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Orthopaedic infection

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https://www.readbyqxmd.com/read/29781818/lower-extremity-megaprostheses-in-orthopaedic-oncology
#1
Santiago A Lozano Calderón, Joseph Kuechle, Kevin A Raskin, Francis J Hornicek
The megaprosthesis is designed to reproduce the form and function of a removed or lost large segment of bone and accompanying soft tissues. Slow but substantial improvements in the design and surgical implementation of these devices have advanced the capacity to restore patients' functional abilities. The essential challenges include identifying the ideal materials, bonding these materials to bone and soft tissues, reproducing functional anatomy, and adapting to the growing skeleton. Failure of these devices can result from soft-tissue insufficiency, aseptic loosening, structural failures, infection, and tumor recurrence...
May 17, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29781552/topical-rifampin-powder-for-orthopaedic-trauma-part-i-rifampin-powder-reduces-recalcitrant-infection-in-a-delayed-treatment-musculoskeletal-trauma-model
#2
Stefanie M Shiels, David J Tennent, Joseph C Wenke
Open fractures become infected despite meticulous debridement and care. Locally applied antibiotics, commonly embedded in polymethylmethacrylate, deliver high doses of drug directly to the fracture site. Direct application of antibiotic powder, which is being applied prophylactically in spine surgery, is a recent interest in the trauma sector, where bacterial biofilms are more prevalent. Traditional antibiotics, such as vancomycin, are poor performers against bacterial biofilms thus are ineffective in delayed treatment...
May 21, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29774178/effects-of-local-application-of-nano-silver-on-osteomyelitis-and-soft-tissue-infections-an-experimental-study-in-rats
#3
Bahattin Kemah, Gökçer Uzer, Yalçın Turhan, Burak Özturan, Bülent Kılıç, Bilge Sümbül Gültepe, Ayşe Bahar Ceyran, Selim Ertürk, Burak Aksoylu, Özlem Şenaydın, Korhan Özkan
Purpose : Bone and soft tissue infections are among the least desired complications after orthopaedic surgery. This study analysed the in vivo effects of the local application of nano-silver particles (AgNPs) [1nm = 1 billionth of a meter] in soft tissue infections. Materials-Method : An experimental osteomyelitis model was formed by inoculating both tibias of 24 rats with methicillin-resistant Staphylococcus aureus . The rats were followed without treatment for 21 days. Blood samples and tibial x-rays at day 21 confirmed the development of infection...
2018: Journal of Bone and Joint Infection
https://www.readbyqxmd.com/read/29771856/vitamin-e-phosphate-coating-stimulates-bone-deposition-in-implant-related-infections-in-a-rat-model
#4
Arianna B Lovati, Marta Bottagisio, Susanna Maraldi, Martina B Violatto, Monica Bortolin, Elena De Vecchi, Paolo Bigini, Lorenzo Drago, Carlo L Romanò
BACKGROUND: Implant-related infections are associated with impaired bone healing and osseointegration. In vitro antiadhesive and antibacterial properties and in vivo antiinflammatory effects protecting against bone loss of various formulations of vitamin E have been demonstrated in animal models. However, to the best of our knowledge, no in vivo studies have demonstrated the synergistic activity of vitamin E in preventing bacterial adhesion to orthopaedic implants, thus supporting the bone-implant integration...
June 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29762111/direct-anterior-approach-has-lower-deep-infection-frequency-than-less-invasive-direct-lateral-approach-in-primary-total-hip-arthroplasty
#5
Sean A Sutphen, Keith R Berend, Michael J Morris, Adolph V Lombardi
Debate continues over the direct anterior (DA) approach. The purpose of this study is to compare the frequency of deep infection between a DA approach and a less invasive direct lateral (LIDL) approach in a large consecutive series of primary total hip arthroplasty (THA). The authors identified 5702 primary THAs performed between 2007 and 2014. DA approach was used in 3540 hips and LIDL in 2162. Patient records were reviewed. Statistical analysis of reoperation, infection- or wound-related complication, and deep infection was performed...
2018: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29761071/long-term-conventionally-dosed-vancomycin-therapy-in-patients-with-orthopaedic-implant-related-infections-seems-as-effective-and-safe-as-long-term-penicillin-or-clindamycin-therapy-a-retrospective-cohort-study-of-103-patients
#6
Jacomien Aleman, Dirk Jan F Moojen, Marc L van Ogtrop, Rudolf W Poolman, Eric J F Franssen
Objectives : Antimicrobial therapy is one of the cornerstones of orthopaedic implant-related infections (OIRI) treatment. Infections with Gram-positive bacteria are often treated with vancomycin, penicillin or clindamycin. A recent IDSA guideline suggests increasing the dose of vancomycin to increase the trough vancomycin target serum concentrations. This is deemed necessary because of an observed decrease in vancomycin susceptibility among Gram-positive bacteria. However, elevated vancomycin concentrations are correlated with the risk of nephrotoxicity, especially with prolonged therapy...
2018: Journal of Bone and Joint Infection
https://www.readbyqxmd.com/read/29753621/analysis-of-hospital-infection-register-indicates-that-the-implementation-of-who-surgical-safety-checklist-has-an-impact-on-early-postoperative-neurosurgical-infections
#7
Marjut Westman, Harri Marttila, Melissa Rahi, Esa Rintala, Eliisa Löyttyniemi, Tuija Ikonen
WHO surgical safety checklist has been proven to reduce postoperative infections in several studies. The aim of our study was to focus on surgical site infections (SSIs) after neurosurgical operations, and to determine whether the checklist implementation would have an impact on the reported SSIs. We used hospital-acquired infection (HAI) register to evaluate the effects of WHO surgical safety checklist in neurosurgery. The HAI register was searched for superficial and deep SSIs, deep organ SSIs, infections following orthopaedic implantation, and other surgical infections of 4678 neurosurgical patients operated on between 2007 and 2011...
May 9, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29751119/bacteriological-relevance-of-linezolid-versus-vancomycin-in-postoperative-empirical-treatment-of-osteoarticular-infections-a-retrospective-single-center-study
#8
E Takoudju, P Bemer, S Touchais, N Asseray, S Corvec, L Khatchatourian, N Serandour, D Boutoille
BACKGROUND: Our center replaced vancomycin by linezolid in 2015 for the postoperative empirical treatment of osteoarticular infections (OAI). OBJECTIVES: This work aims to assess the bacteriological relevance of linezolid for orthopaedic postoperative probabilistic antibiotic therapy. METHODS: Analysis of an observational cohort of patients empirically treated by a combination of linezolid with piperacillin/tazobactam during the immediate postoperative stage for an OAI between July 1st 2015 and July 1st 2016, in a French reference center...
May 8, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29746262/clinical-comparison-of-surgical-constructs-for-anterior-cervical-corpectomy-and-fusion-in-patients-with-cervical-spondylotic-myelopathy-or-ossified-posterior-longitudinal-ligament-a-systematic-review-and-meta-analysis
#9
Timothy R Niedzielak, Joseph Palmer, John P Malloy
STUDY DESIGN: This is a systematic review and meta-analysis. OBJECTIVE: To examine the differences in outcomes among current constructs and techniques for anterior cervical corpectomy and fusion (ACCF) in patients with single or multiple level cervical myelopathy (CM) secondary to cervical spondylosis or ossified posterior longitudinal ligament. SUMMARY OF BACKGROUND DATA: The natural history of CM can be a progressive disease process. In such cases, where surgical decompression is indicated to halt the progression, ACCF is typically chosen for pathology located posterior to the vertebral body...
May 9, 2018: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29744076/a-case-of-methicillin-resistant-staphylococcus-aureus-wound-infection-phylogenetic-analysis-to-establish-if-nosocomial-or-community-acquired
#10
Francesco Cancilleri, Massimo Ciccozzi, Marta Fogolari, Eleonora Cella, Lucia De Florio, Alessandra Berton, Giuseppe Salvatore, Giordano Dicuonzo, Silvia Spoto, Vincenzo Denaro, Silvia Angeletti
Methicillin-resistant Staphylococcus aureus (MRSA) infection is rapidly increasing in both hospital and community settings. A 71-year-old man admitted at the Department of Orthopaedics and Trauma Surgery, University Campus Bio-Medico of Rome, with MRSA wound infection consequent to orthopedic surgery was studied and the MRSA transmission evaluated by phylogenetic analysis.
May 2018: Clinical Case Reports
https://www.readbyqxmd.com/read/29736803/titanium-granules-pre-treated-with-hydrogen-peroxide-inhibit-growth-of-bacteria-associated-with-post-operative-infections-in-spine-surgery
#11
Acke Ohlin, Emma Mattsson, Matthias Mörgelin, Julia R Davies, Gunnel Svensäter, Stéphane Corvec, Pentti Tengvall, Kristian Riesbeck
PURPOSE: Post-operative infections are relatively common after posterior spine surgery, and there are several observations reflecting different infection complications related to various metals implanted. Here, we selected an array of different bacterial species that are often found in infections associated with orthopaedic implants and tested for inhibition by hydrogen peroxide-treated titanium (Ti-peroxy). METHODS: To study the possibility of using Ti-peroxy as an antimicrobial prophylaxis, we developed a protocol for standardized susceptibility testing of bacteria...
May 7, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29720707/implant-infections-adhesion-biofilm-formation-and-immune-evasion
#12
REVIEW
Carla Renata Arciola, Davide Campoccia, Lucio Montanaro
Medical device-associated infections account for a large proportion of hospital-acquired infections. A variety of opportunistic pathogens can cause implant infections, depending on the type of the implant and on the anatomical site of implantation. The success of these versatile pathogens depends on rapid adhesion to virtually all biomaterial surfaces and survival in the hostile host environment. Biofilm formation on implant surfaces shelters the bacteria and encourages persistence of infection. Furthermore, implant-infecting bacteria can elude innate and adaptive host defences as well as biocides and antibiotic chemotherapies...
May 2, 2018: Nature Reviews. Microbiology
https://www.readbyqxmd.com/read/29719874/reducing-the-rate-of-post-surgical-urinary-tract-infections-in-orthopedic-patients
#13
Amit Thakker, Natasha Briggs, Azusa Maeda, Julie Byrne, John Roderick Davey, Timothy D Jackson
Urinary tract infection (UTI) is the fourth leading cause of healthcare-associated infections, with approximately 70%-80% being attributed to the inappropriate use of indwelling catheters. In many cases, indwelling catheters are used inappropriately without any valid indication, creating potentially avoidable and significant patient distress, discomfort, pain and activity restrictions, together with substantial care burden, cost and hospitalisation. In the Division of Orthopedic Surgery at Toronto Western Hospital (TWH), we identified UTI rate reduction as a quality improvement priority...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29701090/a-consensus-exercise-identifying-priorities-for-research-into-clinical-effectiveness-among-children-s-orthopaedic-surgeons-in-the-united-kingdom
#14
D C Perry, J G Wright, S Cooke, A Roposch, M S Gaston, N Nicolaou, T Theologis
Aims High-quality clinical research in children's orthopaedic surgery has lagged behind other surgical subspecialties. This study used a consensus-based approach to identify research priorities for clinical trials in children's orthopaedics. Methods A modified Delphi technique was used, which involved an initial scoping survey, a two-round Delphi process and an expert panel formed of members of the British Society of Children's Orthopaedic Surgery. The survey was conducted amongst orthopaedic surgeons treating children in the United Kingdom and Ireland...
May 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29698303/closed-reduction-osteotomy-and-fibular-graft-are-effective-in-treating-pediatric-femoral-neck-pseudarthrosis-after-infection
#15
Rajesh Kumar Kanojia, Sumit Gupta, Ajay Kumar, Bachha Kanakeya Reddy
BACKGROUND: When treatment of acute septic arthritis of the hip is delayed, severe sequelae can occur. This may take the form of coxa breva, vara, or valga. Pseudoarthrosis of the femoral neck is a rare complication with only a few studies to guide treatment. QUESTION/PURPOSES: In a small series of patients with pseudarthrosis of the femoral neck after acute septic arthritis, we wanted to determine (1) whether femoral neck union can be achieved using a variety of surgical approaches; (2) whether these patients satisfied criteria outlined by Hunka and Choi, defined as a stable hip, a flexion arc ≥ 70° and no fixed adduction or abduction contractures, fixed flexion deformity not more than 20°, pain relief, and restoration of activities of daily living after surgery; and (3) any treatment-related complications if observed...
April 23, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29698291/csa-90-promotes-bone-formation-and-mitigates-methicillin-resistant-staphylococcus-aureus-infection-in-a-rat-open-fracture-model
#16
Rebecca Mills, Tegan L Cheng, Kathy Mikulec, Lauren Peacock, David Isaacs, Carl Genberg, Paul B Savage, David G Little, Aaron Schindeler
BACKGROUND: Infection of open fractures remains a significant cause of morbidity and mortality to patients worldwide. Early administration of prophylactic antibiotics is known to improve outcomes; however, increasing concern regarding antimicrobial resistance makes finding new compounds for use in such cases a pressing area for further research. CSA-90, a synthetic peptidomimetic compound, has previously demonstrated promising antimicrobial action against Staphylococcus aureus in rat open fractures...
April 24, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29685567/minimally-invasive-treatment-of-ankle-fractures-in-patients-at-high-risk-of-soft-tissue-wound-healing-complications
#17
REVIEW
Sherif Mohamed Abdelgaid, Ahmed Fawaz Moursy, Eyad Abd Allah Elgebaly, Aly Mohamed Aboelenien
The complex nature of ankle fractures is magnified when seen in patients at high risk of soft tissue wound healing complications. The major categories include associated soft tissue injury, diabetes, tobacco use, peripheral vascular disease, malnutrition, alcoholism, and corticosteroid use. Because of the potential for wound dehiscence and infection with open reduction and internal fixation of ankle fractures in these patients, minimally invasive procedures have been described. The aims of the present study were to assess the possibility for, and evaluate the results and complications of, minimally invasive techniques for different types of malleolar fractures in high-risk patients...
May 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29675508/are-trabecular-metal-cones-a-valid-option-to-treat-metaphyseal-bone-defects-in-complex-primary-and-revision-knee-arthroplasty
#18
REVIEW
Tommaso Bonanzinga, Thorsten Gehrke, Akos Zahar, Stefano Zaffagnini, Maurilio Marcacci, Carl Haasper
Purpose  Metaphyseal bone defects are a challenge in complex primary and revision total knee arthroplasty (TKA). Recently, several studies have been published with promising results about the use of Trabecular Metal (TM) cones to address bone defects. The aim of this study is to review the literature to assess the efficacy of TM cones to address metaphyseal bone loss. Methods  A comprehensive search was performed on PubMed, Medline, CINAHL, Cochrane, Embase, and Google Scholar databases using various combinations of the following keywords: "metaphyseal," "cones," "tantalum," "knee," and "revision...
March 2018: Joints
https://www.readbyqxmd.com/read/29674772/total-hip-arthroplasty-for-patients-with-residual-poliomyelitis-at-a-mean-eight-years-of-follow-up
#19
Mayumi Sonekatsu, Motoki Sonohata, Masaru Kitajima, Shunsuke Kawano, Masaaki Mawatari
In patients with poliomyelitis, degenerative arthritis of the hip may be encountered in the paralytic or normal contralateral limb because of leg length discrepancy, pelvic obliquity, or severe deformities of the affected hip. Although total hip arthroplasty (THA) is one of the most common orthopedic procedures, there are few reports of THA in adult patients with residual poliomyelitis. From March 2001 to January 2011, 5 patients with residual poliomyelitis (6 hips) underwent THA using uncemented implants at our hospital...
April 2018: Acta Medica Okayama
https://www.readbyqxmd.com/read/29671089/porous-metal-cones-gold-standard-for-massive-bone-loss-in-complex-revision-knee-arthroplasty-a-systematic-review-of-current-literature
#20
Stefano Divano, Luca Cavagnaro, Andrea Zanirato, Marco Basso, Lamberto Felli, Matteo Formica
INTRODUCTION: Revision knee arthroplasty is increasing, and in that case, bone loss management is still a challenging problem. In the last years, the body of literature and interest surrounding porous metal cones has grown, but few systematic evaluations of the existing evidence have been performed. The aim of our systematic review is to collect and critically analyze the available evidence about metal cones in revision knee arthroplasty especially focusing our attention on indications, results, complications, and infection rate of these promising orthopaedic devices...
April 18, 2018: Archives of Orthopaedic and Trauma Surgery
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