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Arthroplasty irrigation

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https://www.readbyqxmd.com/read/28781018/high-early-major-complication-rate-after-revision-for-mechanically-assisted-crevice-corrosion-in-metal-on-polyethylene-total-hip-arthroplasty
#1
Brian J McGrory, Anna H Jorgensen
BACKGROUND: Failed total hip arthroplasty caused by mechanically assisted crevice corrosion (MACC) has serious consequences such as adverse local tissue reaction. Revision is currently indicated for significant hip pain, stiffness, and dysfunction; hip instability; progressive bone loss; and soft tissue destruction. Outcomes of this revision surgery are not yet completely understood. METHODS: We examined the surgical outcomes at a minimum of 6 months (average, 25; range, 7-68 months) in a cohort of 27 consecutive patients who underwent revision total hip arthroplasty for MACC associated with a single implant vendor and taper type...
July 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28751093/two-stage-reimplantation-for-the-treatment-of-deep-infection-after-shoulder-arthroplasty
#2
Andrew T Assenmacher, Eduard Alentorn-Geli, Taylor Dennison, Yaser M K Baghdadi, Robert H Cofield, Joaquín Sánchez-Sotelo, John W Sperling
BACKGROUND: Two-stage reimplantation is the most common treatment modality considered for periprosthetic shoulder infection (PSI). Most studies to date have reported on a relatively small number of shoulders. The purpose of this study was to determine the outcome of 2-stage reimplantation for PSI in terms of both eradication of infection and restoration of function. METHODS: Between 1980 and 2010, 40 shoulders (39 patients) underwent a 2-stage reimplantation for PSI; 35 shoulders (34 patients) met inclusion criteria (10 hemiarthroplasties, 24 anatomic total shoulder arthroplasties, 1 reverse total shoulder arthroplasty)...
July 24, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28735470/staged-reimplantation-of-a-total-hip-prosthesis-after-co-infection-with-candida-tropicalis-and-staphylococcus-haemolyticus-a-case-report
#3
Sujeesh Sebastian, Rajesh Malhotra, Ashish Pande, Deepak Gautam, Immaculata Xess, Benu Dhawan
Fungal prosthetic joint infection is a rare complication in total joint arthroplasty. There are no established guidelines for management of these infections. We present a case of a 53-year-old male with a hip joint prosthesis co-infected with Candida tropicalis and Staphylococcus haemolyticus. A two-stage exchange arthroplasty was performed. The patient underwent implant removal, debridement, irrigation with saline solution and application of cement spacer impregnated with vancomycin followed by aggressive antimicrobial treatment in first stage...
July 22, 2017: Mycopathologia
https://www.readbyqxmd.com/read/28734537/total-elbow-arthroplasty-for-primary-osteoarthritis
#4
Bradley S Schoch, Jean-David Werthel, Joaquín Sánchez-Sotelo, Bernard F Morrey, Mark Morrey
BACKGROUND: Primary osteoarthritis of the elbow is a less common indication for total elbow arthroplasty (TEA). Higher complication rates in younger, active patients may offset short-term improvements in pain and function. The purpose of this study was to determine pain relief, functional outcomes, complications, and survival of TEA in this population. METHODS: Between 1984 and 2011, 20 consecutive TEAs were performed for primary elbow osteoarthritis. Two patients died before the 2-year follow-up...
August 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28670986/-periprosthetic-joint-infection-caused-by-rhodococcus-equi-case-report
#5
Imre Sallai, Nóra Péterfy, Mohammad Sanatkhani, Zoltán Bejek, Imre Antal, Gyula Prinz, Katalin Kristóf, Gábor Skaliczki
Rhodococcus equi is a rare pathogen in humans causing infections mostly in immunocompromised hosts. We present the first case of periprosthetic joint infection caused by Rhodococcus equi. An 88-year-old male patient was referred to our clinic with a history of fever and right hip pain. The patient had multiple hip surgeries including total joint arthroplasty and revision for aseptic loosening on the right side. He was immunocompetent, but his additional medical history was remarkable for diabetes mellitus, diabetic nephropathy and stroke with hemiplegia resulting in immobilization...
July 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28645272/prosthetic-joint-infection-caused-by-granulicatella-adiacens-a-case-series-and-review-of-literature
#6
Fanny Quénard, Piseth Seng, Jean-Christophe Lagier, Florence Fenollar, Andreas Stein
BACKGROUND: Bone and joint infection involving Granulicatella adiacens is rare, and mainly involved in cases of bacteremia and infectious endocarditis. Here we report three cases of prosthetic joint infection involving G. adiacens that were successfully treated with surgery and prolonged antimicrobial treatment. We also review the two cases of prosthetic joint infection involving G. adiacens that are reported in the literature. CASE PRESENTATION: Not all five cases of prosthetic joint infection caused by G...
June 23, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28598492/use-of-2-octyl-cyanoacrylate-adhesive-and-polyester-mesh-for-wound-closure-in-primary-knee-arthroplasty
#7
Andrew J Holte, Josef N Tofte, Greta J Dahlberg, Nicolas Noiseux
Wound closure in primary knee arthroplasty is important both for surgical success, by minimizing the risk of wound complications and infection, and for patient satisfaction with wound care and cosmesis. This article reports the use of a topical self-adhering, pressure-sensitive polyester mesh combined with 2-octyl cyanoacrylate adhesive for final skin closure of primary knee arthroplasty without external staples or sutures. During a 2.5-year period, 360 consecutive primary knee arthroplasty procedures (321 total knee arthroplasty procedures and 39 partial knee arthroplasty procedures) performed by 1 surgeon at 1 institution were reviewed...
June 9, 2017: Orthopedics
https://www.readbyqxmd.com/read/28543707/viable-bacteria-persist-on-antibiotic-spacers-following-two-stage-revision-for-periprosthetic-joint-infection
#8
Dongzhu Ma, Robert M Q Shanks, Charles M Davis, David W Craft, Thomas K Wood, Brian R Hamlin, Kenneth L Urish
Treatment in periprosthetic joint infection (PJI) remains challenging. The failure rate of two-stage revision and irrigation and debridement with component retention in PJI suggests that biofilm cells have a high tolerance to antibiotic chemotherapy. Previous work has demonstrated that biofilm cells have high antibiotic tolerance in vitro, but there is little clinical evidence to support these observations. The aim of this study was to determine if retrieved antibiotic spacers from two-stage revision total knee arthroplasty for PJI have evidence of remaining viable bacteria...
May 19, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28537349/effects-of-topical-antiseptic-solutions-used-during-total-knee-arthroplasty-on-suture-tensile-strength
#9
Jared M Newman, Jaiben George, Jeffery T Shepherd, Alison K Klika, Carlos A Higuera, Viktor E Krebs
INTRODUCTION: Irrigating a surgical wound with an antiseptic solution is commonly performed while suturing following a total knee arthroplasty (TKA) to help prevent wound complications. The purpose of this study was to: 1) evaluate the mean load to failure of different sutures, and 2) compare the mean load to failure of the sutures after soaking in four different antiseptic solutions. MATERIALS AND METHODS: Load-to-failure tests were conducted on four sets of comparable sutures (eight sutures) from two different companies Ethicon Inc...
May 24, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28529860/use-of-chlorhexidine-preparations-in-total-joint-arthroplasty
#10
REVIEW
Jaiben George, Alison K Klika, Carlos A Higuera
Prosthetic joint infection (PJI) is a serious complication after total joint arthroplasty (TJA). Chlorhexidine is a widely used antiseptic because of its rapid and persistent action. It is well tolerated and available in different formulations at various concentrations. Chlorhexidine can be used for pre-operative skin cleansing, surgical site preparation, hand antisepsis of the surgical team and intra-articular irrigation of infected joints. The optimal intra-articular concentration of chlorhexidine gluconate in irrigation solution is 2%, to provide a persistent decrease in biofilm formation, though cytotoxicity might be an issue...
2017: Journal of bone and joint infection
https://www.readbyqxmd.com/read/28529859/treatment-of-periprosthetic-joint-infection-using-antimicrobials-dilute-povidone-iodine-lavage
#11
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: Journal of bone and joint infection
https://www.readbyqxmd.com/read/28529858/hydrogen-peroxide-wound-irrigation-in-orthopaedic-surgery
#12
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: Journal of bone and joint infection
https://www.readbyqxmd.com/read/28455469/management-of-massive-acetabular-bone-defects-in-revision-arthroplasty-of-the-hip-using-a-reconstruction-cage-and-porous-metal-augment
#13
T J Mäkinen, M Abolghasemian, E Watts, S G Fichman, P Kuzyk, O A Safir, A E Gross
AIMS: It may not be possible to undertake revision total hip arthroplasty (THA) in the presence of massive loss of acetabular bone stock using standard cementless hemispherical acetabular components and metal augments, as satisfactory stability cannot always be achieved. We aimed to study the outcome using a reconstruction cage and a porous metal augment in these patients. PATIENTS AND METHODS: A total of 22 acetabular revisions in 19 patients were performed using a combination of a reconstruction cage and porous metal augments...
May 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28434697/poor-outcomes-of-irrigation-and-debridement-in-acute-periprosthetic-joint-infection-with-antibiotic-impregnated-calcium-sulfate-beads
#14
Michael A Flierl, Brian M Culp, Kamil T Okroj, Bryan D Springer, Brett R Levine, Craig J Della Valle
BACKGROUND: One proposed strategy to increase the success of irrigation and debridement with implant retention for the treatment of acute periprosthetic joint infection (PJI) is the use of dissolvable antibiotic-impregnated calcium sulfate beads to provide a local depot of antibiotics. The purpose of this study was to evaluate the outcome of such an approach. METHODS: Thirty-two patients with acute hematogenous (18 patients; 1 bilateral) or acute postoperative (14 patients) PJIs who underwent irrigation and debridement with implant retention and addition of antibiotic-impregnated calcium sulfate beads were retrospectively reviewed...
March 29, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28434695/the-influence-of-a-failed-irrigation-and-debridement-on-the-outcomes-of-a-subsequent-2-stage-revision-knee-arthroplasty
#15
Scott R Nodzo, Keely K Boyle, Allina A Nocon, Michael W Henry, David J Mayman, Geoffrey H Westrich
BACKGROUND: Previous work has suggested a failed irrigation and debridement (I&D) before a 2-stage exchange negatively impacts the outcome of the subsequent 2-stage revision. METHODS: This was a retrospective review of 132 patients who underwent a 2-stage exchange without prior I&D (2-Stage), and 45 patients had a failed I&D before their 2-stage exchange (I&D+2Stage) between April 2009 and April 2015. Charts were reviewed for patient demographics, presenting inflammatory laboratory values, type of antibiotic spacer used, surgical details, microbiology data, length of postoperative antibiotic treatment, and reoperation...
March 22, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28361019/results-of-single-stage-exchange-arthroplasty-with-retention-of-well-fixed-cement-less-femoral-component-in-management-of-infected-total-hip-arthroplasty
#16
Wael A Rahman, Hussain A Kazi, Jeffery D Gollish
AIM: To investigate success of one stage exchange with retention of fixed acetabular cup. METHODS: Fifteen patients treated by single stage acetabular component exchange with retention of well-fixed femoral component in infected total hip arthroplasty (THA) were retrospectively reviewed. Inclusion criteria were patients with painful chronic infected total hip. The patient had radiologically well fixed femoral components, absence of major soft tissue or bone defect compromising, and infecting organism was not poly or virulent micro-organism...
March 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28335753/leuconostoc-mesenteroides-periprosthetic-knee-infection-an-unusual-fastidious-gram-positive-bacteria-a-case-report
#17
Rafael Franco-Cendejas, Claudia A Colín-Castro, Melissa Hernández-Durán, Luis E López-Jácome, Silvestre Ortega-Peña, Guillermo Cerón-González, Samuel Vanegas-Rodríguez, Jaime A Mondragón-Eguiluz, Eduardo Acosta-Rodríguez
BACKGROUND: Periprosthetic joint infections are mainly caused by Gram-positive cocci. Leuconostoc mesenteroides is a rare microorganism mainly causing bloodstream infections. At times, it might be confused with another type of cocci and give rise to misdiagnosed infections. Molecular diagnosis and biofilm production comprise important techniques to guide antibiotic treatment. CASE PRESENTATION: A 68-year-old Hispanic female with a previous history of bilateral knee arthroplasty presented with acute right-knee inflammation and gait impairment...
March 23, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28222649/a-randomized-control-trial-to-evaluate-the-effectiveness-of-intravenous-intra-articular-and-topical-wash-regimes-of-tranexamic-acid-in-primary-total-knee-arthroplasty
#18
Jatin Prakash, Jong-Keun Seon, Yong Jin Park, Cheng Jin, Eun-Kyoo Song
BACKGROUND: The efficacy of tranexamic acid to decrease post-operative blood loss and blood transfusion is well established in literature. However, the ideal mode of administration is debatable. Limited literature has compared all the available modes of administration including intravenous (IV), topical irrigation and retrograde through drain. We hypothesized that no difference would be present in either form of administration of tranexamic acid. METHODS: Fifty patients in four groups were enrolled for study...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28222211/the-learning-curve-for-the-direct-anterior-approach-for-total-hip-arthroplasty-a-single-surgeon-s-first-500-cases
#19
James M Hartford, Michael J Bellino
BACKGROUND: Concerns arise over the early complications encountered during the learning curve for the direct anterior approach for total hip arthroplasty. PURPOSE: The purpose of this study is to examine the learning experience of a single surgeon in adapting this approach. METHODS: The 1st 500 primary total hip arthroplasties are reviewed. The patients were evaluated out to 3 months. Rates of major complications, reoperations, periprosthetic fractures, heterotopic ossification, leg length discrepancies and lateral femoral cutaneous nerve deficits were identified for each of 100 patients...
February 17, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28163947/scedosporium-prolificans-septic-arthritis-and-osteomyelitis-of-the-hip-joints-in-an-immunocompetent-patient-a-case-report-and-literature-review
#20
Luca Daniele, Michael Le, Adam Franklin Parr, Lochlin Mark Brown
Scedosporium prolificans, also known as Scedosporium inflatum, is a fungus widespread in soil, sewage, and manure. This species is highly virulent and is an emerging opportunistic pathogen found in penetrating injuries in immunocompromised patients. Here we report on an immunocompetent patient with bilateral hip S. prolificans-associated osteomyelitis and septic arthritis caused by intentional penetrating trauma. The condition was refractory to initial antimicrobial suppression and surgical irrigation and debridement...
2017: Case Reports in Orthopedics
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