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https://www.readbyqxmd.com/read/28074774/the-dair-debridement-antibiotics-and-implant-retention-procedure-for-infected-total-knee-replacement-a-literature-review
#1
Sultan Naseer Qasim, Andrew Swann, Robert Ashford
Prosthetic joint infection (PJI) is a devastating complication in total knee arthroplasty (TKA) and third most common cause of revision of TKA with significant morbidity and surgical challenges. Treatment options include non-operative measures with long term antibiotic suppression, debridement and implant retention (DAIR), one- or two-stage revision arthroplasty, arthrodesis and amputation. Implant retention without infection is ideal and DAIR has been reported to have variable success rates depending on patient factors, duration of infection, infecting micro-organisms, choice of procedure, single or multiple debridement procedures, arthroscopic or open, antibiotic choice and duration of antibiotic use...
2017: SICOT-J
https://www.readbyqxmd.com/read/28071847/hindfoot-fusion-in-haemophilic-arthropathy-6-year-mean-follow-up-of-41-procedures-performed-in-28-adult-patients
#2
M Brkljac, S Shah, C Hay, E C Rodriguez-Merchan
INTRODUCTION: Haemophilic arthropathy of the ankle is rare disorder caused by recurrent haemarthorses beginning in early adulthood. AIM: Our aim was to evaluate the fusion rate of various techniques of hindfoot fusion using internal fixation for the treatment of haemophilic arthropathy of the hindfoot. METHODS: We have evaluated the fusion rate of various techniques of hindfoot (tibiotalar and subtalar joints) fusion for the treatment of haemophilic arthropathy of the hindfoot...
March 2016: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28070650/revision-total-knee-arthroplasty-due-to-bone-cement-and-metal-hypersensitivity
#3
Ioannis P Stathopoulos, Nicolaos Andrianopoulos, Dimitrios Paschaloglou, Ioannis Tsarouchas
INTRODUCTION: Hypersensitivity to implants is a rare complication of total knee arthroplasty (TKA). Metal and, less frequently, bone cement can produce allergic symptomatology that if unresponsive to conservative treatment could lead to revision. MATERIALS AND METHODS: We present the case of a patient with generalized pruritus and metal taste starting during the first postoperative month after TKA. Dermal allergy exams revealed that the patient had hypersensitivity to nickel sulphate and cobalt chloride and bone cement...
January 9, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28070593/-morphological-investigations-of-deep-sole-ulcers-in-cattle-part-1-the-complicated-rusterholz-ulcer
#4
Susanne Gehringer, Matthias Müller, Johann Maierl
OBJECTIVE: In the context of a larger study on morphological changes of deep sole ulcers, claws with Rusterholz ulcer (RU) were investigated to describe the varied pathological changes of the RU. MATERIAL AND METHODS: Hind limbs of 55 cows displaying external signs of complicated sole ulcers were examined externally and internally. To examine the samples internally, a sagittal section was performed. Furthermore, the material was examined histologically and after bone maceration...
January 10, 2017: Tierärztliche Praxis. Ausgabe G, Grosstiere/Nutztiere
https://www.readbyqxmd.com/read/28068972/an-underlying-diagnosis-of-osteonecrosis-of-bone-is-associated-with-worse-outcomes-than-osteoarthritis-after-total-hip-arthroplasty
#5
Jasvinder A Singh, Jason Chen, Maria C S Inacio, Robert S Namba, Elizabeth W Paxton
BACKGROUND: Well-designed studies of complications and readmission rates in patients undergoing total hip arthroplasty (THA) with osteonecrosis are lacking. Our objective was to examine if a diagnosis of osteonecrosis was associated with complications, mortality and readmission rates after THA. METHODS: We analyzed prospectively collected data from an integrated healthcare system's Total Joint Replacement Registry of adults with osteonecrosis vs. osteoarthritis (OA) undergoing unilateral primary THA during 2001-2012, in an observational cohort study...
January 9, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28068335/dengue-in-latin-america-systematic-review-of-molecular-epidemiological-trends
#6
José Ramos-Castañeda, Flavia Barreto Dos Santos, Ruth Martínez-Vega, Josélio Maria Galvão de Araujo, Graham Joint, Elsa Sarti
Dengue, the predominant arthropod-borne viral disease affecting humans, is caused by one of four distinct serotypes (DENV-1, -2, -3 or -4). A literature analysis and review was undertaken to describe the molecular epidemiological trends in dengue disease and the knowledge generated in specific molecular topics in Latin America, including the Caribbean islands, from 2000 to 2013 in the context of regional trends in order to identify gaps in molecular epidemiological knowledge and future research needs. Searches of literature published between 1 January 2000 and 30 November 2013 were conducted using specific search strategies for each electronic database that was reviewed...
January 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28065627/revision-total-hip-and-knee-arthroplasties-after-solid-organ-transplant
#7
Cameron K Ledford, Joseph M Statz, Brian P Chalmers, Kevin I Perry, Arlen D Hanssen, Matthew P Abdel
BACKGROUND: As solid organ transplant (SOT) patients' survival improves, the number undergoing total hip (THA) and total knee arthroplasty (TKA) is increasing. Accordingly, the number of revision procedures in this higher-risk group is also increasing. The goals of this study were to identify the most common failure mechanisms, associated complications, clinical outcomes, and patient survivorship of SOT patients after revision THA or TKA. METHODS: A retrospective review identified 39 revision procedures (30 revision THAs and 9 revision TKAs) completed in 37 SOT patients between 2000 and 2013...
December 11, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28054327/obesity-epidemic-is-its-impact-on-total-joint-arthroplasty-underestimated-an-analysis-of-national-trends
#8
Jaiben George, Alison K Klika, Suparna M Navale, Jared M Newman, Wael K Barsoum, Carlos A Higuera
BACKGROUND: Obesity is a well-established risk factor for total joint arthroplasty (TJA) and a number of complications including prosthetic joint infection. The annual changes in the prevalence of obesity among primary, revision, and infected TJA has not been studied at a national level. Given the higher costs of complications of TJA, it is important to understand the association of obesity with the annual trends of revision and infected TJA. QUESTIONS/PURPOSES: (1) Is the prevalence of obesity increasing among patients undergoing THA/TKA? (2) Is the prevalence of obesity increasing among patients undergoing revision THA/TKA? (3) Is the prevalence of obesity increasing among patients with infected THA/TKA? METHODS: Annual volumes of primary, revision, and infected THA and TKA from 1998 to 2011 were obtained from the Nationwide Inpatient Sample...
January 4, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28054326/what-is-the-timing-of-general-health-adverse-events-that-occur-after-total-joint-arthroplasty
#9
Daniel D Bohl, Nathaniel T Ondeck, Bryce A Basques, Brett R Levine, Jonathan N Grauer
BACKGROUND: Despite extensive research regarding risk factors for adverse events after total joint arthroplasty (TJA), there are few publications describing the timing at which such adverse events occur. QUESTIONS/PURPOSES: (1) On which postoperative day do certain adverse events occur? (2) What adverse events occur earlier after TKA than after THA? (3) For each adverse event, what proportion occurred after hospital discharge? METHODS: We screened the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) to identify all patients undergoing primary THA and primary TKA between 2005 and 2013, resulting in a study population of 124,657 patients evaluated as part of this retrospective database analysis...
January 4, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28053267/assessment-of-resuscitation-as-measured-by-markers-of-metabolic-acidosis-and-features-of-injury
#10
D S Weinberg, A S Narayanan, T A Moore, H A Vallier
AIMS: The best time for definitive orthopaedic care is often unclear in patients with multiple injuries. The objective of this study was make a prospective assessment of the safety of our early appropriate care (EAC) strategy and to evaluate the potential benefit of additional laboratory data to determine readiness for surgery. PATIENTS AND METHODS: A cohort of 335 patients with fractures of the pelvis, acetabulum, femur, or spine were included. Patients underwent definitive fixation within 36 hours if one of the following three parameters were met: lactate < 4...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28053259/qualitative-%C3%AE-defensin-test-synovasure-for-the-diagnosis-of-periprosthetic-infection-in-revision-total-joint-arthroplasty
#11
I K Sigmund, J Holinka, J Gamper, K Staats, C Böhler, B Kubista, R Windhager
AIMS: The diagnosis of periprosthetic joint infection (PJI) remains demanding due to limitations of all the available diagnostic tests. The synovial fluid marker, α-defensin, is a promising adjunct for the assessment of potential PJI. The purpose of this study was to investigate the qualitative assessment of α-defensin, using Synovasure to detect or exclude periprosthetic infection in total joint arthroplasty. PATIENTS AND METHODS: We studied 50 patients (28 women, 22 men, mean age 65 years; 20 to 89) with a clinical indication for revision arthroplasty who met the inclusion criteria of this prospective diagnostic study...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28053257/knee-joint-distraction-compared-with-total-knee-arthroplasty-a-randomised-controlled-trial
#12
J A D van der Woude, K Wiegant, R J van Heerwaarden, S Spruijt, P J Emans, S C Mastbergen, F P J G Lafeber
AIMS: Knee joint distraction (KJD) is a relatively new, knee-joint preserving procedure with the goal of delaying total knee arthroplasty (TKA) in young and middle-aged patients. We present a randomised controlled trial comparing the two. PATIENTS AND METHODS: The 60 patients ≤ 65 years with end-stage knee osteoarthritis were randomised to either KJD (n = 20) or TKA (n = 40). Outcomes were assessed at baseline, three, six, nine, and 12 months. In the KJD group, the joint space width (JSW) was radiologically assessed, representing a surrogate marker of cartilage thickness...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28053254/the-synergy-cementless-femoral-stem-in-primary-total-hip-arthroplasty-at-a-minimum-follow-up-of-15-years
#13
I De Martino, V De Santis, R D' Apolito, P K Sculco, M B Cross, G Gasparini
AIMS: We report on the outcome of the Synergy cementless femoral stem with a minimum follow-up of 15 years (15 to 17). PATIENTS AND METHODS: A retrospective review was undertaken of a consecutive series of 112 routine primary cementless total hip arthroplasties (THAs) in 102 patients (112 hips). There were 60 female and 42 male patients with a mean age of 61 years (18 to 82) at the time of surgery. A total of 78 hips in the 69 patients remain in situ; nine hips in eight patients died before 15 years, and 16 hips in 16 patients were revised...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28050817/phosphatidylcholine-coatings-deliver-local-antimicrobials-and-reduce-infection-in-a-murine-model-a-preliminary-study
#14
Michael A Harris, Karen E Beenken, Mark S Smeltzer, Warren O Haggard, J Amber Jennings
BACKGROUND: Phosphatidylcholine coatings have been shown to elute antibiotics for several days. A recently developed biofilm inhibitor, cis-2-decenoic acid (C2DA), has been shown to exhibit synergistic activity with several common antibiotics. This study aims to evaluate the effectiveness of C2DA and amikacin dual drug delivery from a phosphatidylcholine coating. QUESTIONS/PURPOSES: (1) What are the in vitro elution profiles of amikacin and C2DA from phosphatidylcholine-coated coupons in incubated phosphate-buffered saline? (2) Does the presence of C2DA in eluate samples lower the amount of amikacin needed for bacterial inhibition in overnight bacterial turbidity assays? (3) Does addition of amikacin and C2DA result in decreased colony-forming units (CFUs) on wire implants and bone when compared with phosphatidylcholine coatings alone in a mouse model of periprosthetic joint infection? METHODS: Effects of loading concentrations were assessed during 7-day in vitro elution studies for coatings containing all mixtures of 0%, 5%, 15%, and 25% wt of amikacin and C2DA (n = 4) through quantitative high-performance liquid chromatography concentration determination and plotting concentration eluted over time...
January 3, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28050457/evaluation-of-clinical-outcomes-of-management-of-paediatric-bone-forearm-fractures-using-titanium-elastic-nailing-system-a-prospective-study-of-50-cases
#15
Rajesh Kapila, Rakesh Sharma, Ankush Chugh, Mahesh Goyal
INTRODUCTION: Forearm fractures are common injuries in children. In older children, there management is difficult due to increased chances of re-displacement after closed reduction. AIM: The aim of this prospective study was to evaluate the clinical outcome of managing paediatric forearm fractures using Titanium Elastic Nailing System (TENS). MATERIALS AND METHODS: A total of 50 patients in the age group 6 to 14 years with fractures in both bones of forearm were managed by internal fixation using TENS and prospective follow-up were done for six months...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28049455/effectiveness-of-isoniazid-preventative-therapy-in-reducing-incidence-of-active-tuberculosis-among-people-living-with-hiv-aids-in-public-health-facilities-of-addis-ababa-ethiopia-a-historical-cohort-study
#16
Mahlet Semu, Teferi Gedif Fenta, Girmay Medhin, Dawit Assefa
BACKGROUND: Human Immunodeficiency Virus (HIV) pandemic has exacerbated tuberculosis disease especially in Sub-Saharan African countries. The World Health Organization (WHO) and Joint United Nations Program on HIV/AIDS (UNAIDS) have recommended Isoniazid Preventive Therapy (IPT) for HIV infected patients to reduce the burden of tuberculosis (TB). Ethiopia has been implementing IPT since 2007. However, effectiveness of IPT in averting occurrence of active tuberculosis among HIV infected patients has not been assessed...
January 3, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28042111/joint-registries-what-can-we-learn-in-2016
#17
D J Berry
AIMS: To demonstrate, with concrete examples, the value of in-depth exploration and comparison of data published in National Joint Arthroplasty registry reports. PATIENTS AND METHODS: The author reviewed published current reports of National Joint Arthroplasty registries for findings of current significance to current orthopaedic practice. RESULTS: A total of six observations that demonstrate actionable or unexpected findings from joint registries are described...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28041772/elevated-intra-articular-cobalt-and-chromium-levels-in-mechanically-assisted-crevice-corrosion-in-metal-on-polyethylene-total-hip-arthroplasty
#18
Brian J McGrory, Abigail M Payson, Johanna A MacKenzie
BACKGROUND: Failed total hip arthroplasty (THA) caused by mechanically assisted crevice corrosion (MACC) has serious consequences such as adverse local tissue reaction (ALTR). Serum cobalt (Co) and chromium (Cr) ion levels have been used to diagnose taper corrosion, but have not been shown to be an accurate measure of the severity of MACC or associated ALTRs. Additionally, elevated serum ions are not specific in patients with multiple artificial joints. METHODS: We examined the relationship between serum and intra-articular (IA) Co and Cr levels in a cohort of 20 patients undergoing revision THA, 16 who had symptomatic MACC...
December 14, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28040399/operative-time-affects-short-term-complications-in-total-joint-arthroplasty
#19
Kyle R Duchman, Andrew J Pugely, Christopher T Martin, Yubo Gao, Nicholas A Bedard, John J Callaghan
BACKGROUND: Increased operative time has been associated with increased complications after total joint arthroplasty (TJA). The purpose of the present study was to investigate the effect of operative time on short-term complications after TJA while also identifying patient and operative factors associated with prolonged operative times. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was queried from 2011-2013 to identify all patients who underwent primary total hip or knee arthroplasty...
December 14, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28040397/should-preoperative-antibiotics-be-tailored-according-to-patient-s-comorbidities-and-susceptibility-to-organisms
#20
Timothy L Tan, Miguel M Gomez, Michael M Kheir, Mitchell G Maltenfort, Antonia F Chen
BACKGROUND: Preoperative antibiotic prophylaxis remains one of the most important strategies for preventing periprosthetic joint infection (PJI). Current guidelines recommend giving universal antibiotic prophylaxis to all total joint arthroplasty patients regardless of their medical conditions or immune status; however, no studies have evaluated the individualizing of antibiotics. The aims of this study were (1) to determine if comorbidities influence the organism profile of PJIs, and (2) to investigate if the efficacy of two different perioperative antibiotics (cefazolin or vancomycin) for preventing PJI is affected by patient's comorbidities...
November 23, 2016: Journal of Arthroplasty
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