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Orthopaedic infection

Joseph M Statz, Eric R Wagner, John W Sperling, Robert H Cofield
PURPOSE: Although diabetes mellitus (DM) has an adverse effect on complication rates in orthopaedic surgery, neither the effect of DM nor the association between haemoglobin A1C (HbA1C) and outcomes after shoulder arthroplasty (SA) has been studied. METHODS: A retrospective review of 406 SAs (70 HAs, 188 total shoulder arthroplasties [TSAs], 148 reverse total shoulder arthroplasties [RSAs]) with HbA1Cs within 90 days of surgery was conducted. The average age was 70 years (range 27-97) and 55% were female...
March 18, 2018: International Orthopaedics
T Liu, F L Bao, S J Kang, T Jiang, D S Huang, W Gao, L J Geng, Y M Hu
Objective: To explore a standard procedure for the treatment of combined dorsal and palmar internal fixation for complex four part distal radius fractures and assess its clinical results. Methods: From May 2009 to October 2016, 38 patients(39 sides)who suffered from complex four part distal radius fractures were performed operatively with open reduction and internal fixation via combined dorsal and palmar approach in Department of Orthopaedic Trauma, Qilu Hospital of Shandong University(Qingdao). The series included 22 males(22 sides) and 16 females(17 sides)...
March 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
K N Li, H Lan, Z Y He, X J Wang, J Yuan, P Zhao, J S Mu
Objective: To explore the characteristics and methods of different fixation methods and prevention of open knee joint fracture. Methods: The data of 86 cases of open knee joint fracture admitted from January 2002 to December 2015 in Department of Orthopaedics, Affiliated Hospital of Chengdu University were analyzed retrospectively.There were 65 males and 21 females aged of 38.6 years. There were 38 cases treated with trans articular external fixation alone, 48 cases were in the trans articular external fixation plus auxiliary limited internal fixation group...
March 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Siddharth A Mahure, Joseph A Bosco, James D Slover, Jonathan Vigdorchik, Richard Iorio, Ran Schwarzkopf
BACKGROUND: Individuals coinfected with both hepatitis C virus (HCV) and HIV represent a unique and growing population of patients undergoing orthopaedic surgical procedures. Data regarding complications for HCV monoinfection or HIV monoinfection are robust, but there are no data available, to our knowledge, on patients who have both HCV and HIV infections. QUESTIONS/PURPOSES: We sought to determine whether patients with coinfection differed in terms of baseline demographics and comorbidity burden as compared with patients without coinfection and whether these potential differences were translated into varying levels of postoperative complications, mortality, and hospital readmission risk...
February 2018: Clinical Orthopaedics and related Research
Nicholas A Bedard, Andrew J Pugely, Michael McHugh, Nathan Lux, Jesse E Otero, Kevin J Bozic, Yubo Gao, John J Callaghan
BACKGROUND: Use of large clinical and administrative databases for orthopaedic research has increased exponentially. Each database represents unique patient populations and varies in their methodology of data acquisition, which makes it possible that similar research questions posed to different databases might result in answers that differ in important ways. QUESTIONS/PURPOSES: (1) What are the differences in reported demographics, comorbidities, and complications for patients undergoing primary TKA among four databases commonly used in orthopaedic research? (2) How does the difference in reported complication rates vary depending on whether only inpatient data or 30-day postoperative data are analyzed? METHODS: Patients who underwent primary TKA during 2010 to 2012 were identified within the National Surgical Quality Improvement Programs (NSQIP), the Nationwide Inpatient Sample (NIS), the Medicare Standard Analytic Files (MED), and the Humana Administrative Claims database (HAC)...
January 2018: Clinical Orthopaedics and related Research
Christopher T Born, Joseph A Gil, Joey P Johnson
Periprosthetic fractures around total knee arthroplasty have become an increasingly common and challenging orthopaedic problem. Appropriate management of these fractures depends on careful scrutiny of radiographs and a thorough clinical history to exclude the diagnosis of a periprosthetic infection. In a periprosthetic tibial fracture with a stable, well-aligned tibial component and well-aligned mechanical tibial axis, the fracture can be successfully managed with closed reduction and cast immobilization; meticulous follow-up is essential to ensure that the alignment is maintained...
March 9, 2018: Journal of the American Academy of Orthopaedic Surgeons
Meletis Rozis, Ioannis Benetos, Panagiotis Karampinas, Vasilios Polyzois, John Vlamis, Spyros Pneumaticos
BACKGROUND: Conservative treatment of an acute Achilles rupture remains a viable and acceptable option as does surgical fixation, with open and percutaneous repair consisting the main operative techniques. The purpose of this study was to compare the outcomes and complication rates of open versus percutaneous surgical procedures. METHODS: From 2009 to 2016, 131 patients were admitted to our department with clinically and radiologically confirmed acute Achilles tendon ruptures...
March 1, 2018: Foot & Ankle International
Jen-Ta Shih, Chun-Lin Kuo, Tsu-Te Yeh, Hsain-Chung Shen, Ru-Yu Pan, Chia-Chun Wu
BACKGROUND: The ideal treatment for comminuted intraarticular calcaneal fractures is still debated. Open reduction and internal fixation (ORIF) is the most popular surgical procedure; however, wound complications, implant choice, and infection remain major concerns. This study aimed to demonstrate the results of an innovative, minimally invasive surgical procedure, namely, a closed reduction technique using large-diameter Steinmann pins and percutaneous calcaneoplasty using injectable calcium sulfate cement (MIIG X3, Wright Medical Technology, Inc...
March 9, 2018: BMC Musculoskeletal Disorders
Luke D Plant, David McDonald Taylor, Thomas Worland, Arvind Puri, Antony Ugoni, Sheila K Patel, Douglas F Johnson, Louise M Burrell
BACKGROUND: We aimed to investigate the incidence, precipitants, and outcomes of acute decompensated heart failure (ADHF) that develops during the inpatient stay. METHODS: We undertook a case-control study in the medical, oncology, surgical, and orthopaedic wards of a tertiary referral hospital (February-May, 2016). Patients aged ≥18 years who developed ADHF during their inpatient stay were enrolled as cases. One control patient was matched to each case by age, gender, presenting complaint/surgery performed and co-morbidities...
December 23, 2017: Heart, Lung & Circulation
Guangyong Xu, Juan Zhao, Jie Sun, Yizong Liu
Objective: To evaluate the incidence of postoperative infection and fracture nonunion as well as the risk factors for postoperative infection in human immunodeficiency virus (HIV) positive patients. Methods: From May 2013 to March 2016, the HIV positive fracture patients treated surgically in orthopaedics department of our hospital were analyzed retrospectively, and fifty HIV negative fracture patients during the same period were selected as control. The clinical data of included patients were reviewed...
November 2017: Pakistan Journal of Medical Sciences Quarterly
Steven Slotkin, Andrew Thome, Cassandra Ricketts, Andrew Georgiadis, Aristides Cruz, Mark Seeley
Anterior knee pain (AKP) is a common presenting complaint for pediatricians and orthopaedic surgeons and is often seen in young athletes. AKP is multifactorial and has a broad differential diagnosis. The growth changes, biomechanics, and anatomy around the knee add to the complexity of diagnosis and treatment of AKP. Common causes of AKP include Osgood-Schlatter's disease, patellar tendinitis, and patellofemoral instability. In the diagnosis of AKP, it is important to rule out serious and morbid causes of pain, including infection and tumor...
February 28, 2018: Journal of Knee Surgery
Oddvar Oppegaard, Haima Mylvaganam, Steinar Skrede, Bård Reiakvam Kittang
BACKGROUND: During the past decades, Streptococcus dysgalactiae subspecies equisimilis (SDSE) has been increasingly recognized as an important human pathogen. Osteoarticular infections is one of the predominant disease manifestations of SDSE, but the pathogenetic rationale for its arthritogenicity has yet to be unravelled. We aimed to explore if the rising incidence of osteoarticular infections caused by this pathogen in our region emanated from clonal expansion of strains with enhanced tropism for bone and joint tissue components or orthopaedic implants...
February 27, 2018: BMC Microbiology
Jason A Horowitz, Varun Puvanesarajah, Amit Jain, Xudong J Li, Adam L Shimer, Francis H Shen, Hamid Hassanzadeh
STUDY DESIGN: Retrospective review OBJECTIVE.: To identify the incidence and analyze the risk of postoperative complications amongst elderly patients with rheumatoid arthritis undergoing anterior cervical fusion. SUMMARY OF BACKGROUND DATA: Previous studies have reported elevated risks of postoperative complications for rheumatoid arthritis patients undergoing orthopaedic procedures. However, little is known about the risk of postoperative complications in rheumatoid arthritis patients following spine surgery...
February 23, 2018: Spine
Joyce C Zhang, John Matelski, Rajiv Gandhi, Timothy Jackson, David Urbach, Peter Cram
BACKGROUND: The "obesity paradox" is a phenomenon described in prior research in which patients who are obese have been shown to have lower postoperative mortality and morbidity compared with normal-weight individuals. The paradox is that clinical experience suggests that obesity is a risk factor for difficult wound healing and adverse cardiovascular outcomes. We suspect that the obesity paradox may reflect selection bias in which only the healthiest patients who are obese are offered surgery, whereas nonobese surgical patients are comprised of both healthy and unhealthy individuals...
February 14, 2018: Clinical Orthopaedics and related Research
Ben Parkinson, Drew Armit, Peter McEwen, Michelle Lorimer, Ian A Harris
BACKGROUND: Climate factors have been shown to be associated with spontaneous musculoskeletal and some surgical site infections with increased rates of infection during warmer periods. To date, little research has been performed to determine if this phenomenon is associated with differences in the risk of revision for prosthetic joint infection (PJI) in primary TKA. QUESTIONS/PURPOSES: (1) Does the rate of revision for early PJI within the first year after primary TKA differ between tropical and nontropical regions? (2) Is there a seasonal variation in the rate of revision for PJI? (3) Is the geographic and seasonal variation (if present) associated with the sex, age, and/or American Society of Anesthesiologists (ASA) grade of the patient? METHODS: All 219,983 primary TKAs performed for osteoarthritis over a 5-year period (2011-2015) in the Australian Orthopaedic Association National Joint Replacement Registry were examined based on the month of the primary procedure to determine the rate of revision for PJI within 12 months...
February 21, 2018: Clinical Orthopaedics and related Research
Aaron Nauth, Mark Lee, Michael J Gardner, Mark R Brinker, Stephen J Warner, Paul Tornetta, Philipp Leucht
A substantial proportion of fractures can present with nonunion, and the management of nonunion continues to present a challenge for orthopaedic surgeons. A variety of biological, mechanical, patient, and injury factors can contribute to the occurrence of nonunion, and often the cause of nonunion may be multifactorial. Successful management often requires assessment and treatment of more than one of these factors. This article reviews common factors that may contribute to nonunion including infection, impaired biology, and metabolic disorders...
March 2018: Journal of Orthopaedic Trauma
Todd O McKinley, Greg E Gaski, Yoram Vodovotz, Benjamin T Corona, Timothy R Billiar
Multiply injured patients with severe extremity trauma are at risk of acute systemic complications and are at high risk of developing longer term orthopaedic complications including soft-tissue infection, osteomyelitis, posttraumatic osteoarthritis, and nonunion. It is becoming increasingly recognized that injury magnitude and response to injury have major jurisdiction pertaining to patient outcomes and complications. The complexities of injury and injury response that affect outcomes present opportunities to apply precision approaches to understand and quantify injury magnitude and injury response on a patient-specific basis...
March 2018: Journal of Orthopaedic Trauma
D G Mostafa, M I Qavi, M M Bari, M Arifuzzaman, M Kamruzzaman, M K Saha
High-energy tibial plateau fractures associated with severe soft tissue injury are difficult to manage. The risk of wound complications following open reduction and internal fixation is notably high owing to extensive soft tissue dissection. Alternatively, application of Ilizarov ring fixator minimizes soft tissue dissection and provides adequate fracture stabilization to allow early range of motion and correction of any mal-alignment. With this technique, soft tissue complications particularly surgical site infections are expected to be significantly reduced...
January 2018: Mymensingh Medical Journal: MMJ
Alka Jaggessar, Asha Mathew, Hongxia Wang, Tuquabo Tesfamichael, Cheng Yan, Prasad Kdv Yarlagadda
The application of orthopaedic implants is associated with risks of bacterial infection and long-term antibiotic therapy. This problem has led to the study of implants with nano-textured surfaces as a method of inhibiting bacterial adhesion and reducing implant failure due to infection. In this research, various nano-textured surfaces of TiO2 were synthesised using hydrothermal synthesis, by varying NaOH concentration, reaction time and reaction temperature. Their correlations to mechanical, morphological, bactericidal and osteogenic properties of the surfaces were investigated...
February 12, 2018: Journal of the Mechanical Behavior of Biomedical Materials
Satoshi Ikebe, Motoki Sonohata, Masaru Kitajima, Shunsuke Kawano, Masaaki Mawatari
BACKGROUND: Complications associated with re-implantation of total hip arthroplasty (THA) after resection arthroplasty for the treatment of primary septic hip arthritis or infected THA and bipolar hemiarthroplasty (BHA) are not well-documented. Furthermore, no comparison has been made between septic arthritis (SA) and infected THA and BHA. We divided subjects into two groups for evaluation: a SA group and an infected THA or BHA group. METHODS: Nineteen hips in 19 patients (12 in the SA group, 7 in the infected THA or BHA group) with an average of 77 months of follow-up from the time of re-implantation THA were retrospectively evaluated...
February 17, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
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