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antibiotics and cements

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28690040/bioactivity-of-ceftazidime-and-fluconazole-included-in-polymethyl-methacrylate-bone-cement-for-use-in-arthroplasty
#7
J Martínez-Moreno, V Merino, A Nácher, J L Rodrigo, Blanca B Bonet Yuste, M Merino-Sanjuán
BACKGROUND: The microorganisms that most frequently cause prosthetic joint infection are methicillin-resistant Staphylococcus aureus and gram-negative aerobic bacillus. Studies have documented the efficacy of mixing antibiotics with polymethyl methacrylate, but that of antifungal drugs has not received much attention. The objective of this in vitro study was to characterize the elution profile and bioactivity of ceftazidime and fluconazole when incorporated into bone cement in proportions intended for prophylaxis and treatment of bone infections...
May 4, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28684112/tibiotalocalcaneal-fusion-with-a-cemented-coated-retrograde-nail-as-a-salvage-procedure-for-infected-orif-of-the-ankle
#8
M Herrera-Pérez, J Boluda-Mengod, M J Gutierrez-Morales, J L Pais-Brito
Tibiotalocalcaneal arthrodesis is an effective salvage procedure in cases of combined ankle and subtalar osteoarthritis as well as severe multiplanar deformities and severe joint destruction of the hindfoot. Special mention should be made of this procedure in cases of bone loss, especially from the talus, secondary to failed previous surgeries or bone infection, often being the only way to achieve a stable and painless foot and ankle. We present a case of ankle fracture in a patient with associated morbidity and multiple complications following osteosynthesis, in which tibiotalocalcaneal arthrodesis with cemented with antibiotic coated retrograde nail has achieved a satisfactory final result...
July 3, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28683496/-prosthetic-joint-infection-after-total-hip-arthroplasty-results-of-an-online-questionnaire-about-current-diagnostic-and-therapeutic-procedures-in-107-german-hospitals
#9
Elia Raoul Langenmair, Lukas Konstantinidis, Norbert P Südkamp, Peter Helwig
Background Prosthetic hip joint infection is a common severe complication with a high socio-economic impact. The inconsistency of the available data and the absence of binding guidelines lead to a variety of diagnostic and therapeutic strategies. The aim of this study is to present the current diagnostic and therapeutic approach to treating infections after total hip arthroplasties in German hospitals, link it with current evidence, and evaluate the willingness of these hospitals to participate in prospective multicentre trials...
June 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28656873/health-related-quality-of-life-with-long-term-retention-of-the-prosthesis-of-antibiotic-loaded-acrylic-cement-system-following-infection-resolution-in-low-demand-patients
#10
Lauren A Beaupre, Kyle Stampe, Edward Masson, Gregory O'Connor, Marcia Clark, A Mark Joffe, Lesia R Boychuk, Guy Lavoie
BACKGROUND: The study purpose was to (1) evaluate health-related quality of life (HRQL) with the PROSthesis of Antibiotic Loaded Acrylic Cement (PROSTALAC) in situ for infected total hip arthroplasty (THA), (2) determine infection resolution, and (3) compare subjects who underwent second stage surgery with those who retained the PROSTALAC on a longer term basis. METHODS: Demographics, physical demand level, and comorbidities were recorded prospectively in 29 subjects followed to at least 24 months after initial PROSTALAC insertion...
May 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28656144/antibiotic-elution-from-hip-and-knee-acrylic-bone-cement-spacers-a-systematic-review
#11
REVIEW
Konstantinos Anagnostakos, Christof Meyer
Knowledge about the elution from antibiotic-loaded cement spacers is an indispensable premise for guarantee of clinical success. A systematic literature search was performed through PubMed. Search terms were "antibiotic elution" and "antibiotic release" in combination with "spacer," "hip spacer," and "knee spacer," respectively. A total of 11 studies could be identified. Seven studies reported on the release of antibiotics after spacer implantation, three studies at spacer removal, and one study on both time points...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28653761/a-prospective-clinical-study-of-regenerative-endodontic-treatment-of-traumatised-immature-teeth-with-necrotic-pulps-using-bi-antibiotic-paste
#12
H Nazzal, K Kenny, A Altimimi, J Kang, M S Duggal
AIM: To evaluate the treatment outcomes of a revitalisation endodontic technique (RET) for the management of traumatised immature teeth with necrotic pulps in children. METHODOLOGY: Fifteen healthy children (age range=7-10 years) with traumatised immature maxillary incisors with necrotic pulps treated with bi-antibiotic revitalisation endodontic techniques were prospectively assessed over approximately two years (mean=22 months). One operator undertook all treatments, clinical reviews and standardised radiographic exposures with radiographic analysis being carried out by two calibrated experienced clinicians...
June 27, 2017: International Endodontic Journal
https://www.readbyqxmd.com/read/28653101/ct-guided-cement-sacroplasty-csp-as-pain-therapy-in-non-dislocated-insufficiency-fractures
#13
Reimer Andresen, Sebastian Radmer, Mathias Wollny, Julian Ramin Andresen, Urs Nissen, Hans-Christof Schober
INTRODUCTION: In elderly patients with reduced bone quality, insufficiency fractures of the sacrum are relatively common and are typically associated with severe disabling pain. The objective of the present study was to examine the feasibility of cement augmentation by CSP, to determine post-interventional leakages and other complications, and to present the outcome of pain over the course of 18 months. MATERIALS AND METHODS: In 23 patients (20 women and 3 men) with an average age of 81...
June 26, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28646693/antibacterial-effect-of-genetically-engineered-bacteriophage-%C3%AF-ef11-%C3%AF-fl1c-%C3%AE-36-p-nisa-on-dentin-infected-with-antibiotic-resistant-enterococcus-faecalis
#14
Justine Monnerat Tinoco, Nadia Liss, Hongming Zhang, Roni Nissan, Wanda Gordon, Eduardo Tinoco, Luciana Sassone, Roy Stevens
OBJECTIVE: Enterococcus faecalis is a gram-positive facultative anaerobic bacterium, which is present in 30-89% of teeth with postendodontic treatment failures. E. faecalis is capable of penetrating dentinal tubules and surviving as a monoculture after conventional endodontic therapy, indicating that it is resistant to commonly used endodontic disinfection protocols. Different E. faecalis strains have shown resistance to several antibiotics, and have been associated with both dental pathology and systemic infections...
June 12, 2017: Archives of Oral Biology
https://www.readbyqxmd.com/read/28643095/-local-antibiotic-therapy
#15
REVIEW
Klaus-Dieter Kühn, Nora Renz, Andrej Trampuz
The treatment of superficial wound infections with local antibiotics is considered to be problematic as it is accompanied by an increased risk of resistance development and ineffectiveness in deeper regions. On the contrary, the local application of antibiotics is useful in arthroplasty and necessary if implants are utilized. The reason for this is the prevention of a rapid biofilm formation on foreign implants and a resulting infection may remain undiscovered until it becomes chronic. Apart from exogenous material, necrotic tissue (e...
July 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28639529/circular-external-fixation-and-cemented-pmma-spacers-for-the-treatment-of-complex-tibial-fractures-and-infected-nonunions-with-segmental-bone-loss
#16
Andries H van Niekerk, Franz F Birkholtz, Phillip de Lange, Kevin Tetsworth, Erik Hohmann
PURPOSE: The purpose of this study was to compare the outcome of combined circular external fixation and cemented polymethylmethacrylate (PMMA) spacer application between a cohort of patients with grade 3 open fractures and infected tibial nonunions and concomitant segmental bone loss. METHODS: The study was designed as a retrospective cohort study. All patients who were treated for complex tibial fractures or infected nonunions with segmental bone loss between 2009 and 2013 were included if they were aged between 16 years and 60 years, sustained acute traumatic grade 3 open tibial fractures, presented with infected nonunion, and were followed up for a minimum of 12 months...
May 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28606606/potential-risks-of-using-cement-augmented-screws-for-spinal-fusion-in-patients-with-low-bone-quality
#17
M Martín-Fernández, A López-Herrradón, A R Piñera, F Tomé-Bermejo, J M Duart, M D Vlad, M G Rodríguez-Arguisjuela, L Álvarez-Galovich
BACKGROUND CONTEXT: Dramatic increases in the average life expectancy have led to increases in the variety of degenerative changes and deformities observed in the aging spine. The elderly population can present challenges for spine surgeons, not only because of increased comorbidities, but also because of the quality of their bones. Pedicle screws are the implants used most commonly in spinal surgery for fixation, but their efficacy depends directly on bone quality. While PMMA-augmented screws represent an alternative for patients with osteoporotic vertebrae, their use has raised some concerns due to the possible association between cement leakages (CLs) and other morbidities...
June 9, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28606128/outcomes-of-cement-beads-and-cement-spacers-in-the-treatment-of-bone-defects-associated-with-post-traumatic-osteomyelitis
#18
Xu-Sheng Qiu, Yi-Xin Chen, Xiao-Yang Qi, Hong-Fei Shi, Jun-Fei Wang, Jin Xiong
BACKGROUND: Cement spacers (Masquelet technique) have traditionally been used for the treatment of segmental bone defects. However, no reports have used cement spacers for the treatment of small/partial segmental bone defects associated with osteomyelitis and compared the outcomes with cement beads. METHODS: We retrospectively analysed 40 patients with post-traumatic osteomyelitis of the tibia who underwent treatment, which was performed in two stages. In the first stage, thorough debridement was performed, and bone defects were filled with either antibiotic-impregnated cement beads (bead group, 18 patients) or spacers (spacer group, 22 patients)...
June 12, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28578840/acute-kidney-injury-after-first-stage-joint-revision-for-infection-risk-factors-and-the-impact-of-antibiotic-dosing
#19
Jeffrey A Geller, Gregory Cunn, Thomas Herschmiller, Taylor Murtaugh, Antonia Chen
BACKGROUND: Scarce literature exists regarding risk factors associated with postoperative acute kidney injury (AKI) after first-stage revision procedures. The purpose of this study was to determine risk factors for AKI and the efficacy of intra-articular antibiotics in infection eradication. METHODS: We retrospectively identified 247 patients who underwent a 2-stage revision procedure for the treatment of hip or knee periprosthetic joint infection. We applied previously published diagnostic criteria for AKI to determine its incidence and risk factors for its development...
May 4, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28550428/partial-component-retained-two-stage-reconstruction-for-chronic-infection-after-uncemented-total-hip-arthroplasty-results-of-sixteen-cases-after-five-years-of-follow-up
#20
Kun-Hui Chen, Shang-Wen Tsai, Po-Kuei Wu, Cheng-Fong Chen, Hsin-Yi Wang, Wei-Ming Chen
PURPOSE: Two-stage reconstruction with total implant removal and re-implantation after infection control is considered the gold standard treatment for infection after hip arthroplasty. However, removal of the well-fixed stem or cup may cause substantial bone loss and other complications, thereby making reconstruction difficult. We evaluated whether an infection post total hip arthroplasty can be treated without removal of the radiographically and clinically well-fixed femoral stem or acetabular cup...
May 27, 2017: International Orthopaedics
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