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Orthopaedic infection

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https://www.readbyqxmd.com/read/28529866/which-orthopaedic-patients-are-infected-with-gram-negative-non-fermenting-rods
#1
Omid Jamei, Shpresa Gjoni, Besa Zenelaj, Benjamin Kressmann, Wilson Belaieff, Didier Hannouche, Ilker Uçkay
Background : 1(st) and 2(nd) generation cephalosporins used for perioperative prophylaxis in orthopaedic surgery do not cover non-fermenting Gram-negative rods (NFR). Methods: Epidemiological cohort study of adult patients operated for orthopedic infections between 2004 and 2014 with perioperative cefuroxim or vancomycin prophylaxis. Exclusion of polyneuropathic ischemic foot infections and septic bursitis cases. Results: Of the total 1840 surgical procedures in the study, 430 grew Gram-negative pathogens (23%), of which 194 (11%) were due to NFR and 143 (8%) to Pseudomonas aeruginosa...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529865/hyaluronic-acid-and-its-composites-as-a-local-antimicrobial-antiadhesive-barrier
#2
REVIEW
C L Romanò, E De Vecchi, M Bortolin, I Morelli, L Drago
Living in biofilms is probably the most common condition for bacteria and fungi and biofilm-related infections account for the majority of bacterial infectious diseases worldwide. Among others biofilm-related infections, those associated with implanted biomaterials have an enormous and still largely underestimated impact in orthopaedics and trauma, cardio-surgery and several other surgical disciplines. Given the limited efficacy of existing antibiotics in the prevention and treatment of bacterial biofilms, new strategies are needed to protect implants and host tissues, overcoming the striking ability of the microorganisms to adhere on different surfaces and to immediately protect themselves by forming the biofilm matrix...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529861/local-intra-wound-administration-of-powdered-antibiotics-in-orthopaedic-surgery
#3
REVIEW
Andrew N Fleischman, Matthew S Austin
Surgical site infection (SSI) is one of the most common complications after orthopaedic surgery, leading to significant morbidity and its associated costs. Surgical guidelines strongly recommend the use of systemic antibiotic prophylaxis to reduce the risk for developing SSI. Locally administered powdered antibiotics have the potential to provide remarkably high intra-wound concentrations without risk for systemic toxicity. However, a paucity of high quality evidence in the orthopaedic literature has prevented widespread adoption of this technique...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529859/treatment-of-periprosthetic-joint-infection-using-antimicrobials-dilute-povidone-iodine-lavage
#4
REVIEW
John A Ruder, Bryan D Springer
Periprosthetic joint infections (PJI) remain a challenge for the orthopaedic surgeon to treat and remain a leading cause of failure of both primary and revision total joint arthroplasty. Once a PJI develops, surgical treatment is generally indicated and includes an aggressive irrigation and debridement. One component of the irrigation and debridement involves the use of an antiseptic irrigating solution. In primary and revision TJA, dilute povidone-iodine lavage can be performed prior to wound closure. Approximately 17...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529858/hydrogen-peroxide-wound-irrigation-in-orthopaedic-surgery
#5
REVIEW
Min Lu, Erik Nathan Hansen
As the burden of deep hardware infections continues to rise in orthopaedics, there is increasing interest in strategies for more effective debridement of colonized tissues and biofilm. Hydrogen peroxide has been used medically for almost a century, but its applications in orthopaedic surgery have yet to be fully determined. The basic science and clinical research on the antiseptic efficacy of hydrogen peroxide have demonstrated its efficacy against bacteria, and it has demonstrated potential synergy with other irrigation solutions such as chlorhexidine and povidone-iodine...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529857/local-antimicrobial-treatment-in-orthopaedic-surgery
#6
EDITORIAL
Antonia F Chen, Heinz Winkler
The purpose of this special issue of Journal of Bone and Joint Infection is to provide orthopaedic surgeons with basic science explanations as to how these local antimicrobials work, clinical evidence that supports these local treatments, and the role of these local treatments against biofilm.
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529014/comparative-prospective-study-between-medial-and-lateral-distal-tibial-locking-compression-plates-for-distal-third-tibial-fractures
#7
Sandeep Garg, Vikram Khanna, Mahaveer Prashad Goyal, Narendra Joshi, Amrut Borade, Ishan Ghuse
PURPOSE: Tibial fracture is the most common long bone fracture. Distal third tibial fractures are challenging though open reduction and plating can result in anatomical reduction and rigid fixation. This paper aimed to evaluate and compare the results of medial and lateral locking compression plates for distal third tibial fractures. METHODS: This prospective clinical study involved 36 patients with distal tibial fractures admitted in Department of Orthopaedics, Sawai Mansingh Medical College & Affiliated Hospital, Jaipur, India, from June 2011 to May 2012, including 29 closed fractures and 7 open fractures at the mean age of 38...
April 14, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28522446/non-contact-electromagnetic-induction-heating-for-eradicating-bacteria-and-yeasts-on-biomaterials-and-possible-relevance-to-orthopaedic-implant-infections-in-vitro-findings
#8
B G Pijls, I M J G Sanders, E J Kuijper, R G H H Nelissen
OBJECTIVES: Infection of implants is a major problem in elective and trauma surgery. Heating is an effective way to reduce the bacterial load in food preparation, and studies on hyperthermia treatment for cancer have shown that it is possible to heat metal objects with pulsed electromagnetic fields selectively (PEMF), also known as induction heating. We therefore set out to answer the following research question: is non-contact induction heating of metallic implants effective in reducing bacterial load in vitro? METHODS: Titanium alloy cylinders (Ti6Al4V) were exposed to PEMF from an induction heater with maximum 2000 watts at 27 kHz after being contaminated with five different types of micro-organisms: Staphylococcus epidermidis; Staphylococcus aureus; Pseudomonas aeruginosa; spore-forming Bacillus cereus; and yeast Candida albicans...
May 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28522445/evaluation-of-bacterial-adherence-of-clinical-isolates-of-staphylococcus-sp-using-a-competitive-model-an-in-vitro-approach-to-the-race-for-the-surface-theory
#9
M Martinez-Perez, C Perez-Jorge, D Lozano, S Portal-Nuñez, R Perez-Tanoira, A Conde, M A Arenas, J M Hernandez-Lopez, J J de Damborenea, E Gomez-Barrena, P Esbrit, J Esteban
OBJECTIVES: Implant-related infection is one of the most devastating complications in orthopaedic surgery. Many surface and/or material modifications have been developed in order to minimise this problem; however, most of the in vitro studies did not evaluate bacterial adhesion in the presence of eukaryotic cells, as stated by the 'race for the surface' theory. Moreover, the adherence of numerous clinical strains with different initial concentrations has not been studied. METHODS: We describe a method for the study of bacterial adherence in the presence of preosteoblastic cells...
May 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28521381/-time-in-the-or-outcome-and-surgeons-experience-the-use-of-patient-matched-instruments-in-arthroplasty-of-the-knee
#10
Christoph Schulze, Cem Kai Inan, Claudia Hacke, Alexander Kaltenborn, André Gutcke
Background Arthrosis of the knee is a common problem in Germany that is often treated with arthroplasty. To support the orthopaedic surgeon, person-matched instruments (PMI) are available from several providers. In this study we investigated the clinical and radiological outcome of the use of the PMI Visionaire(™) (Smith&Nephew). Furthermore, we investigated the influence of operative experience of the orthopaedic surgeon on the clinical and radiological results. Time in the operating room (OR) was identified as a parameter for cost effectiveness even during training to become an orthopaedic surgeon...
May 18, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28515059/antibiotic-stability-over-six-weeks-in-aqueous-solution-at-body-temperature-with-and-without-heat-treatment-that-mimics-the-curing-of-bone-cement
#11
E Samara, T F Moriarty, L A Decosterd, R G Richards, E Gautier, P Wahl
OBJECTIVES: Thermal stability is a key property in determining the suitability of an antibiotic agent for local application in the treatment of orthopaedic infections. Despite the fact that long-term therapy is a stated goal of novel local delivery carriers, data describing thermal stability over a long period are scarce, and studies that avoid interference from specific carrier materials are absent from the orthopaedic literature. METHODS: In this study, a total of 38 frequently used antibiotic agents were maintained at 37°C in saline solution, and degradation and antibacterial activity assessed over six weeks...
May 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28508765/a-comparison-of-outcomes-of-treatment-with-resection-prosthesis-of-the-hip-in-revision-and-oncological-surgery
#12
Paweł Kamiński, Jakub Szmyd, Jarosław Ambroży, Jerzy Mirosław Jaworski, Bogusław Frańczuk
INTRODUCTION: The introduction of resection prostheses paved the way for the development of limb-sparing surgery in patients with primary or metastatic bone tumours. After some time, the developing possibilities of treatment of extensive bone defects allowed for the use of resection prostheses as an emergency procedure in patients undergoing revision surgery due to hip implant loosening. The aim of this paper is to compare treatment outcomes in patients receiving the Modular Universal Tumour and Revision System (MUTARS) resection prosthesis during arthroplasty performed for different indications: treatment of a tumour metastasis and revision surgery in cases of implant loosening...
April 12, 2017: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28497536/robotic-guided-waterjet-cutting-technique-for-high-tibial-dome-osteotomy-a-pilot-study
#13
Eduardo M Suero, Ralph Westphal, David Zaremba, Musa Citak, Nael Hawi, Mustafa Citak, Timo Stuebig, Christian Krettek, Emmanouil Liodakis
BACKGROUND: Oscillating saws generate high levels of heat (up to 150°C), which can lead to tissue necrosis, delayed healing and infection. Abrasive waterjet-cutting techniques have been described as a new tool to perform bone cuts, with less heat generation. METHODS: Four lower-limbs of four human alcohol conserved cadavers were tested. Navigation references were attached to the tibia and an intraoperative fluoroscopy-based 3D scan was obtained. A 1.2 mm diameter nozzle was attached to a robotic arm, which was guided to follow a pre-specified path...
May 12, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/28490492/molecular-diagnosis-of-orthopaedic-device-infection-direct-from-sonication-fluid-by-metagenomic-sequencing
#14
Teresa L Street, Nicholas D Sanderson, Bridget L Atkins, Andrew J Brent, Kevin Cole, Dona Foster, Martin A McNally, Sarah Oakley, Leon Peto, Adrian Taylor, Tim E A Peto, Derrick W Crook, David W Eyre
Culture of multiple periprosthetic tissue samples is the current gold-standard for microbiological diagnosis of prosthetic joint infections (PJI). Additional diagnostic information may be obtained through sonication fluid culture of explants. However, current techniques can have relatively low sensitivity, with prior antimicrobial therapy and infection by fastidious organisms influencing results. We assessed if metagenomic sequencing of total DNA extracts obtained direct from sonication fluid can provide an alternative rapid and sensitive tool for diagnosis of PJI...
May 10, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28488017/c-reactive-protein-course-during-the-first-5-days-after-total-knee-arthroplasty-cannot-predict-early-prosthetic-joint-infection
#15
Christoph Windisch, Steffen Brodt, Eric Roehner, Georg Matziolis
INTRODUCTION: Periprosthetic joint infection (PJI) is one of the most devastating major complications after total knee arthroplasty (TKA). The laboratory value C-reactive protein (CRP) is the inflammatory biomarker most suitable for detecting a potential postoperative (p.o.) early infection in orthopaedic surgery. However, on the basis of multiple receiver operating characteristic (ROC) analyses, CRP only has limited sensitivity and specificity. The objective of the present study was to test the hypothesis that, besides the absolute preoperative CRP value, also the absolute postoperative CRP value and its course over the first 5 days after TKA are valid indicators of periprosthetic early infection...
May 9, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28483964/towards-elimination-of-pin-tract-infections-novel-antibacterial-coating-on-orthopaedic-wires
#16
Dmitry Gil, Sergey Shuvaev, Anastasia Frank-Kamenetskii, Vladimir Reukov, Christopher Gross, Alexey Vertegel
Novel approaches to prevention of microbial infections after insertion of orthopedic external fixators are in great demand because of extremely high incidence rate of such infections, which can reach up to 100% for longer implant residence times. Monolaurin is an antimicrobial agent with known safety record, broadly used in food and cosmetic industries; however, its use in antimicrobial coatings of medical devices has not been studied in much detail. Here, we report the use of monolaurin as an antibacterial coating on external fixators for the first time...
May 8, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28475261/impact-of-the-orthopaedic-nurse-practitioner-role-on-acute-hospital-length-of-stay-and-cost-savings-for-patients-with-hip-fracture-a-retrospective-cohort-study
#17
Linda L Coventry, Sharon Pickles, Michelle Sin, Amanda Towell, Margaret Giles, Kevin Murray, Di Twigg
AIMS: To compare acute hospital length of stay and cost-savings for patients with hip fracture before-and-after commencement of the Orthopaedic Nurse Practitioner and identify variables that increase length of stay in hospital. BACKGROUND: Globally, hip fractures are associated with significant morbidity and mortality. Whilst the practical benefits of the Orthopaedic Nurse Practitioner have been anecdotally shown, an analysis showing the cost-saving benefits has yet to be published...
May 5, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28473167/review-of-mrsa-screening-and-antibiotics-prophylaxis-in-orthopaedic-trauma-patients-the-risk-of-surgical-site-infection-with-inadequate-antibiotic-prophylaxis-in-patients-colonized-with-mrsa
#18
H J Iqbal, N Ponniah, S Long, N Rath, M Kent
AIMS: The primary aim of this study was to determine whether orthopaedic trauma patients receive appropriate antibiotic prophylaxis keeping in view the results of their MRSA screening. The secondary aim was to analyse the risk of developing MRSA surgical site infection with and without appropriate antibiotic prophylaxis in those colonized with MRSA. PATIENTS AND METHODS: We reviewed 400 consecutive orthopaedic trauma patient episodes. Preoperative MRSA screening results, operative procedures, prophylactic antibiotics and postoperative course were explored...
April 13, 2017: Injury
https://www.readbyqxmd.com/read/28467136/staphylococcus-aureus-versus-streptococci-in-orthopaedic-infections
#19
Antonio Tumminello, Dennis Dominguez, Dan Lebowitz, Placido Bartolone, Michael Betz, Didier Hannouche, Ilker Uçkay
No abstract text is available yet for this article.
May 3, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28466796/-effect-of-smoking-on-orthopaedic-conditions-an-overview-for-everyday-practice
#20
M F Nieboer, T Gosens
- We are learning more and more about the effects of smoking on orthopaedic conditions such as osteoporosis and osteoarthritis and on healing of fractures and tendons.- Smoking seems to have a slight protective effect on osteoarthritis.- Smokers have a higher risk of postoperative complications such as wound infection, death and prosthesis-related complications.- If smokers stop smoking preoperatively, the risk of general postoperative complications can be reduced, but this is yet to be proven for prosthesis-related complications...
2017: Nederlands Tijdschrift Voor Geneeskunde
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