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Total joint infection

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https://www.readbyqxmd.com/read/28438449/ankylosing-spondylitis-increases-perioperative-and-postoperative-complications-after-total-hip-arthroplasty
#1
Daniel J Blizzard, Colin T Penrose, Charles Z Sheets, Thorsten M Seyler, Michael P Bolognesi, Christopher R Brown
BACKGROUND: Ankylosing spondylitis (AS) is a chronic autoimmune spondyloarthropathy that primarily affects the axial spine and hips. Progressive disease leads to pronounced spinal kyphosis, positive sagittal balance, and altered biomechanics. The purpose of this study is to determine the complication profile of patients with AS undergoing total hip arthroplasty (THA). METHODS: The Medicare sample was searched from 2005 to 2012 yielding 1006 patients with AS who subsequently underwent THA...
March 27, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28436379/economic-analysis-of-4221-revisions-due-to-periprosthetic-joint-infection-in-poland
#2
Ireneusz Babiak, Piotr Pędzisz, Jakub Janowicz, Mateusz Kulig, Paweł Małdyk
BACKGROUND: Periprosthetic joint infection (PJI) is one of the most severe complications of total hip (THA) and total knee (TKA) arthroplasty. The aim of the study is to determine the number and type of hip and knee prosthesis revisions in Poland performed due to infection and reimbursement of the cost of septic revisions and to compare the costs of septic and aseptic revisions in Poland and other countries. MATERIAL AND METHODS: The data published for the period 2009-2013 by the National Health Fund (NHF) were analysed and the average cost of septic and aseptic revisions was calculated...
January 26, 2017: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28434697/poor-outcomes-of-irrigation-and-debridement-in-acute-periprosthetic-joint-infection-with-antibiotic-impregnated-calcium-sulfate-beads
#3
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/28421514/corr-insights-%C3%A2-vancomycin-prophylaxis-for-total-joint-arthroplasty-incorrectly-dosed-and-has-a-higher-rate-of-periprosthetic-infection-than-cefazolin
#4
Alex Soriano
No abstract text is available yet for this article.
April 18, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28421237/radiographic-interpretation-of-carpometacarpal-arthroplasty-correlation-between-radiographic-loosening-and-clinical-outcome
#5
Laurence Stillwater, Brett Memauri, Imran Ratanshi, Avinash Islur, Thelina Amaratunga
OBJECTIVE: To assess the radiographic appearance and interpretation of loosening in patients following first carpometacarpal joint pyrohemisphere arthroplasty. MATERIALS AND METHODS: A retrospective review over a 6-year period was performed identifying patients with first carpometacarpal pyrohemisphere implants. All postoperative radiographs were reviewed and compared with clinical information. Loosening was defined as greater than 1 mm of periprosthetic lucency or increasing lucency on serial studies...
April 19, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28419029/females-with-unexplained-joint-pain-following-total-joint-arthroplasty-exhibit-a-higher-rate-and-severity-of-hypersensitivity-to-implant-metals-compared-with-males-implications-of-sex-based-bioreactivity-differences
#6
Marco S Caicedo, Edward Solver, Latasha Coleman, Joshua J Jacobs, Nadim J Hallab
BACKGROUND: Recent studies indicate that females demonstrate an increased risk of experiencing adverse local tissue reactions, aseptic loosening, and revision after primary metal-on-metal hip resurfacing arthroplasty compared with males; the underlying biological mechanisms responsible for sex discrepancies in implant failure remain unclear. In addition to anatomical and biomechanical sex differences, there may be inherent immunological disparities that predispose females to more aggressive adaptive immune reactivity to implant debris, i...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28418574/inadequacy-of-joint-aspiration-for-detection-of-persistent-periprosthetic-infection-during-two-stage-septic-revision-knee-surgery
#7
Bernd Preininger, Viktor Janz, Philipp von Roth, Andrej Trampuz, Carsten F Perka, Tilman Pfitzner
Despite the lack of validation, synovial aspiration remains a common practice during 2-stage septic revision total knee arthroplasty (TKA). The goal of this study was to investigate the diagnostic validity of synovial polymethylmethacrylate (PMMA) spacer aspiration of temporary knee arthrodesis to detect persistent periprosthetic joint infection before TKA reimplantation. This retrospective cohort study included 73 consecutive patients who underwent 2-stage septic revision TKA according to a standard protocol...
April 18, 2017: Orthopedics
https://www.readbyqxmd.com/read/28416968/safety-and-efficacy-of-resistive-polymer-versus-forced-air-warming-in-total-joint-surgery
#8
Melanie F Sandoval, Paul D Mongan, Michael R Dayton, Craig A Hogan
BACKGROUND: Forced-air warming is used as a mechanism to prevent hypothermia and adverse outcomes associated with hypothermia among patients undergoing surgery. Patient safety in healthcare includes the use of devices and technology that minimize potential adverse events to patients. The present study sought to compare the capabilities of patient warming between two different devices that use different mechanisms of warming: forced-air warming and non-air warming. METHODS: One hundred twenty patients undergoing total hip or total knee arthroplasty received patient warming via a forced warming device or non-air warming fabric conductive material...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28416838/-clinical-research-on-robot-assisted-percutaneous-pelvic-and-acetabular-screws-surgery
#9
C P Zhao, J Q Wang, Y G Su, W Han, L Zhou, M Y Wang
OBJECTIVE: To evaluate the security and efficiency of a surgical robotic assisted percutaneous screw fixation for the treatment of pelvic and acetabular fractures. METHODS: In the study, 12 patients with pelvic and acetabular fractures who were treated in Beijing Jishuitan Hospital from January to April in 2016 were involved in this research. The research subjects were randomly divided into two groups: the experimental group and the control group. Robotic-assisted percutaneous sacroiliac screw internal fixations were performed under the guidance of fluoroscopy navigation in the experimental group; in the control group, doctors operated manually guided by fluoroscopy...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28410834/wearing-id-badges-in-the-operating-room-environment-is-reconsideration-warranted
#10
Matthew H Hogue, Kris P Heilmann, John J Callaghan
BACKGROUND: Surgical site infection and nosocomial infections in general have appropriately undergone increased scrutiny over the last decade. Numerous studies have documented pathogenic bacterial contamination of personal items such as cell phones, pagers, ties, and pens in the hospital setting. It is our understanding that Joint Commission on Accreditation of Healthcare Organizations requires all personnel to wear an identification badge at all times, which includes the operating room environment...
February 3, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28410692/treatment-outcome-of-extrapulmonary-tuberculosis-under-revised-national-tuberculosis-control-programme
#11
J J Cherian, I Lobo, A Sukhlecha, U Chawan, N A Kshirsagar, B L Nair, L Sawardekar
BACKGROUND: Extrapulmonary tuberculosis (EPTB) constitutes 15-20% of tuberculosis cases in India. Earlier studies have evaluated treatment outcomes of EPTB with little information on outcomes of individual site of EPTB. AIMS: The objective was to study the outcome of Directly Observed Treatment Short course (DOTS) treatment of EPTB in different organ systems under Revised National Tuberculosis Control Programme. METHODS: Multi-centric retrospectives record review was carried out in three states in India...
April 2017: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/28407472/introduction-to-the-centers-for-disease-control-and-prevention-and-healthcare-infection-control-practices-advisory-committee-guideline-for-prevention-of-surgical-site-infection-prosthetic-joint-arthroplasty-section
#12
John Segreti, Javad Parvizi, Elie Berbari, Philip Ricks, Sandra I Berríos-Torres
Peri-prosthetic joint infection (PJI) is a severe complication of total joint arthroplasty that appears to be increasing as more of these procedures are performed. Numerous risk factors for incisional (superficial and deep) and organ/space (e.g., PJI) surgical site infections (SSIs) have been identified. A better understanding and reversal of modifiable risk factors may lead to a reduction in the incidence of incisional SSI and PJI. The Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC) recently updated the national Guideline for Prevention of Surgical Site Infection...
April 13, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28401341/vancomycin-prophylaxis-for-total-joint-arthroplasty-incorrectly-dosed-and-has-a-higher-rate-of-periprosthetic-infection-than-cefazolin
#13
Michael M Kheir, Timothy L Tan, Ibrahim Azboy, Dean D Tan, Javad Parvizi
BACKGROUND: In total joint arthroplasty (TJA), vancomycin is used as perioperative antibiotic prophylaxis in patients with penicillin allergy or in patients colonized with methicillin-resistant Staphylococcus aureus (MRSA). Although vancomycin dosing should be weight-based (15 mg/kg), not all surgeons are aware of this; a fixed 1-g dose is instead frequently administered. QUESTIONS/PURPOSES: (1) Is there a difference in the risk of periprosthetic joint infection (PJI) in patients receiving vancomycin or cefazolin prophylaxis after primary TJA? (2) What proportion of patients is adequately dosed with vancomycin? (3) Compared with actual fixed dosing, does weight-based dosing result in a greater proportion of patients staying above the recommended 15-mg/L level at the beginning and end of surgery? (4) Are patients overdosed with vancomycin at greater risk of developing nephrotoxicity and acute kidney injury? METHODS: A single-institution, retrospective study was performed on 1828 patients undergoing primary TJAs who received vancomycin prophylaxis between 2008 and 2014...
April 11, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28400668/nontuberculous-mycobacterial-infection-of-the-musculoskeletal-system-in-immunocompetent-hosts
#14
Manit K Gundavda, Hitendra G Patil, Vikas M Agashe, Rajeev Soman, Camilla Rodriques, Ramesh B Deshpande
BACKGROUND: Nontuberculous mycobacteria (NTM) were considered saprophytic organisms for many years but now are recognized as human pathogens. Although humans are routinely exposed to NTM, the rate of clinical infection is low. Such infections usually occur in the elderly and in patients who are immunocompromised. However, there has been an increasing incidence in recent years of infections in immunocompetent hosts. NTM infections in immunocompetent individuals are secondary to direct inoculation either contamination from surgical procedures or penetrating injuries rather than hematogenous dissemination...
March 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28400048/near-perfect-compliance-with-scip-inf-9-had-no-effect-on-catheter-utilization-or-urinary-tract-infections-at-an-academic-medical-center
#15
Jennifer A Kaplan, Jonathan T Carter
BACKGROUND: The Joint Commission's SCIP Inf-9 mandated early removal of indwelling urinary catheters (IUCs), but the impact of compliance on catheter-associated urinary tract infection (CAUTI) and postoperative urinary retention (POUR) are unknown. METHODS: Retrospective pre- and post-intervention study at a single tertiary academic medical center of all patients undergoing general surgery procedures with an IUC placed at the time of surgery who were admitted for at least two days before and after a Best Practice Advisory was put in place to improve compliance with SCIP Inf-9...
April 5, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28390884/preoperative-anemia-independently-predicts-30-day-complications-after-aseptic-and-septic-revision-total-joint-arthroplasty
#16
Min Lu, David C Sing, Alfred C Kuo, Erik N Hansen
BACKGROUND: Preoperative anemia is a common, important risk factor for adverse events after joint arthroplasty surgery. It affects 21%-35% patients undergoing total joint arthroplasty. To date, few studies have investigated the effect of preoperative anemia, specifically in revision total joint arthroplasty surgery. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was used to identify patients who underwent revision total joint arthroplasty from 2006 to 2014...
March 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28389865/what-is-the-long-term-economic-societal-effect-of-periprosthetic-infections-after-tha-a-markov-analysis
#17
Thomas J Parisi, Joseph F Konopka, Hany S Bedair
BACKGROUND: Current estimates for the direct costs of a single episode of care for periprosthetic joint infection (PJI) after THA are approximately USD 100,000. These estimates do not account for the costs of failed treatments and do not include indirect costs such as lost wages. QUESTIONS/PURPOSES: The goal of this study was to estimate the long-term economic effect to society (direct and indirect costs) of a PJI after THA treated with contemporary standards of care in a hypothetical patient of working age (three scenarios, age 55, 60, and 65 years)...
April 7, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28385946/the-management-of-open-tibial-fractures-in-children-a-retrospective-case-series-of-eight-years-experience-of-61-cases-at-a-paediatric-specialist-centre
#18
R S Nandra, F Wu, A Gaffey, C E Bache
AIMS: Following the introduction of national standards in 2009, most major paediatric trauma is now triaged to specialist units offering combined orthopaedic and plastic surgical expertise. We investigated the management of open tibia fractures at a paediatric trauma centre, primarily reporting the risk of infection and rate of union. PATIENTS AND METHODS: A retrospective review was performed on 61 children who between 2007 and 2015 presented with an open tibia fracture...
April 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28385943/is-there-still-a-role-for-osteoarticular-allograft-reconstruction-in-musculoskeletal-tumour-surgery-a-long-term-follow-up-study-of-38-patients-and-systematic-review-of-the-literature
#19
M P A Bus, M A J van de Sande, A H M Taminiau, P D S Dijkstra
AIMS: To assess complications and failure mechanisms of osteoarticular allograft reconstructions for primary bone tumours. PATIENTS AND METHODS: We retrospectively evaluated 38 patients (28 men, 74%) who were treated at our institution with osteoarticular allograft reconstruction between 1989 and 2010. Median age was 19 years (interquartile range 14 to 32). Median follow-up was 19.5 years (95% confidence interval (CI) 13.0 to 26.1) when 26 patients (68%) were alive...
April 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28384558/temporary-total-hip-arthroplasty-like-spacer-for-treating-an-infected-periprosthetic-femoral-fracture-using-a-long-stem-a-case-report
#20
Youngwoo Kim, Yoshiaki Katsura, Nina Kasahara, Takashi Kasahara, Masashi Kanamura, Keiichi Kawanabe
INTRODUCTION: Infected periprosthetic femoral fractures are among the most complex and significant complications of total hip arthroplasty (THA). We report the novel use of a temporary THA-like spacer for treating an infected periprosthetic femoral fracture after revision surgery using a long stem. CASE PRESENTATION: We present a 72-year-old woman sustained a left infected periprosthetic femoral fracture after revi - streptococci in the culture sample. On suspicion of a periprosthetic joint infection, we planned a two-stage procedure...
2017: International Journal of Surgery Case Reports
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