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Arthroplasty irrigation

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https://www.readbyqxmd.com/read/29916991/risk-factors-for-early-reoperation-after-operative-treatment-of-acetabular-fractures
#1
Anthony Ding, Robert V OʼToole, Renan Castillo, Brad Reahl, Ryan Montalvo, Jason W Nascone, Marcus F Sciadini, Anthony R Carlini, Theodore T Manson
OBJECTIVES: To identify the risk factors for early reoperation after operative fixation of acetabular fractures. DESIGN: Retrospective evaluation. SETTING: Level I Trauma Center. PATIENTS: Seven hundred ninety-one patients with displaced acetabular fractures treated with open reduction and internal fixation (ORIF) from 2006 to 2015. Average follow-up was 52 weeks. MAIN OUTCOME MEASURES: Early reoperation after acetabular ORIF, defined as secondary procedure for infection or revision within 3 years of initial operation...
July 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29902831/the-effect-of-antiseptics-in-the-prophylaxis-of-infection-in-orthopaedic-surgery
#2
Martin Lüdemann, Pablo Munoz, Martin Wagner, Uwe Malzahn, Konstantin Horas, Peter Heuschmann, Maximilian Rudert
INTRODUCTION: Over the past decade, the incidence of revision arthroplasty has increased substantially. One of the main reasons for revision arthroplasty is periprosthetic joint infection, often resulting in multiple surgical interventions with variable success and poor clinical outcome. Intraoperative wound irrigation has been proposed to reduce bacterial contamination and thus the risk of periprosthetic infection. However, there is currently no widely accepted recommendation for the use of topical antiseptics within the operative setting for primary implantation...
June 14, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29881225/increased-antibiotic-duration-improves-reoperation-free-survival-after-total-hip-arthroplasty-irrigation-and-debridement
#3
Nicholas Bene, Xing Li, Sumon Nandi
Background: We aimed to determine if reoperation-free survival following irrigation and debridement (I&D) with head and liner exchange of infected primary THA is affected by: 1) postoperative antibiotic duration; 2) patient characteristics; 3) infecting organism; or 4) postoperative versus hematogenous infection. Methods: Revision THAs from 2006 to 2012 (n = 1184) were observed; 26 underwent I&D with head and liner exchange with mean 4.1-year follow-up...
June 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29881219/local-bio-absorbable-antibiotic-delivery-in-calcium-sulfate-beads-in-hip-and-knee-arthroplasty
#4
Zachary C Lum, Gavin C Pereira
Antibiotic-impregnated calcium sulfate (AICS) beads have been used for prevention and treatment of periprosthetic joint infections. We evaluated post-operative complications following the use of AICS beads. 56 patients undergoing complex primary or revision hip or knee arthroplasty received antibiotic calcium sulfate beads. Primary outcomes were wound complication rates. Secondary outcomes included reoperation and reinfection rates. One case (1.7%) of persistent wound drainage occurred requiring surgical irrigation and a poly-exchange...
June 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29870449/vancomycin-loaded-polymethylmethacrylate-spacers-fail-to-eradicate-periprosthetic-joint-infection-in-a-clinically-representative-mouse-model
#5
Alberto V Carli, Samrath Bhimani, Xu Yang, Karen L de Mesy Bentley, F Patrick Ross, Mathias P G Bostrom
BACKGROUND: Periprosthetic joint infection (PJI) remains a devastating complication following total joint arthroplasty. Current animal models of PJI do not effectively recreate the clinical condition and thus provide limited help in understanding why treatments fail. We developed a mouse model of the first-stage surgery of a 2-stage revision for PJI involving a 3-dimensionally printed Ti-6Al-4V implant and a mouse-sized cement spacer that elutes vancomycin. METHODS: Vancomycin was mixed with polymethylmethacrylate (PMMA) cement and inserted into custom-made mouse-sized spacer molds...
June 6, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29868943/an-often-unrecognized-entity-as-cause-of-recurrent-infection-after-successfully-treated-two-stage-exchange-arthroplasty-hematogenous-infection
#6
Doruk Akgün, Michael Müller, Carsten Perka, Tobias Winkler
INTRODUCTION: Reinfection after two-stage exchange arthroplasty is a difficult clinical scenario with limited data on adequate treatment algorithms. Beside the possibility of treatment failure and a new intraoperative infection at the time of reimplantation, hematogenous seeding could play an up to date underestimated crucial role as another cause of an infection after two-stage exchange. The aim of this study was to evaluate its incidence and treatment possibilities in a prospectively followed case series...
June 5, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29843197/two-stage-reimplantation-in-infected-total-knee-arthroplasty
#7
REVIEW
Yong Seuk Lee, Antonia F Chen
Two-stage reimplantation is considered the gold standard for the management of periprosthetic joint infection. The first stage involves the removal of the prosthesis, followed by extensive debridement of all nonviable tissues, synovectomy, irrigation, and reaming of the medullary canals. Once the joint has been prepared, antibiotic-impregnated cement beads and/or spacer are inserted. Antibiotic-impregnated spacers are now more commonly used, and an increasing number of orthopaedic surgeons are using articulating spacers if indicated...
June 1, 2018: Knee Surgery & related Research
https://www.readbyqxmd.com/read/29708568/preoperative-vitamin-d-deficiency-is-associated-with-higher-postoperative-complication-rates-in-total-knee-arthroplasty
#8
Vishal Hegde, Armin Arshi, Christopher Wang, Zorica Buser, Jeffrey C Wang, Andrew R Jensen, John S Adams, Erik N Zeegen, Nicholas M Bernthal
The purpose of this study was to determine the relative incidence of postoperative complications in 25-hydroxyvitamin D (25D)-deficient and -sufficient patients undergoing total knee arthroplasty (TKA). Patients who were either serum 25D deficient (25D <20 ng/mL) or 25D sufficient (25D ≥20 ng/mL) 90 days prior to primary TKA from 2007 to 2016 were identified using the Humana administrative claims registry. The incidence of postoperative medical and surgical complications was determined by querying for relevant International Classification of Diseases, Ninth Revision and Current Procedural Terminology codes...
April 27, 2018: Orthopedics
https://www.readbyqxmd.com/read/29696322/-minimally-invasive-cheilectomy
#9
REVIEW
M Walther, P Chomej, S Kriegelstein, S Altenberger, A Röser
OBJECTIVES: Treatment of hallux rigidus by minimally invasive resection of the dorsal osteophytes, synovectomy and resection of the dorsal part of the metatarsal head. INDICATIONS: Hallux rigidus grades II and III CONTRAINDICATIONS: End-stage osteoarthritis of the first metatarsophalangeal joint with beginning ankylosis. SURGICAL TECHNIQUE: Osteophytes around the metatarsophalangeal joint are removed using a 1 cm incision dorsomedial, approximately 3 cm proximal of the joint space...
June 2018: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/29691170/outcomes-of-articulating-spacers-with-autoclaved-femoral-components-in-total-knee-arthroplasty-infection
#10
Daniel E Goltz, E Grant Sutter, Michael P Bolognesi, Samuel S Wellman
BACKGROUND: In 2-stage revision of total knee arthroplasty (TKA) infection, articulating antibiotic spacers show similar eradication rates and superior range of motion compared with static spacers. This study evaluated infection control and other outcomes in articulating spacers with an autoclaved index femoral component. METHODS: We reviewed 59 patients who underwent 2-stage treatment of TKA infection using articulating antibiotic spacers with an autoclaved femoral component with at least 2-year follow-up (mean: 5...
March 30, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29627258/does-prior-failed-debridement-compromise-the-outcome-of-subsequent-two-stage-revision-done-for-periprosthetic-joint-infection-following-total-knee-arthroplasty
#11
Ashok Rajgopal, Inayat Panda, Arun Rao, Vivek Dahiya, Himanshu Gupta
BACKGROUND: There has been a debate regarding the outcomes of 2-stage revision total knee arthroplasty (TKA) when debridement, antibiotics, irrigation, and implant retention (DAIR) had been carried out previously. The purpose of this study is to evaluate the influence of prior failed DAIR (F-DAIR) on the outcomes of 2-stage revision TKA done for periprosthetic joint infection (PJI). METHODS: This is a retrospective study of a consecutive series of 184 knees that completed 2-stage revision TKA for PJI, operated by a single surgeon between January 2000 and July 2011...
March 9, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29572038/high-efficiency-particulate-air-filters-do-not-affect-acute-infection-rates-during-primary-total-joint-arthroplasty-using-forced-air-warmers
#12
Gannon L Curtis, Mhamad Faour, Jaiben George, Alison K Klika, Wael K Barsoum, Carlos A Higuera
BACKGROUND: Studies have suggested that forced-air warmers (FAWs) increase contamination of the surgical site. In response, FAWs with high efficiency particulate air filters (FAW-HEPA) were introduced. This study compared infection rates following primary total joint arthroplasty (TJA) using FAW and FAW-HEPA. METHODS: Primary TJA patients at a single healthcare system were retrospectively reviewed. A total of 5405 THA (n = 2419) and TKA (n = 2986) consecutive cases in 2013 and 2015 were identified...
June 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29572037/prognostic-factors-for-success-after-irrigation-and-debridement-with-modular-component-exchange-for-infected-total-knee-arthroplasty
#13
Christian M Klare, Thomas A Fortney, Peter W Kahng, Andrew P Cox, Benjamin J Keeney, Wayne E Moschetti
BACKGROUND: Irrigation and debridement with modular component exchange (IDMCE) can treat prosthetic joint infection (PJI) after total knee arthroplasty (TKA). Compared to 2-stage revision, IDMCE is associated with lower morbidity but may carry higher infection recurrence rates. We aimed to identify prognostic factors associated with successful IDMCE in patients with PJI. METHODS: We identified 99 consecutive patients who underwent IDMCE following TKA PJI at a tertiary academic medical center from November 2009 through January 2016...
February 13, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29554718/efficacy-of-taurolidine-irrigation-in-primary-total-knee-arthroplasty
#14
Young Ha Woo, Ju Seon Jeong, Ok Geol Kim, In Seung Lee
Purpose: Taurolidine is an antimicrobial agent that was originally used in the local treatment of peritonitis. The aim of this study was to evaluate the efficacy of taurolidine irrigation in primary total knee arthroplasty (TKA). Materials and Methods: All patients who underwent TKA at our institute from January 2015 to March 2017 were eligible. There were 300 patients in the taurolidine irrigation group and 300 patients in the control group. The patients in the taurolidine irrigation group were irrigated after implantation with a mix of 250 mL of taurolidine and 750 mL of normal saline...
March 19, 2018: Knee Surgery & related Research
https://www.readbyqxmd.com/read/29547115/medium-term-results-of-total-knee-arthroplasty-as-a-primary-treatment-for-knee-fractures
#15
Ayman Ebied, Ahmed Zayda, Sameh Marei, Hany Elsayed
INTRODUCTION: Successful treatment of knee comminuted periarticular fractures associated with osteoporosis and pre-existing arthritis is a challenging task. METHODS: This is a prospective study on 27 patients who had comminuted intra and periarticular knee fractures and pre-existing arthritis. Fractures were classified according to Muller's AO classification. Primary knee arthroplasty was performed ± internal fixation following 4 weeks of splinting. A stem was added to the tibial tray and Legacy Constrained Condylar Knee (LCCK) or Rotating Hinge (RH) prosthesis were used depending on the level of ligament damage and bone defects...
2018: SICOT-J
https://www.readbyqxmd.com/read/29510952/comparison-of-postoperative-complications-following-metal-on-metal-total-hip-arthroplasty-with-other-hip-bearings-in-medicare-population
#16
Lindsay T Kleeman, Abiram Bala, Colin T Penrose, Thorsten M Seyler, Samuel S Wellman, Michael P Bolognesi
BACKGROUND: The use of metal-on-metal (MoM) hip bearings has declined in the recent years due to strong evidence of their high complication rates and early failure. Hip implants with highly cross-linked polyethylene liners and ceramic bearings have become the modern implants of choice. We sought to determine if MoM implants are associated with higher complication and revision rates when compared to other hip bearings in the Medicare population. METHODS: We retrospectively reviewed a Medicare database (2005-2011) for patients who underwent a primary total hip arthroplasty with a MoM, metal-on-polyethylene (MoP), ceramic-on-polyethylene (CoP), or ceramic-on-ceramic (CoC) implant (minimum 2 years of follow-up)...
February 5, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29428466/irrigation-and-debridement-for-early-periprosthetic-knee-infection-is-it-effective
#17
Rajkishen Narayanan, Afshin A Anoushiravani, Ameer M Elbuluk, Kevin K Chen, Edward M Adler, Ran Schwarzkopf
BACKGROUND: Irrigation and debridement (I&D) is performed for early management of periprosthetic joint infection (PJI) following total knee arthroplasty (TKA). Symptom reporting is a subjective measure and may miss direct management of PJI. Utilizing an objective time interval from index procedure to I&D may better inform treatment decisions. METHODS: From 2009 to 2017, retrospective review was performed of 55 knee PJI cases at our institution. All patients underwent polyethylene liner exchange and I&D for PJI...
January 9, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29356798/staged-prone-supine-fixation-of-high-energy-multicolumnar-tibial-plateau-fractures-a-multicenter-analysis
#18
Elliot R Row, David E Komatsu, J Tracy Watson, Clifford Jones, Stephen Kottmeier
PURPOSE: We present a surgical strategy to manage multicolumnar tibial plateau fracture variants by addressing the predominant posterior fragment employing a Lobenhoffer approach in the prone position followed by supine patient repositioning for anterolateral column access. DESIGN: Multicenter retrospective analysis. SETTING: Three academic Level 1 trauma centers. PATIENTS/METHODS: Twenty-eight cases (28 patients/28 knees) met inclusion criteria between 2003 and 2014...
April 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29299475/total-knee-arthroplasty-fibrosis-following-arthroscopic-intervention
#19
Jessica L Churchill, Nipun Sodhi, Anton Khlopas, Nicolas S Piuzzi, Sarah E Dalton, Morad Chughtai, Assem A Sultan, Steven Jones, Nick Williams, Peter M Bonutti, Michael A Mont
Background: Although arthroscopy is generally considered to be a relatively benign procedure with limited trauma to periarticular soft tissues, post-arthroscopic bleeding as well as osmolality differences between the normal saline used to irrigate and the native synovial fluid (282 vs . 420 mOs) can lead to capsular reactions. Therefore, the purpose of this study was to evaluate whether capsular reaction occurred after knee arthroscopy, by comparing a matched cohort of patients who either did or did not undergo prior arthroscopic surgery...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29244685/mycobacterium-cosmeticum-infection-after-total-knee-arthroplasty-a-case-report
#20
Emil Stefan Vutescu, Karl M Koenig
CASE: A 67-year-old immunocompetent man presented with a periprosthetic infection 4 months after a left total knee arthroplasty. Repeated aspirations failed to show any organism growth. After irrigation and debridement with polyethylene exchange, there was minimal clinical improvement. Subsequently, the patient developed an arthrocutaneous fistula, which prompted a 2-stage revision arthroplasty. Mycobacterium cosmeticum grew on the culture specimens taken during this procedure, and the patient was treated with 6 months of antibiotics...
January 2017: JBJS Case Connector
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