of all blocks were calculated...
August 2017: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/28735655/an-intramedullary-nail-coated-with-antibiotic-and-growth-factor-nanoparticles-an-individualized-state-of-the-art-treatment-for-chronic-osteomyelitis-with-bone-defects
#15
Roberto Berebichez-Fridman, Pablo Montero-Olvera, Ricardo Gómez-García, Enrique Berebichez-Fastlicht
Among various infections, chronic osteomyelitis is one of the most challenging in terms of treatment. This infection is more common among patients with open fractures and those who have undergone elective orthopedic procedures. The treatment of osteomyelitis requires high antibiotic doses and an aggressive and multifaceted surgical approach. The use of parenteral antibiotics alone, without debridement, is not sufficiently effective, due to the formation of sequestra and the low vascularity of the affected area...
August 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28724376/sonication-contribution-to-identifying-prosthetic-joint-infection-with-ralstonia-pickettii-a-case-report-and-review-of-the-literature
#16
Rares Mircea Birlutiu, Mihai Dan Roman, Razvan Silviu Cismasiu, Sorin Radu Fleaca, Crina Maria Popa, Manuela Mihalache, Victoria Birlutiu
BACKGROUND: In the context of an increase number of primary and revision total hip and total knee arthroplasty performed yearly, an increased risk of complication is expected. Prosthetic joint infection (PJI) remains the most common and feared arthroplasty complication. Ralstonia pickettii is a Gram-negative bacterium, that has also been identified in biofilms. It remains an extremely rare cause of PJI. There is no report of an identification of R. pickettii on an extracted spacer loaded with antibiotic...
July 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28723917/evidence-base-and-practice-variation-in-acute-care-processes-for-knee-and-hip-arthroplasty-surgeries
#17
Marcel Mayer, Justine Naylor, Ian Harris, Helen Badge, Sam Adie, Kathryn Mills, Joseph Descallar
BACKGROUND: Lack of evidence contributes to unnecessary variation in treatment costs and outcomes. This study aimed to identify from interventions historically used for total knee or hip arthroplasty (TKA, THA): i) if routine use is supported by high-level evidence; ii) whether surgeon use aligns with the evidence. METHODS: Part 1: Systematic search of electronic library databases for systematic reviews and practice guidelines concerning seven acute-care interventions...
2017: PloS One
https://www.readbyqxmd.com/read/28712488/staged-reconstruction-of-diaphyseal-fractures-with-segmental-defects-surgical-and-patient-reported-outcomes
#18
S D Zoller, L A Cao, R A Smith, W Sheppard, E L Lord, C D Hamad, J H Ghodasra, C Lee, D Jeffcoat
INTRODUCTION: Two-stage limb reconstruction is an option for patients with critical size segmental bone defects following acute trauma or non-union. Reconstruction is technically demanding and associated with a high complication rate. Current protocols for limb reconstruction have well-documented challenges, and no study has reported on patient outcomes using a validated questionnaire. In this study, we aimed to examine the clinical and patient-centered outcomes following our surgical protocol for two-stage limb reconstruction following critical size segmental defects...
June 23, 2017: Injury
https://www.readbyqxmd.com/read/28697078/segmental-bone-defect-treated-with-the-induced-membrane-technique
#19
Sanjit R Konda, Mark Gage, Nina Fisher, Kenneth A Egol
PURPOSE: Posttraumatic bone defects in the setting of severe open injuries of the lower extremity present a significant challenge for orthopaedic trauma surgeons. The induced membrane technique, also known as the Masquelet technique, has been shown to be generally successful in achieving bony union. This video demonstrates the use of the Masquelet technique for a large (18 cm) femoral defect. METHODS: The Masquelet technique is a 2-stage process. The first stage involves debridement of all devitalized tissue, using open reduction and internal fixation, and placement of a cement spacer with or without antibiotics...
August 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28692571/efficacy-of-target-drug-delivery-and-dead-space-reduction-using-antibiotic-loaded-bone-cement-for-the-treatment-of-complex-spinal-infection
#20
Soichiro Masuda, Shunsuke Fujibayashi, Bungo Otsuki, Hiroaki Kimura, Shuichi Matsuda
STUDY DESIGN: A retrospective study. OBJECTIVES: We have treated complex cases of surgical site infection (SSI) successfully using antibiotic-loaded bone cement to avoid the need for implant removal. In the present study, we describe a new treatment option for SSI. SUMMARY OF BACKGROUND DATA: Although there are several treatment options for SSI after spinal surgery involving instrumentation, several types of problems may arise and are difficult to cure...
July 7, 2017: Clinical Spine Surgery
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