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Orthopaedic infection

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https://www.readbyqxmd.com/read/28336040/the-impact-of-negative-pressure-wound-therapy-on-orthopaedic-infection
#1
REVIEW
Lawrence X Webb
By hastening the resolution of edema and improving local microcirculation, topical negative pressure wound therapy (TNP) aids the establishment of early wound coverage. Its use in the setting of type III open fractures is reviewed. The author's initial use of TNP for closed surgical incisions and how it morphed its way into being applied to closed surgical wounds with heightened likelihood for infection is presented. Several case studies are presented to illustrate the role and the technique for management of acute or subacute infections involving bone and implant...
April 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28332761/a-uk-national-survey-of-care-pathways-and-support-offered-to-patients-receiving-revision-surgery-for-prosthetic-joint-infection-in-the-highest-volume-nhs-orthopaedic-centres
#2
Andrew J Moore, Michael R Whitehouse, Rachael Gooberman-Hill, Jason Heddington, Andrew D Beswick, Ashley W Blom, Tim J Peters
BACKGROUND: Deep prosthetic joint infection (PJI) is a devastating complication of joint replacement surgery. It is difficult to treat, and patients often require multiple major revision surgeries to eradicate the infection. Treatment can have negative and long-term impact on patients' quality of life. Understanding current service provision provides valuable information needed to design and evaluate support interventions for patients. AIM: This survey aimed to identify usual care pathways and support in UK National Health Service (NHS) orthopaedic centres for patients receiving revision surgery for PJI after hip or knee replacement...
March 23, 2017: Musculoskeletal Care
https://www.readbyqxmd.com/read/28331279/unplanned-90-day-readmissions-in-a-specialty-orthopaedic-unit-a-prospective-analysis-of-consecutive-12729-admissions
#3
Mahender Avinash, S Rajasekaran, Siddharth N Aiyer
INTRODUCTION: Unplanned readmissions are an undesirable and expensive outcome of clinical practice. Previous reported literature is limited by retrospective study designs and 30 day study intervals. We analyzed causes for 90-day unplanned readmission, temporal occurrence of major causes, possible predisposing factors, bed days lost and economic impact. MATERIALS & METHODS: A prospective analysis of 12729 admissions was performed over 1 year in an Orthopaedic unit...
June 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28326413/antibiotic-prophylaxis-for-dental-treatment-after-prosthetic-joint-replacement-exploring-the-orthopaedic-surgeon-s-opinion
#4
Clare M McNally, Renuka Visvanathan, Sharon Liberali, Robert J Adams
BACKGROUND: Antibiotic prophylaxis before dental treatment is routinely recommended by orthopaedic surgeons to prevent prosthetic joint infection (PJI). This recommendation is at odds with current guidelines. METHODS: A postal survey of 9 checkbox or short-answer questions was completed by 633 orthopaedic surgeons. RESULTS: The majority of respondents (n = 186 of 260, 72%) believe that antibiotic prophylaxis is required indefinitely for dental treatment...
September 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28323798/supplemental-perioperative-oxygen-to-reduce-surgical-site-infection-after-high-energy-fracture-surgery-oxygen-study
#5
Robert V OʼToole, Manjari Joshi, Anthony R Carlini, Robert A Sikorski, Armagan Dagal, Clinton K Murray, Michael J Weaver, Ebrahim Paryavi, Alec C Stall, Daniel O Scharfstein, Julie Agel, Mary Zadnik, Michael J Bosse, Renan C Castillo
Supplemental perioperative oxygen (SPO) therapy has been proposed as one approach for reducing the risk of surgical site infection (SSI). Current data are mixed regarding efficacy in decreasing SSI rates and hospital inpatient stays in general and few data exist for orthopaedic trauma patients. This study is a phase III, double-blind, prospective randomized clinical trial with a primary goal of assessing the efficacy of 2 different concentrations of perioperative oxygen in the prevention of SSIs in adults with tibial plateau, pilon (tibial plafond), or calcaneus fractures at higher risk of infection and definitively treated with plate and screw fixation...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323797/local-antibiotic-therapy-to-reduce-infection-after-operative-treatment-of-fractures-at-high-risk-of-infection-a-multicenter-randomized-controlled-trial-vanco-study
#6
Robert V OʼToole, Manjari Joshi, Anthony R Carlini, Clinton K Murray, Lauren E Allen, Daniel O Scharfstein, Joshua L Gary, Michael J Bosse, Renan C Castillo
A number of clinical studies in the spine literature suggest that the use of local vancomycin powder may substantially reduce surgical site infections (SSIs). These studies are primarily retrospective and observational and few focus on orthopaedic trauma patients. This study is a phase III, prospective, randomized, clinical trial to assess the efficacy of locally administered vancomycin powder in the prevention of SSI after fracture surgery. The primary goal of the VANCO Study is to compare the proportion of deep SSI 6 months after fracture fixation surgery...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323794/section-1-preventing-and-managing-infection-and-other-complications-after-orthopaedic-trauma
#7
(no author information available yet)
No abstract text is available yet for this article.
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28321490/c-reactive-protein-may-misdiagnose-prosthetic-joint-infections-particularly-chronic-and-low-grade-infections
#8
Daniel Pérez-Prieto, María E Portillo, Lluís Puig-Verdié, Albert Alier, Santos Martínez, Lluisa Sorlí, Juan P Horcajada, Joan C Monllau
BACKGROUND: Periprosthetic tissue cultures, sonication and synovial fluid cultures remain the gold standard for prosthetic joint infection (PJI) diagnosis. However, some 15-20% culture-negative PJI are still reported. Therefore, there is the need for other diagnostic criteria. One point of concern relative to the different definitions of PJI is as to the inclusion of the c-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR) as diagnostic criteria for PJI despite them being non-specific inflammatory blood tests...
March 21, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28320836/adaptive-upregulation-of-clumping-factor-a-clfa-by-s-aureus-in-the-obese-type-2-diabetic-host-mediates-increased-virulence
#9
Christopher W Farnsworth, Eric M Schott, Sarah E Jensen, Jacob Zukoski, Abigail M Benvie, Majed A Refaai, Stephen L Kates, Edward M Schwarz, Michael J Zuscik, Steven R Gill, Robert A Mooney
Obesity and associated type 2 diabetes (T2D) are important risk factors for infection following orthopaedic implant surgery. Staphylococcus aureus, the most common pathogen in bone infections, adapts to multiple environments to survive and evade host immune responses. Whether adaptation of S. aureus to the unique environment of the obese/T2D host accounts for its increased virulence and persistence in this population is unknown. Thus, we assessed implant-associated osteomyelitis in normal versus high fat-diet obese/T2D mice and found that S...
March 20, 2017: Infection and Immunity
https://www.readbyqxmd.com/read/28314997/clinical-and-microbiological-outcomes-in-haematogenous-spondylodiscitis-treated-conservatively
#10
Tiziana Ascione, Giovanni Balato, Sigismondo Luca Di Donato, Pasquale Pagliano, Francesco Granata, Gianluca Colella, Carlo Ruosi
INTRODUCTION: Spondylodiscitis refers to infections of the intervertebral disc and the adjacent vertebral body. Although it is still considered a rare condition, its rate is projected to increase. Mortality rate is considered to be low, but an estimated one third of the survivors experience residual disabilities. Literature shows that uncomplicated spondylodiscitis can be adequately treated by early antibiotic therapy and immobilization. The aim of the study is to evaluate the outcome of conservative treatment in patients with haematogenous spondylodiscitis...
March 17, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28314891/revision-total-knee-arthroplasty-with-porous-coated-metaphyseal-sleeves-provides-radiographic-ingrowth-and-stable-fixation
#11
Catherine J Fedorka, Antonia F Chen, Michael R Pagnotto, Lawrence S Crossett, Brian A Klatt
PURPOSE: Porous-coated metaphyseal sleeves are designed to fill bone defects and facilitate osseointegration when bone loss in encountered during revision total knee arthroplasty (TKA). The purpose of this study is to evaluate short-term results of porous-coated metaphyseal sleeves with regards to implant fixation and clinical outcomes. METHODS: A retrospective review was conducted on 50 patients (79 sleeves-49 tibial and 30 femoral) who had a press-fit metaphyseal sleeve with revision TKA...
March 17, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28303535/hyaluronic-acid-based-hydrogel-coating-does-not-affect-bone-apposition-at-the-implant-surface-in-a-rabbit-model
#12
W Boot, D Gawlitta, P G J Nikkels, B Pouran, M H P van Rijen, W J A Dhert, H Ch Vogely
BACKGROUND: Uncemented orthopaedic implants rely on the bone-implant interface to provide stability, therefore it is essential that a coating does not interfere with the bone-forming processes occurring at the implant interface. In addition, local application of high concentrations of antibiotics for prophylaxis or treatment of infection may be toxic for osteoblasts and could impair bone growth. QUESTIONS/PURPOSES: In this animal study, we investigated the effect of a commercially available hydrogel, either unloaded or loaded with 2% vancomycin...
March 16, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28291146/malignant-lymphoma-mimicking-an-infection-after-shoulder-surgery
#13
Jabari Ian Justin Martin, Jasmine Bauknight, Vincent Desiderio, Bahman Sadr
Involvement of the musculoskeletal system by primary or metastatic malignant neoplasms mimicking common orthopaedic conditions is well recognized. The diagnosis may be delayed in the absence of radiographic abnormalities. Twenty-five percent of lymphoma cases have skeletal involvement, and they can affect both bone and soft tissue. Lymphoma is sometimes discovered by means of routine histologic examination of tissue collected at the time of orthopaedic surgery. To the best of our knowledge, this is the first report of lymphoma occurring at the site of prior shoulder surgery and mimicking an infection...
April 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28276650/comparison-of-arthrodesis-and-non-fusion-to-treat-lisfranc-injuries
#14
Yu-Sen Qiao, Jun-Kun Li, Hao Shen, Hai-Yan Bao, Ming Jiang, Yan Liu, Wasim Kapadia, Hong-Tao Zhang, Hui-Lin Yang
OBJECTIVE: "Lisfranc joint injury" is comprised of a tarsometatarsal joint-complex injury. The Lisfranc complex injury is always a challenge for orthopedists, and the optimum treatment is still up for debate. Anatomic reduction and stable internal fixation prove to have no satisfactory outcomes. This research aims to compare the clinical curative effects, complications and radiographic features of arthrodesis and non-fusion of the Lisfranc joint in the follow-up of the patients who suffered Lisfranc injuries...
March 9, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28274011/expect-the-unexpected-mycobacterial-infection-in-post-total-knee-arthroplasty-patients
#15
Vikram Kishor Kandhari, Mohan M Desai, Roshan N Wade, Surendar S Bava
Orthopaedic Surgeons rarely encounter mycobacterial infections in Post Total Knee Arthroplasty (TKA) patients. We present series of two cases to create awareness among clinicians to expect the unexpected. Tuberculosis typical/ atypical is a hidden culprit in catch clinical situations when chronic infection is Suspected, but the lab investigations are negative in persistently symptomatic patients. In such situations clinicians should suspect atypical or complex mycobacterial infections and evaluate the patients accordingly...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28271932/mid-term-results-of-minimally-invasive-plate-osteosynthesis-and-circular-external-fixation-in-the-treatment-of-complex-distal-tibia-fractures
#16
Yunus Imren, Engin Eren Desteli, Mehmet Erdil, Hasan Hüseyin Ceylan, Ibrahim Tuncay, Cengiz Sen
BACKGROUND: The treatment of pilon tibia fractures is challenging. Anatomical reduction of the joint surface is essential. Excessive soft-tissue dissection may interfere with the blood supply and can result in nonunion. We sought to compare the outcomes of distal tibia fractures treated with medial locking plates versus circular external fixators. METHODS: We retrospectively evaluated 41 consecutive patients with closed pilon tibia fractures treated with either minimally invasive locking plate osteosynthesis (n = 21) or external fixation (EF) (n = 20)...
January 2017: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/28271085/the-zeitgeist-of-challenging-the-evidence-a-perspective-on-the-international-consensus-meeting-on-periprosthetic-joint-infection
#17
Hangama C Fayaz, Jesse B Jupiter
BACKGROUND: The economic burden of the treatment of periprosthetic joint infection (PJI) is high and the treatment of PJI has a high degree of international controversy. Several papers have declared the International Consensus Meeting on Periprosthetic Joint Infection (ICMPJI) to be the "flawless pledge of international academics" to overcome the challenges of musculoskeletal infections. The purpose of this paper is to highlight for the first time some essential insights into the key dilemmas that are associated with this international consensus process...
January 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28262590/the-implications-of-biologic-therapy-for-elective-foot-and-ankle-surgery-in-patients-with-rheumatoid-arthritis
#18
REVIEW
Ross Diaper, Ernest Wong, Stuart A Metcalfe
INTRODUCTION: Rheumatoid arthritis (RA) is one of a number of inflammatory arthropathies resulting in foot pain and deformity. Patients with this disease may require surgical intervention as part of their management. Many of these patients are now taking biologic agents which pose several risks to patients in the perioperative phase. The surgical team therefore need to be aware of these associated complications and how to manage these cases. AIM: This paper aims to review the current literature about perioperative needs (foot and ankle surgery) associated with patients with rheumatoid arthritis receiving biologic therapy...
January 27, 2017: Foot
https://www.readbyqxmd.com/read/28251059/challenges-of-bone-tissue-engineering-in-orthopaedic-patients
#19
EDITORIAL
Enrique Guerado, Enrique Caso
Bone defects may impede normal biomechanics and the structural stability of bone as an organ. In many cases, the correction of bone defects requires extensive surgical intervention involving the use of bone-grafting techniques and other procedures in which healing is slow, there is a high risk of infection and considerable pain is provoked - with no guarantee of complete correction of the defect. Therefore, the search for surgical alternatives continues to present a major challenge in orthopaedic traumatology...
February 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28249884/unusual-morel-lavallee-lesion-of-the-knee-region-in-an-elderly-patient
#20
Walid El Kininy, Shane Davy, Murali Sayana
The Morel-Lavallee lesion (MLL) of the knee region has been described in the Orthopaedic literature, and all of those were fit and healthy young participants sustaining sports-related trauma to the knee. We describe a case of an elderly woman, on aspirin and prophylactic clexane, who sustained a low-energy injury to the right knee and developed an MLL of the knee region. A delayed recognition, led to the persistence of the MLL as a diffuse haematoma, which subsequently became colonised with methicillin-resistant Staphylococcus aureus We discuss the management of a case and highlight the importance of early identification and management of MLL of the knee region...
March 1, 2017: BMJ Case Reports
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