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Orthopaedic infection

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https://www.readbyqxmd.com/read/29342496/-adverse-events-in-the-treatment-of-periprosthetic-fractures-around-the-knee-a-clinical-and-radiological-outcome-analysis
#1
Anna Janine Schreiner, Christoph Gonser, Christoph Ihle, Max Konstantin Zauleck, Tim Klopfer, Fabian Stuby, Ulrich Stöckle, Björn Gunnar Ochs
BACKGROUND: The incidence of periprosthetic fractures associated with total knee arthroplasty (PpFxK) has been reported to be 0.3 - 5.5%. 40% of all cases are related to revision TKA. The most common localisation is the distal femur. Classification is performed according to Rorabeck (RB). RB I - II fractures are usually treated with locked plating and retrograde intramedullary nailing, whereas RB III fractures are an indication for revision arthroplasty using a hinged endoprosthesis...
January 17, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29342061/the-effect-of-alternative-bearing-surfaces-on-the-risk-of-revision-due-to-infection-in-minimally-stabilized-total-knee-replacement-an-analysis-of-326-603-prostheses-from-the-australian-orthopaedic-association-national-joint-replacement-registry
#2
Christopher J Vertullo, Peter L Lewis, Yi Peng, Stephen E Graves, Richard N de Steiger
BACKGROUND: The effect of alternative bearing materials on the risk of revision due to infection after total knee replacement remains uncertain. By reducing the immunomodulating polyethylene wear-particle burden and with different substrate bacterial adhesion properties, Oxinium oxidized zirconium and cross-linked polyethylene (XLPE) could alter infection risk. The purpose of the current study was to analyze the risk of revision for infection in 3 comparisons of bearing combinations. METHODS: To evaluate the risk of revision for infection with XLPE, cobalt-chromium (CoCr) on XLPE was compared with CoCr on non-cross-linked polyethylene (NXLPE)...
January 17, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29341933/the-effects-of-platelet-lysate-patches-on-the-activity-of-tendon-derived-cells
#3
Raquel Costa-Almeida, Albina R Franco, Tamagno Pesqueira, Mariana B Oliveira, Pedro S Babo, Isabel B Leonor, João F Mano, Rui L Reis, Manuela E Gomes
Platelet-derived biomaterials are widely explored as cost-effective sources of therapeutic factors, holding a strong potential for endogenous regenerative medicine. Particularly for tendon repair, treatment approaches that shift the injury environment are explored to accelerate tendon regeneration. Herein, genipin-crosslinked platelet lysate (PL) patches are proposed for the delivery of human-derived therapeutic factors in patch augmentation strategies aiming at tendon repair. Developed PL patches exhibited a controlled release profile of PL proteins, including bFGF and PDGF-BB...
January 13, 2018: Acta Biomaterialia
https://www.readbyqxmd.com/read/29341846/primary-intra-medullary-nailing-of-open-tibia-fractures-caused-by-low-velocity-gunshots-does-operative-debridement-increase-infection-rates
#4
Chester J Donnally, Charles M Lawrie, Jonathan I Sheu, Meredith A Gunder, Stephen M Quinnan
BACKGROUND: Although gunshot-induced extremity fractures are typically not considered open fractures, there is controversy regarding wound management in the setting of operative fixation to limit infection complications. Previous studies have evaluated the need for a formal irrigation and debridement (I&D) prior to intra-medullary nailing (IMN) of gunshot-induced femur fractures but none have specifically evaluated tibias. By comparing primary IMN for tibial shaft fractures caused by low-velocity firearms additionally treated with a formal operative I&D (group 1) with those without an I&D (group 2), we sought to identify whether there are: differences in treatment group infection rates; particular fracture patterns more prone to infection; and patient characteristics more prone to infections...
January 17, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29339298/implementation-and-impact-of-an-audit-and-feedback-antimicrobial-stewardship-intervention-in-the-orthopaedics-department-of-a-tertiary-care-hospital-a-controlled-interrupted-time-series-study
#5
Margarida Tavares, Ana Cláudia Carvalho, José Pedro Almeida, Paulo Andrade, Ricardo São Simão, Pedro Soares, Carlos Alves, Rui Pinto, Arnaud Fontanet, Laurence Watier
A prospective audit and feedback antimicrobial stewardship intervention conducted in the Orthopaedics Department of a University Hospital in Portugal was evaluated by comparing an interrupted time series in an intervention group and a non-intervention (control) group. Monthly antibiotic use (except cefazolin) was measured as World Health Organization- and Anatomical Therapeutic Chemical-defined daily doses (DDD) from January 2012 to September 2016, excluding the 6-month phase of intervention implementation starting on January 1, 2015...
January 12, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29330346/underestimation-of-staphylococcus-aureus-mrsa-and-mssa-carriage-associated-with-standard-culturing-techniques-one-third-of-carriers-missed
#6
S T J Tsang, M P McHugh, D Guerendiain, P J Gwynne, J Boyd, A H R W Simpson, T S Walsh, I F Laurenson, K E Templeton
OBJECTIVES: Nasal carriers of Staphylococcus (S.) aureus (MRSA and MSSA) have an increased risk for healthcare-associated infections. There are currently limited national screening policies for the detection of S. aureus despite the World Health Organization's recommendations. This study aimed to evaluate the diagnostic performance of molecular and culture techniques in S. aureus screening, determine the cause of any discrepancy between the diagnostic techniques, and model the potential effect of different diagnostic techniques on S...
January 2018: Bone & Joint Research
https://www.readbyqxmd.com/read/29326375/group-b-streptococcus-septic-arthritis-of-the-hip-following-spontaneous-abortion
#7
Madeline Lyons, Elizabeth Zielinski, Jibanananda Satpathy
Group B streptococcus (GBS) infection of the hip in otherwise healthy adults is a rare entity that is previously only reported following peripartum gynaecological procedure and instrumentation. We report a case of infection of the hip with GBS following spontaneous abortion. Delay in identification of infection as the cause of pain ultimately leads to irreversible joint destruction. This case report will heighten the awareness of the first contact providers as well as orthopaedic surgeons to be more vigilant for possible septic complications associated with gynaecological procedures/complications and subsequent painful joints...
January 11, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29322892/could-the-orthopaedic-surgeon-deployed-in-austere-setting-perform-flaps-on-the-leg
#8
O Barbier, D Ollat, P Pasquier, S Rigal, G Versier
The orthopaedic military surgeons deployed in operations are led to perform soft tissue coverage on the lower limb. The purpose of this study was to evaluate if flaps performed by surgeons' non-specialist in reconstructive surgery are associated with good outcome. All patients operated for a flap on the leg in French Forward Surgical Team deployed in theatre of operations between 2003 and 2013 were retrospectively reviewed. Forty-nine patients were included, for a total of 54 flaps' procedures. Indications were open fractures in 25 cases and osseous infections in 29 cases...
March 2017: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/29320842/carpal-tunnel-syndrome-in-hiv-positive-patients-coinfected-with-hcv
#9
A Mastroianni, F Allegrini, S Nardi, D Donatucci, F Girelli, C Guidi
A wide range of rheumatic and peripheral nervous system disorders may develop in patients with HIV infection, leading to pain, sensory symptoms, and muscle weakness. Over the past three decades, the progress in management of HIV disease with anti-retroviral therapy (ART) has resulted in increased life expectancy for people living with HIV disease. With this new chronicity of the disease has a constellation of chronic musculoskeletal, orthopaedic and rheumatic manifestations has emerged, as potential complications of the disease itself and/or the results of ART treatment regimen and/or because of expected age-related symptoms/manifestations...
December 21, 2017: Reumatismo
https://www.readbyqxmd.com/read/29318171/mobile-web-based-follow-up-for-postoperative-acl-reconstruction-a-single-center-experience
#10
James Higgins, John Semple, Lucas Murnaghan, Sarah Sharpe, John Theodoropoulos
Background: The initial 6 weeks after surgery has been identified as an area for improvement in patient care. During this period, the persistence of symptoms that go unchecked can lead to unscheduled emergency room and clinic visits, calls to surgeons' offices, and readmissions. Purpose: To analyze postoperative data from a previous study examining postoperative outcomes in 2 patient populations following breast reconstruction and anterior cruciate ligament (ACL) reconstruction with use of a patient-centered mobile application...
December 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29316952/risk-factor-analysis-for-postoperative-complications-requiring-revision-surgery-after-transtrochanteric-rotational-osteotomy-for-osteonecrosis-of-the-femoral-head
#11
Kazuyuki Karasuyama, Goro Motomura, Satoshi Ikemura, Jun-Ichi Fukushi, Satoshi Hamai, Kazuhiko Sonoda, Yusuke Kubo, Takuaki Yamamoto, Yasuharu Nakashima
BACKGROUND: This study investigated the risk factors for postoperative complications requiring revision surgery within 3 years after transtrochanteric rotational osteotomy (TRO) for osteonecrosis of the femoral head (ONFH). METHODS: We reviewed 127 patients (147 hips) who underwent TRO (anterior or posterior rotational osteotomy) for ONFH between January 2002 and December 2014. Two patients were lost to follow-up, and five patients with progression of femoral head collapse requiring a salvage procedure such as total hip arthroplasty within 3 years after TRO were excluded...
January 10, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29316602/no-evidence-of-increased-infection-risk-with-forced-air-warming-devices-a-systematic-review
#12
Heather S Haeberle, Sergio M Navarro, Linsen T Samuel, Anton Khlopas, Assem A Sultan, Nipun Sodhi, Morad Chughtai, Michael A Mont, Prem N Ramkumar
INTRODUCTION: Forced-air warming devices have been reported to present a potential risk for surgical site infections (SSIs) and periprosthetic joint infections. Due to a lack of consensus, we reviewed the infection risk of forced-air warming devices. MATERIALS AND METHODS: A systematic literature review was performed, evaluating overall infection risk and bacterial load. A total of eight studies reporting outcomes from 1,965 subjects were included. RESULTS AND CONCLUSIONS: There is no current evidence in the orthopaedic literature that forced-air warming devices translate to increased SSIs...
December 22, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29306854/successful-management-of-a-24-year-old-pregnant-woman-with-necrotising-fasciitis-of-the-forearm
#13
Sam Nahas, Anne McKirdy, Arjuna Imbuldeniya
A 24-year-old woman who was 24 weeks pregnant presented to the emergency department with septic shock and an elbow wound that had become infected. She sustained an injury to the tip of the right elbow on a light switch 4 days prior. In the space of 1 day, she developed a necrotising soft tissue infection, which was rapidly spread to the forearm with florid sepsis. Her initial serum C reactive protein was 392 mg/L, and white cell count was 32×109/L. The patient was treated promptly with aggressive surgical debridement and broad-spectrum antibiotics...
January 6, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29305460/delays-in-the-diagnosis-and-treatment-of-bone-and-joint-tuberculosis-in-the-united-kingdom
#14
C Broderick, S Hopkins, D J F Mack, W Aston, R Pollock, J A Skinner, S Warren
AIMS: Tuberculosis (TB) infection of bones and joints accounts for 6.7% of TB cases in England, and is associated with significant morbidity and disability. Public Health England reports that patients with TB experience delays in diagnosis and treatment. Our aims were to determine the demographics, presentation and investigation of patients with a TB infection of bones and joints, to help doctors assessing potential cases and to identify avoidable delays. PATIENTS AND METHODS: This was a retrospective observational study of all adults with positive TB cultures on specimens taken at a tertiary orthopaedic centre between June 2012 and May 2014...
January 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29305368/treatment-of-a-complex-orthopaedic-infection-due-to-extensively-drug-resistant-pseudomonas-aeruginosa
#15
Sidra Hassan, Mani D Kahn, Nidhi Saraiya, Priya Nori
According to the Centers for Disease Control and Prevention (CDC), approximately 51 000 healthcare-associated infections caused by Pseudomonas aeruginosa occur annually in the USA, more than 6000 of which (13%) are caused by multidrug resistant (MDR) strains. Ceftolozane/tazobactam (TOL/TAZ) (Zerbaxa) was approved by the US Food and Drug Administration (FDA) in December 2014 for the treatment of complicated intra-abdominal and urinary tract infections. At this time, clinical data on the role of TOL/TAZ treatment outside of FDA-approved indications is limited...
January 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29303471/comparison-of-percutaneous-endoscopic-transforaminal-discectomy-microendoscopic-discectomy-and-microdiscectomy-for-symptomatic-lumbar-disc-herniation-minimum-2-year-follow-up-results
#16
Xinyu Liu, Suomao Yuan, Yonghao Tian, Lianlei Wang, Liangtai Gong, Yanping Zheng, Jianmin Li
OBJECTIVE This study aimed to evaluate the clinical outcomes of percutaneous endoscopic transforaminal discectomy (PETD), microendoscopic discectomy (MED), and microdiscectomy (MD) for treatment of symptomatic lumbar disc herniation (LDH). METHODS One hundred ninety-two patients with symptomatic LDH at L3-4 and L4-5 were included in this study. The mean (± SD) age of patients was 34.2 ± 2.6 years (range 18-62 years). The patients were divided into groups as follows: group A was treated with PETD and included 60 patients (31 men and 29 women) with a mean age of 36...
January 5, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29301794/surgical-trauma-induces-overgrowth-in-lower-limb-gigantism-regulation-with-use-of-rapamycin-is-promising
#17
Rohan Sebastian Pinto, William David Harrison, Kenneth Graham, Durai Nayagam
We describe an unclassified overgrowth syndrome characterised by unregulated growth of dermal fibroblasts in the lower limbs of a 35-year-old woman. A PIK3CA gene mutation resulted in lower limb gigantism. Below the waist, she weighed 117 kg with each leg measuring over 100 cm in circumference. Her total adiposity was 50% accounted for by her legs mainly. Liposuction and surgical debulking were performed to reduce the size of the limbs but had exacerbated the overgrowth in her lower limbs. Systemic sepsis from an infected foot ulcer necessitated treatment by an above-knee amputation...
January 4, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29275385/oyster-related-tenosynovitis-a-rare-case-of-mycobacterium-szulgai-in-the-immunocompromised
#18
Michael Howard Baca-Atlas, Amir Homayoun Barzin
A 66-year-old man with a history of renal transplant on chronic immunosuppression presented to his primary care physician with a swollen right index finger. On examination, mild swelling was present. Conservative management failed and initial plain films were negative. Corticosteroid injection was performed by orthopaedics, but symptoms recurred several months later and an MRI showed flexor digitorum tenosynovitis and abscesses of the superficialis and profundus tendons. A flexor tenolysis was performed with cultures positive for Mycobacterium szulgai, a rare, non-tuberculous mycobacterial infection...
December 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29261553/local-modalities-for-preventing-surgical-site-infections-an-evidence-based-review
#19
Julia A Katarincic, Amanda Fantry, J Mason DePasse, Ross Feller
Surgical site infections remain a dreaded complication of orthopaedic surgery, affecting both patient economics and quality of life. It is important to note that infections are multifactorial, involving both surgical and patient factors. To decrease the occurrence of infections, surgeons frequently use local modalities, such as methicillin-resistant Staphylococcus aureus screening; preoperative bathing; intraoperative povidone-iodine lavage; and application of vancomycin powder, silver-impregnated dressings, and incisional negative-pressure wound therapy...
January 1, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29244969/treatment-of-open-upper-limb-injuries-with-infection-prevention-and-negative-pressure-wound-therapy-a-systematic-review
#20
E Ali, M Raghuvanshi
OBJECTIVE: Open upper limb injuries requiring soft reconstruction can pose a dilemma for trauma surgeons when considering the treatment options. The British Orthopaedic Association and British Association of Plastic, Reconstructive and Aesthetic Surgeons Standard for Trauma (BOAST) have addressed the management of severe open lower limb fractures with the creation of the BOAST 4 guidelines. However, no such gold standard exists for the treatment of open injuries of the upper limb. Furthermore, treatment of these injuries is often more difficult and requires complicated strategies...
December 2, 2017: Journal of Wound Care
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