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antibiotics and cements

Vajara Wilairatana, Peerasit Sinlapavilawan, Sittisak Honsawek, Noppachart Limpaphayom
BACKGROUND: The aim was to compare serum levels of interleukin-6 (SIL6), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and joint fluid IL-6 (JIL-6) level between total knee arthroplasty (TKA) that used bone cement (BC group) and antibiotic-loaded bone cement (ALBC group). MATERIALS AND METHODS: Thirty-nine patients (40 TKAs) with a mean age of 69.6 years were non-randomly assigned to the BC or ALBC groups. Samples of SIL6, ESR, and CRP were collected at baseline and at 24 h, 72 h, and 4 weeks after surgery...
October 21, 2016: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
Michael G Ficklin, Michael P Kowaleski, Kevin A R Kunkel, Jonathan T Suber
A two-year-old, 44 kg dog with a right Helica cementless total hip replacement (THR) was radiographically diagnosed with implant loosening eight months after the index total hip replacement procedure. Subsequent synoviocentesis and synovial fluid culture revealed a methicillin-resistant coagulase-negative Staphylococcus spp infection of the right THR. A one-stage revision using a hybrid BFX cementless acetabular cup and CFX cemented femoral stem was performed. Vancomycin and micro-silver antimicrobial powder impregnated cement were used in the revision...
October 20, 2016: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
Massimo Del Fabbro, Stefano Corbella, Patrick Sequeira-Byron, Igor Tsesis, Eyal Rosen, Alessandra Lolato, Silvio Taschieri
BACKGROUND: When primary root canal therapy fails, periapical lesions can be retreated with or without surgery. Root canal retreatment is a non-surgical procedure that involves removal of root canal filling materials from the tooth, followed by cleaning, shaping and obturating of the canals. Root-end resection is a surgical procedure that involves exposure of the periapical lesion through an osteotomy, surgical removal of the lesion, removal of part of the root-end tip, disinfection and, commonly, retrograde sealing or filling of the apical portion of the remaining root canal...
October 19, 2016: Cochrane Database of Systematic Reviews
Ayman M Ebied, Adel I Elseedy, Osama Gamal
BACKGROUND: Staged revision for periprosthetic infection of the hip is an accepted and widely used technique by many surgeons. However, single-stage exchange of the hip prosthesis remains an attractive option to others because of the advantages of reduced morbidity, shorter treatment time and hospital stay in addition to the reduced cost of treatment. HYPOTHESIS: Single-stage revision for periprosthetic hip infection can achieve excellent results if a specific protocol for patients' selection and management is followed...
October 10, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Ahmed Elsadek Fakhr, Maha Kamal Gohar, Amal Hassan Atta
Fecal contamination of drinking water is a major health problem which accounts for many cases of diarrhea mainly in infants and foreigners. This contamination is a complex interaction of many parameters. Antibiotic resistance among bacterial isolates complicates the problem. The study was done to identify fecal contamination of drinking water by Diarrheagenic Antibiotic-Resistant Escherichia coli in Zagazig city and to trace reasons for such contamination, three hundred potable water samples were investigated for E...
2016: International Journal of Microbiology
Jared M Newman, Jaiben George, Alison K Klika, Stephen F Hatem, Wael K Barsoum, W Trevor North, Carlos A Higuera
BACKGROUND: Periprosthetic joint infection is a serious complication after THA and commonly is treated with a two-stage revision. Antibiotic-eluting cement spacers are placed for local delivery of antibiotics. Aspirations may be performed before the second-stage reimplantation for identification of persistent infection. However, limited data exist regarding the diagnostic parameters of synovial fluid aspiration with or without saline lavage from a hip with an antibiotic-loaded cement spacer...
September 26, 2016: Clinical Orthopaedics and related Research
Hui Lu, Qiang Chen, Hu Yang, Hui Shen
UNLABELLED: The goal of our study was to report the clinical presentation, treatment, and complications of enchondroma in the distal phalanx of the finger. This was a retrospective study of 34 patients (19 women and 15 men) who underwent surgery between May 2004 and September 2012 for enchondroma in the distal phalanx of the finger. The average age of the patients was 39.38 ± 10.97 years old (range 14-59). The presenting symptoms and imaging features were recorded. The surgical procedure was performed under regional or general anesthesia...
September 2016: Medicine (Baltimore)
Federico Canavese, Marco Corradin, Ahmad Khan, Mounira Mansour, Marie Rousset, Antoine Samba
PURPOSE: Chronic osteomyelitis and infected nonunion are relatively rare conditions in pediatric patients and are more frequently seen in developing countries. Although relatively rare, they are medically and surgically challenging. Here we report a novel surgical technique used to manage five patients with chronic osteomyelitis of long bones. METHODS: Five skeletally immature patients with chronic osteomyelitis and infected nonunion of the long bones were treated surgically between 2010 and 2014 by a combination of resection of necrotic infected bone, debridement of surrounding soft tissue, and application of antibiotic-laden cement spacer inducing periosteal membrane before final bone reconstruction...
September 19, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Débora C Coraça-Huber, Christoph G Ammann, Michael Nogler, Manfred Fille, Lars Frommelt, Klaus-Dieter Kühn, Christian Fölsch
The rising number of primary joint replacements worldwide causes an increase of revision surgery of endoprostheses 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 give a good support for the implant. In this study we evaluated the release of antibiotics from fresh-frozen and lyophilized allogeneic bone grafts. Lyophilized bone chips and fresh frozen bone chips were mixed with gentamicin sulphate, gentamicin palmitate, vancomycin, calcium carbonate/calcium sulphate impregnated with gentamicin sulphate, and calcium carbonate/calcium sulphate bone substitute material impregnated with vancomycin...
September 8, 2016: Cell and Tissue Banking
Lucy C Walker, Paul Baker, Richard Holleyman, David Deehan
PURPOSE: The use of antibiotic-loaded bone cement (ALBC) has a range of indications for use in orthopaedics. It has the advantage of delivering high loads of antibiotics to a targeted site, thereby avoiding the side effects associated with systemic administration. However, there is concern that the use of ALBC may precipitate the development of antibiotic-resistant bacteria. METHODS: This review focuses on (1) the published research using both animal and human models examining the association between ALBC and the induction of microbial resistance (2) the mechanisms by which antimicrobial resistance develop (3) the research pertaining to specific classes of antibiotics commonly used in orthopaedic practice (4) the recent developments in calcium sulphate beads, nanoparticles and chitosan, as alternative antimicrobial treatments for periprosthetic joint infections...
September 12, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
A Schiavone Panni, K Corona, M Giulianelli, G Mazzitelli, C Del Regno, M Vasso
PURPOSE: Antibiotic-loaded bone cement has been widely used for the treatment of infected knee replacement, but its routine use in primary TKA remains controversial. The aim of this systematic review was to analyze the literature about the antimicrobial efficacy and safety of antibiotic-loaded bone cement for its prophylactic use in primary TKA. METHODS: A detailed and systematic search of the Pubmed, Medline, Cochrane Reviews and Google Scholar databases had been performed using the keyword "total knee arthroplasty" "total knee replacement" "total knee prosthesis" and "antibiotic-loaded bone cement" with no limit regarding the year of publication...
October 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Surajit Mistry, Subhasis Roy, Nilendu Jyoti Maitra, Biswanath Kundu, Abhijit Chanda, Someswar Datta, Mathew Joy
This article discloses the development of an effective and versatile technology to prepare a novel antibiotics-loaded biodegradable composite bone cement to treat methicillin-resistant Staphylococcal (MRSA) osteomyelitis and reports its detail in vitro characterization, drug loading efficiency, physico-mechanical properties, drug elution in simulated body fluid (SBF) and human plasma, merits and demerits over poly-methyl methacrylate (PMMA) cement. Chronic osteomyelitis in rabbit tibia (42) was induced by MRSA and composite cement was implanted to evaluate its safety and efficacy over PMMA cement and parenteral treated animals with histopathology, radiographs, bone/plasma drugs concentration, and SEM for 90days...
October 10, 2016: Journal of Controlled Release: Official Journal of the Controlled Release Society
J Zou, Z Shi, G Mei, J Xue, W Gu, X Li
INTRODUCTION: Tuberculosis (TB) in midfoot is often secondary to tuberculosis elsewhere in the body. The experience and literatures to treat midfoot tuberculosis are rare. Up until now, no successful method is reported to treat midfoot tuberculosis. HYPOTHESIS: Stage surgery is an effective method to treat midfoot bone TB. MATERIAL AND METHODS: Between January 2008 to January 2011, 14 patients who were diagnosed midfoot tuberculosis and suffered stage operation were enrolled...
August 26, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Xin Yu, Hongri Wu, Jianhua Li, Zhao Xie
PURPOSE: Recently we modified the Masquelet technique by using an antibiotic cement-coated locking plate as a temporary internal fixator when treating septic bone defects. This modification is in order to prevent the complications related to external fixator use and provides the involved limb with a greater stability to undergo earlier and more vigorous physical therapy for recovery of joint function. The purpose of this study was to assess the outcomes of large femoral osteomyelitis defects managed by Masquelet technique combined with the antibiotic cement-coated locking plate used as a temporary internal fixator...
August 13, 2016: International Orthopaedics
Leo A Whiteside, M E Roy
BACKGROUND: Two-stage revision surgery for infected total hip arthroplasty (THA) is commonly advocated, but substantial morbidity and expense are associated with this technique. In certain cases of infected THA, treatment with one-stage revision surgery and intraarticular infusion of antibiotics may offer a reasonable alternative with the distinct advantage of providing a means of delivering the drug in high concentrations. QUESTIONS/PURPOSES: We describe a protocol for intraarticular delivery of antibiotics to the hip through an indwelling catheter combined with one-stage revision surgery and examine (1) the success as judged by eradication of infection at 1 year when treating chronically infected cemented stems; (2) success in treating late-onset acute infections in well-ingrown cementless stems; and (3) what complications were associated with this approach in a small case series...
August 10, 2016: Clinical Orthopaedics and related Research
John M Hardcastle, David H So, Gwo-Chin Lee
BACKGROUND: Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are important markers in the evaluation and treatment of painful total knee arthroplasty (TKA). Elevation of both markers usually occurs with infected TKAs while a normal ESR and CRP usually point to aseptic causes for failure. The purpose of this study is to compare (1) rate of revision, (2) infection, and (3) reason for reoperation in a group of patients undergoing revision TKA with a single abnormality in either ESR or CRP in an otherwise negative conventional infection work-up compared to patients with normal preoperative ESR and CRP...
July 5, 2016: Journal of Arthroplasty
Sze-Ann Woon, Dale Fisher
BACKGROUND: There is no more challenging a group of pharmaceuticals than antimicrobials. With the antibiotic era came great optimism as countless deaths were prevented from what were previously fatal conditions. Although antimicrobial resistance was quickly identified, the abundance of antibiotics entering the market helped cement attitudes of arrogance as the "battle against pestilence appeared won". Opposite emotions soon followed as many heralded the return of the pre-antibiotic era, suggesting that the "antibiotic pipeline had dried up" and that our existing armament would soon be rendered worthless...
2016: BMC Medicine
Gregory Vrabec, Willis Stevenson, Sameh Elguizaoui, Matthew Kirsch, John Pinkowski
BACKGROUND: Antibiotic-impregnated bone cement has increased in popularity as an effort to reduce the risk of infection in high-risk TKAs. However, limited data has been reported regarding antibiotic levels achieved when using tobramycin-impregnated bone cement after implanting total knee components. QUESTIONS/PURPOSES: We asked: (1) What is the tobramycin serum and knee intraarticular levels in patients undergoing primary TKA using tobramycin cement? (2) What is the intraarticular tobramycin level for patients receiving only intravenous tobramycin? METHODS: All patients undergoing primary TKA by one of the two study surgeons (GV, JP) during a 6-month period were evaluated for inclusion and invited to participate...
November 2016: Clinical Orthopaedics and related Research
Nicholas Graves, Catherine Wloch, Jennie Wilson, Adrian Barnett, Alex Sutton, Nicola Cooper, Katharina Merollini, Victoria McCreanor, Qinglu Cheng, Edward Burn, Theresa Lamagni, Andre Charlett
BACKGROUND: A deep infection of the surgical site is reported in 0.7% of all cases of total hip arthroplasty (THA). This often leads to revision surgery that is invasive, painful and costly. A range of strategies is employed in NHS hospitals to reduce risk, yet no economic analysis has been undertaken to compare the value for money of competing prevention strategies. OBJECTIVES: To compare the costs and health benefits of strategies that reduce the risk of deep infection following THA in NHS hospitals...
July 2016: Health Technology Assessment: HTA
Oliver Bissinger, Kilian Kreutzer, Klaus-Dietrich Wolff, Gabriele Wexel, Alexander Hapfelmeier, Christoph Pautke, Stephan Vogt, Peter Michael Prodinger, Thomas Tischer
Cefuroxime is widely used for antibiotic prophylaxis in orthopedic surgery. However, a recent study indicated a dose-dependent reduction in osteoblast function in vitro. Nevertheless, cell culture might not sufficiently imitate the complex process of bone remodeling. As data concerning possible in vivo interactions of cefuroxime on fracture healing are completely missing, we investigated the following hypothesis: Does Cefuroxime impair bone healing in vivo? Therefore, 34 male Wistar rats were randomised to cefuroxime-treated or control groups, a Kirschner wire was inserted into right femora and closed transverse fractures were produced...
July 27, 2016: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
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