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https://www.readbyqxmd.com/read/29332203/custom-made-antibiotic-loaded-acrylic-cement-spacers-using-a-dental-silicone-template-for-treatment-of-infected-hip-prostheses
#1
Tadahiko Ohtsuru, Yuji Morita, Yasuaki Murata, Yutaro Munakata, Masafumi Itoh, Yoshiharu Kato, Ken Okazaki
PURPOSE: Antibiotic-loaded acrylic cement (ALAC) spacers are useful for treatment of infected prostheses in the course of a two-stage revision. Spacers are handmade or are made using a commercial template, with reportedly good treatment outcomes. This study aimed to confirm the usefulness of custom-made ALAC spacers shaped like bipolar hip prostheses using a dental silicone template for treatment of infected hip prostheses, and described their manufacture. METHODS: This study evaluated 10 patients who underwent two-stage revision for treatment of infected hip prostheses...
January 13, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29312854/antibiotic-bone-cement-s-effect-on-infection-rates-in-primary-and-revision-total-knee-arthroplasties
#2
Donald Kleppel, Jacob Stirton, Jiayong Liu, Nabil A Ebraheim
AIM: To compare infection rates in primary and revision total knee arthroplasty (TKA) procedures using antibiotic impregnated bone cement (AIBC) to those rates in procedures not using AIBC. METHODS: A systematic review and meta-analysis was conducted in search for randomized controlled trials/studies (RCTs) pertaining to the field of antibiotic AIBC vs non-AIBC groups in both primary and revision TKA procedures. The primary literature search performed was to identify all RCTs that assessed AIBC in primary and revision TKA procedures...
December 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/29312846/role-of-fast-setting-cements-in-arthroplasty-a-comparative-analysis-of-characteristics
#3
Neil Ayron Caraan, Reinhard Windhager, Jason Webb, Nadine Zentgraf, Klaus-Dieter Kuehn
AIM: To evaluate the behaviour of two fast-setting polymethylmethacrylate (PMMA) cements CMW® 2G and Palacos® fast R + G, as reference: Standard-setting Palacos® R + G. METHODS: The fast-setting cements CMW® 2G and Palacos® fast R + G were studied, using standard-setting high viscosity Palacos® R + G as a reference. Eleven units (of two batch numbers) of each cement were tested. All cements were mixed as specified by the manufacturer and analysed on the following parameters: Handling properties (mixing, waiting, working and hardening phase) according to Kuehn, Mechanical properties according to ISO 5833 and DIN 53435, Fatigue strength according to ISO 16402, Benzoyl Peroxide (BPO) - Content by titration, powder/liquid-ratio by weighing, antibiotic elution profile by High Performance Liquid Chromatography...
December 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/29301167/acute-kidney-injury-after-total-knee-arthroplasty-a-clinical-review
#4
Ahmed Siddiqi, Peter B White, Jennifer I Etcheson, Nicole E George, Chukwuweike U Gwam, Jaydev B Mistry, Nirav G Patel, Hephizibah Adam, Ronald E Delanois
INTRODUCTION: Patients who develop acute kidney injury (AKI) have an increased risk for progression to chronic kidney disease, end-stage renal disease, and increased mortality. The outcomes of total knee arthroplasty (TKA) patients who develop AKI have remained controversial. The purpose of this review was to summarize and identify the current literature focused on 1) major risk factors, 2) short-term outcomes, and 3) costs associated with the development of perioperative AKI after TKA...
December 22, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29282858/release-of-vancomycin-and-tobramycin-from-polymethylmethacrylate-cements-impregnated-with-calcium-polyphosphate-hydrogel
#5
Zubin Zhou, Joe Seta, David C Markel, Wei Song, Sally M Yurgelevic, Xiao Wei Yu, Weiping Ren
The influence of calcium polyphosphate (CPP) gel incorporation on the release of vancomycin and tobramycin from polymethyl methacrylate (PMMA) cement (Simplex P, SP) has been studied. Adding 10% CPP gel to SP led to a much lower burst release of vancomycin and considerably extended release of both vancomycin and tobramycin up to 24 weeks. Antibiotics released from this new material retain their bactericidal activity for up to 15 weeks. The improvement in the antibiotic release is mainly due to the molecular interactions of antibiotics with embedded CPP polyphosphate chains as confirmed by Raman spectroscopy analysis...
December 28, 2017: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/29275114/in-hospital-acute-kidney-injury-after-tka-revision-with-placement-of-an-antibiotic-cement-spacer
#6
Zachary P Berliner, Andrew Z Mo, David A Porter, Jamie M Grossman, Matthew S Hepinstall, H John Cooper, Giles R Scuderi
BACKGROUND: There is mounting evidence that treatment of periprosthetic joint infection of the knee with an antibiotic cement spacer (ACS) may increase risk for acute kidney injury (AKI). We sought to determine the incidence, as well as potential risk factors, of in-hospital AKI in this cohort. METHODS: We retrospectively identified 75 patients that received either a static or articulating ACS at a single institution. In-hospital AKI was defined by a more than 50% rise in serum creatinine from preoperative baseline to at least 1...
December 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29230489/-potential-of-allogeneic-bone-grafts-as-antibiotic-carriers-effect-of-different-preparation-processes-on-efficacy
#7
REVIEW
D C Coraça-Huber, M Nogler, K-D Kühn
BACKGROUND: The rising number of primary joint replacements worldwide is causing an increase of endoprosthetic revision surgery due bacterial infection. Revision surgery using non-cemented implants seems beneficial for the long-term outcome, and the use of antibiotic-impregnated bone grafts might control the infection and provide a good support for the implant. In this study, we evaluated the release of antibiotics from fresh-frozen and lyophilized allogeneic bone grafts. METHODS: Heat-treated, lyophilized and fresh frozen cryopreserved bone chips were impregnated with gentamicin sulphate, gentamicin palmitate and vancomycin, and calcium carbonate/calcium sulphate treated with antibiotics...
December 11, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/29201302/antibiotic-spacers-in-shoulder-arthroplasty-comparison-of-stemmed-and-stemless-implants
#8
Eric M Padegimas, Alexia Narzikul, Cassandra Lawrence, Benjamin A Hendy, Joseph A Abboud, Matthew L Ramsey, Gerald R Williams, Surena Namdari
Background: Antibiotic spacers in shoulder periprosthetic joint infection deliver antibiotics locally and provide temporary stability. The purpose of this study was to evaluate differences between stemmed and stemless spacers. Methods: All spacers placed from 2011 to 2013 were identified. Stemless spacers were made by creating a spherical ball of cement placed in the joint space. Stemmed spacers had some portion in the humeral canal. Operative time, complications, reimplantation, reinfection, and range of motion were analyzed...
December 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/29197943/two-stage-revision-of-infected-shoulder-arthroplasty-using-prosthesis-of-antibiotic-loaded-acrylic-cement-minimum-three-year-follow-up
#9
Sung Hyun Lee, Se Jin Kim, Seng Hwan Kook, Jeong Woo Kim
PURPOSE: This study aimed to evaluate the clinical outcomes and persistent infection rate of two-stage revision of infected shoulder arthroplasty. METHODS: We enrolled 12 patients who developed an infection after undergoing shoulder arthroplasty between January 2009 and January 2014. They underwent a two-stage revision with PROSTALAC implantation and shoulder re-implantation in the first- and second-stage surgery, respectively. The mean follow-up period was 40.88 months (range, 36-52 months)...
December 2, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29188677/scanning-electron-3d-confocal-and-stereotactic-microscopies-morpho-structural-analysis-of-antibiotic-loaded-cement-porosity-in-three-different-formulations
#10
D Fenga, G Vermiglio, F Traina, A Favaloro, M A Rosa
Chronic osteoarticular infections such as osteomyelitis or periprosthetic joint infection (PJI) have become a growing problem over the years. The “gold standard” in local antibiotic administration is still the antibiotic-loaded acrylic bone cement (ALABC) which is used in both prophylaxis, because it has been shown it can reduce the risk of infection and used in therapy during a “two-stage surgery” in PJI or in chronic osteomyelitis. We performed morphological analysis of three different formulations of antibiotic-loaded cement (ALABC) using techniques of light microscopy, scanning electron microscopy (SEM) and 3D immunofluorescence, in order to explain how the morphological aspects of cement could influence and modulate antibiotic elution...
October 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29188174/diagnosis-of-persistent-infection-in-prosthetic-two-stage-exchange-pcr-analysis-of-sonication-fluid-from-bone-cement-spacers
#11
Sandrine Mariaux, Ulrika Furustrand Tafin, Olivier Borens
Introduction: When treating periprosthetic joint infections with a two-stage procedure, antibiotic-impregnated spacers are used in the interval between removal of prosthesis and reimplantation. According to our experience, cultures of sonicated spacers are most often negative. The objective of our study was to investigate whether PCR analysis would improve the detection of bacteria in the spacer sonication fluid. Methods: A prospective monocentric study was performed from September 2014 to January 2016. Inclusion criteria were two-stage procedure for prosthetic infection and agreement of the patient to participate in the study...
2017: Journal of Bone and Joint Infection
https://www.readbyqxmd.com/read/29188173/influence-of-sonication-on-bacterial-regrowth-from-antibiotic-loaded-pmma-scaffolds-an-in-vitro-study
#12
Martin Clauss, Esther Laschkolnig, Susanne Graf, Klaus-Dieter Kühn
Periprosthetic joint infection (PJI) is one of the most challenging complications after joint replacement. However, when treated correctly, chances of recovery are good. The most important step in correct diagnosis and management of PJI is the detection of the causative germ. In the last years, the use of sonication in the diagnostic process has become more important. However, this diagnostic methodology has been controversially discussed when used in combination with antibiotic loaded bone cement (PMMA), which is frequently used in joint replacement surgeries...
2017: Journal of Bone and Joint Infection
https://www.readbyqxmd.com/read/29184978/chronic-infection-and-infected-non-union-of-the-long-bones-in-paediatric-patients-preliminary-results-of-bone-versus-beta-tricalcium-phosphate-grafting-after-induced-membrane-formation
#13
Marie Rousset, Marjolaine Walle, Ludivine Cambou, Mounira Mansour, Antoine Samba, Bruno Pereira, Ismat Ghanem, Federico Canavese
PURPOSE: Chronic infection (CO) and infected non-union of the long bones are relatively rare conditions in paediatric patients. Large bone defects secondary to these conditions can be managed with the induced membrane technique. The technique requires grafting of the bone void, although it is not yet established what bone substitute is the best option. The aim of this work was to evaluate the outcome and efficacy of treatment in children with CO and infected non-union of the long bones using the induced membrane technique and bone (BG) versus beta-tricalcium phosphate (BTP) grafting...
November 28, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29181352/a-case-report-of-dual-incision-technique-for-total-femur-arthroplasty-as-a-salvage-procedure-in-infected-non-unions
#14
Aniruddh Agrawal, Vinod Agrawal, Sandeepkumar Yadav, Shushil K Soni, Sawan Kumar Pawar
Introduction: Total femur arthroplasty (TFA) is a rare salvage limb procedure which serves as an effective alternative to limb amputation. Most commonly, it is indicated for oncologic orthopedic cases, and very few cases of a purely traumatic history for TFA have been documented. The decision to perform this complex procedure involves paying careful attention to reconstructive needs and functional expectations of the patient. Alternatives to this procedure are quite detrimental and include hip disarticulation and above-the-knee amputation...
July 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29178309/antibiotic-loaded-bone-cement-as-prophylaxis-in-total-joint-replacement
#15
REVIEW
Javier Martínez-Moreno, Virginia Merino, Amparo Nácher, José Luis Rodrigo, Mónica Climente, Matilde Merino-Sanjuán
One of its most serious complications associated with arthroplasty is the development of infections. Although its prevalence is only between 0.5% and 3%, in some cases it can lead to death. Therefore, an important challenge in joint surgery is the prevention of infections when an arthroplasty is performed. The use of antibiotic-loaded cements could be a suitable tool due to numerous advantages. The main advantage of the use of antibiotic loading into bone cement derives directly from antibiotic release in the effect site, allowing achievement of high concentrations at the site of action, and minimal or no systemic toxicity...
November 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/29157990/new-method-for-antibiotic-release-from-bone-cement-polymethylmethacrylate-redefining-boundaries
#16
E Carbó-Laso, P Sanz-Ruiz, J C Del Real-Romero, Y Ballesteros-Iglesias, E Paz-Jiménez, F Arán-Ais, M Sánchez-Navarro, M A Pérez-Limiñana, I López-Torres, J Vaquero-Martín
INTRODUCTION: The increasing antimicrobial resistance is promoting the addition of antibiotics with high antistaphylococcal activity to polymethylmethacrylate (PMMA), for use in cement spacers in periprosthetic joint infection. Linezolid and levofloxacin have already been used in in-vitro studies, however, rifampicin has been shown to have a deleterious effect on the mechanical properties of PMMA, because it inhibits PMMA polymerization. The objective of our study was to isolate the rifampicin during the polymerization process using microencapsulation techniques, in order to obtain a PMMA suitable for manufacturing bone cement spacers...
November 17, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29138696/use-of-common-inflammatory-markers-in-the-long-term-screening-of-total-hip-arthroprosthesis-infections-our-experience
#17
Gabriele Falzarano, Antonio Piscopo, Predrag Grubor, Giuseppe Rollo, Antonio Medici, Valerio Pipola, Michele Bisaccia, Auro Caraffa, Elizabeth Mary Barron, Francesco Nobile, Raffaele Cioffi, Luigi Meccariello
Orthopedic implants have become essential components of modern medicine. The risk of infection of total hip arthroplasty (THA) is 1.5%-2%. Are the C-reactive protein (CRP), the erythrocyte sedimentation rate (ESR), and procalcitonin (PCT) good markers for THA infection screenings? From February 2009 to December 2012 at our Department of Orthopedics and Traumatology, 1248 patients were treated with THA. No prosthesis was cemented. All patients received antibiotic prophylaxis. All patients were discharged approximately 7...
2017: Advances in Orthopedics
https://www.readbyqxmd.com/read/29114643/analytical-evaluation-of-a-vancomycin-immunoassay-in-synovial-fluid
#18
REVIEW
Francesca Luceri, Fiamma Balboni, Giovanni Balato, Paola Pezzati, Nicoletta Cini, Gianni Virgili, Andrea Baldini
In clinical laboratories performing routine activities, the need to answer the burning clinical question in emerging field may be limited by lack of technology support or assays accessibility. Commercially available methods, although originally validated for specific biological matrices, may be employed for other matrices, following appropriate guidelines such as Clinical and Laboratory Standards Institute (CLSI) EP 19. We investigated the use of a vancomycin assay with synovial fluid samples, in view of a possible employment in vancomycin release study...
June 2017: Joints
https://www.readbyqxmd.com/read/29104387/evaluation-of-antimicrobial-efficacy-of-various-intracanal-medicaments-in-primary-teeth-an-in-vivo-study
#19
Brahmananda Dutta, Kanika S Dhull, Debasmita Das, P V Samir, Rajnish K Verma, Nipa Singh
Introduction: Bacteria and their products play a primary etiological role in the initiation and perpetuation of pulpoperiapical pathosis. Intracanal medication is important for endodontic success as it eliminates microorganisms that persist after chemomechanical preparation. Aim: To compare antimicrobial efficacy of calcium hydroxide powder, triple antibiotic paste, calcium hydroxide with 2% chlorhexidine solution, and triple antibiotic paste with 2% chlorhexidine solution...
July 2017: International Journal of Clinical Pediatric Dentistry
https://www.readbyqxmd.com/read/29103776/systemic-absorption-of-antibiotics-from-antibiotic-loaded-cement-spacers-for-the-treatment-of-periprosthetic-joint-infection
#20
Adam I Edelstein, Kamil T Okroj, Thea Rogers, Craig J Della Valle, Scott M Sporer
BACKGROUND: Two-stage treatment of periprosthetic joint infections involves placement of high-dose antibiotic-loaded cement spacers (ACSs). Reports of ACS-induced nephrotoxicity have raised concern regarding systemic absorption of antibiotics after ACS placement. We sought to characterize the serum concentrations of antibiotics that occur after ACS placement. METHODS: We performed a prospective study of patients with an infected primary total hip (THA) or knee arthroplasty (TKA) treated with standardized ACSs with vancomycin, gentamicin, and tobramycin...
October 5, 2017: Journal of Arthroplasty
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