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https://www.readbyqxmd.com/read/28529860/use-of-chlorhexidine-preparations-in-total-joint-arthroplasty
#1
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: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529859/treatment-of-periprosthetic-joint-infection-using-antimicrobials-dilute-povidone-iodine-lavage
#2
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: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529858/hydrogen-peroxide-wound-irrigation-in-orthopaedic-surgery
#3
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: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529343/excellent-auc-for-joint-fluid-cytology-in-the-detection-exclusion-of-hip-and-knee-prosthetic-joint-infection
#4
Jiri Gallo, Jarmila Juranova, Michal Svoboda, Jana Zapletalova
BACKGROUND AND AIM: The aim of this study was to evaluate the characteristics of synovial fluid (SF) white cell count (SWCC) and neutrophil/lymphocyte percentage in the diagnosis of prosthetic joint infection (PJI) for particular threshold values. METHODS AND RESULTS: This was a prospective study of 391 patients in whom SF specimens were collected before total joint replacement revisions. SF was aspirated before joint capsule incision. The PJI diagnosis was based only on non-SF data...
May 15, 2017: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/28528753/healthcare-access-and-quality-index-based-on-mortality-from-causes-amenable-to-personal-health-care-in-195-countries-and-territories-1990-2015-a-novel-analysis-from-the-global-burden-of-disease-study-2015
#5
(no author information available yet)
BACKGROUND: National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015...
May 18, 2017: Lancet
https://www.readbyqxmd.com/read/28527684/patient-perceptions-regarding-outpatient-hip-and-knee-arthroplasties
#6
R Michael Meneghini, Mary Ziemba-Davis
BACKGROUND: There has been increasing interest in outpatient total joint arthroplasty (TJA) in the orthopedic community, but how patients feel about outpatient TJA is unknown. The purpose of this study was to understand patient perspectives on hip and knee replacements performed in an outpatient setting. METHODS: We surveyed 110 consecutive patients scheduled for primary TJA in an academic suburban arthroplasty practice regarding their knowledge and perceptions of outpatient TJA...
April 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28526569/total-joint-replacement-for-neglected-posterior-knee-dislocation-following-septic-arthritis-after-arthroscopy
#7
Yusuf Öztürkmen, Yunus Emre Akman, Ethem Ayhan Ünkar, Erhan Şükür
This report presents the first case of a knee dislocation following septic arthritis after arthroscopy. A 65-year-old woman had an arthroscopy with irrigation and debridement (I&D) of the joint and microfracture for the chondral lesions. She had complaints of postarthroscopic infection but non-steroidal anti-inflammatory medication and local ice compression was recommended. She revisited her physician twice and at the last visit she had a large purulent effusion in her knee. The gram stain of the joint fluid aspirate demonstrated gram-positive cocci and the cultures grew methicilline-sensitive Staphylococcus aureus...
May 16, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28526565/efficacy-of-indefinite-chronic-oral-antimicrobial-suppression-for-prosthetic-joint-infection-in-the-elderly-a-comparative-study
#8
V Prendki, P Sergent, A Barrelet, E Oziol, E Beretti, M Berlioz-Thibal, F Bouchand, F Dauchy, E Forestier, G Gavazzi, C Ronde-Oustau, J Stirnemann, A Dinh
OBJECTIVES: During prosthetic joint infection (PJI), surgical management is sometimes impossible, indefinite chronic oral antimicrobial suppression (ICOAS) may sometimes be the only option. We evaluated the outcome of elderly patients who benefited from ICOAS for a strictly palliative goal METHODS: We performed a national retrospective cohort study in France of patients aged >75years old with PJI, and managed with ICOAS planned for life long from 2009 to 2014, and compared the population with an event versus the population free of event...
May 16, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28526311/dramatic-effects-of-a-new-antimicrobial-stewardship-program-in-a-rural-community-hospital
#9
Claudia R Libertin, Stephanie H Watson, William L Tillett, Joy H Peterson
BACKGROUND: New Joint Commission antimicrobial stewardship requirements took effect on January 1, 2017, promoted as a central strategy for coping with the emerging problems of antimicrobial resistance and Clostridium difficile infection. Our objective was to measure the effects of a new antimicrobial stewardship program (ASP) in a rural community hospital with no prior ASP, in the context of having a new infectious disease specialist on staff. METHODS: An ASP team was formed to implement a prospective audit with health care provider feedback and targeting 12 antimicrobial agents in a rural hospital in Georgia...
May 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28526202/capnocytophaga-canimorsus-an-underestimated-cause-of-periprosthetic-joint-infection
#10
Marcel Orth, Patrick Orth, Konstantinos Anagnostakos
BACKGROUND: Periprosthetic joint infection (PJI) is a major clinical problem in orthopedic surgery. Capnocytophaga canimorsus (C. canimorsus) is an unusual and hardly detectable bacterium. A review of the literature indicates that C. canimorsus affects mainly immunocompromised patients. It has not been reported to cause periprosthetic joint infections in immunocompetent patients so far. This case report aims to raise awareness of C. canimorsus in orthopedic surgery with special regard to joint arthroplasty...
May 16, 2017: Knee
https://www.readbyqxmd.com/read/28526023/high-incidence-of-periprosthetic-joint-infection-with-propionibacterium-acnes-after-the-use-of-a-stemless-shoulder-prosthesis-with-metaphyseal-screw-fixation-a-retrospective-cohort-study-of-241-patients-propionibacter-infections-after-eclipse-tsa
#11
Lisa Johansson, Nils P Hailer, Hans Rahme
BACKGROUND: A stemless shoulder prosthesis with humeral metaphyseal screw fixation was introduced in order to save bone-stock and to facilitate reconstruction of biomechanics (Eclipse®). The aim of this study was to analyze whether the risk of infection is different with this implant compared to conventional shoulder prosthesis. METHODS: Two hundred and forty-one patients (54.8% females) were operated with a shoulder arthroplasty and followed for median 2.0 (0...
May 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28523427/-total-ankle-arthroplasty-with-simultaneous-subtalar-fusion
#12
J Mainzer, P Rippstein
OBJECTIVE: Pain free weight bearing ability with orthograde hindfoot position and preserved tibiotalar motion. INDICATIONS: Symptomatic arthritis of the ankle and subtalar joint, additional subtalar hindfoot malalignment. CONTRAINDICATIONS: Absolute: acute infection, noncorrectable ligamentous instability or bony defects, restricted perfusion, diabetic foot syndrome. Relative: inability to comply with postoperative partial weight bearing, only moderate symptoms of subtalar arthritis, smoking, intricate soft tissue situation...
May 18, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28522245/pin-site-complications-associated-with-computer-assisted-navigation-in-hip-and-knee-arthroplasty
#13
Eli Kamara, Zachary P Berliner, Matthew S Hepinstall, H John Cooper
BACKGROUND: There has been a great increase in the use of navigation technology in joint arthroplasty. In most types of navigation-assisted surgery, several temporary navigation pins are placed in the patient. Goals of this study are (1) to identify complications and (2) risk factors associated with placement of these pins. METHODS: This is a retrospective cohort study of all navigation-assisted hip and knee arthroplasty performed a single institution over a 3-year period...
April 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28516223/two-stage-revision-hip-arthroplasty-in-periprosthetic-joint-infection-comparison-study-with-or-without-the-use-of-a-spacer
#14
Dariusz Marczak, Marek Synder, Marcin Sibiński, Michał Polguj, Julian Dudka, Jacek Kowalczewski
PURPOSE: The aim of this study was to compare two methods of two-stage surgery for PJI (periprosthetic joint infection) after THA (total hip arthroplasty): one with and one without the use of an antibiotic-loaded cement spacer. METHODS: This retrospective study was performed on 99 consecutive patients (99 hips) with a minimum follow-up of 24 months. Patients were divided into two groups: (1) in whom the operation was performed using a spacer, and (2) for whom a spacer was not used...
May 18, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28515059/antibiotic-stability-over-six-weeks-in-aqueous-solution-at-body-temperature-with-and-without-heat-treatment-that-mimics-the-curing-of-bone-cement
#15
E Samara, T F Moriarty, L A Decosterd, R G Richards, E Gautier, P Wahl
OBJECTIVES: Thermal stability is a key property in determining the suitability of an antibiotic agent for local application in the treatment of orthopaedic infections. Despite the fact that long-term therapy is a stated goal of novel local delivery carriers, data describing thermal stability over a long period are scarce, and studies that avoid interference from specific carrier materials are absent from the orthopaedic literature. METHODS: In this study, a total of 38 frequently used antibiotic agents were maintained at 37°C in saline solution, and degradation and antibacterial activity assessed over six weeks...
May 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28507961/total-hip-arthroplasty-indicated-for-a-tuberculous-coxitis-complicating-a-controlled-acquired-imunodefficiency-syndrom-condition-a-preliminary-report-concerning-a-case
#16
Handy Eone Daniel, Jean Emile Bayiha, Théophyle Chunteng Nana, Olivier Kennedy Muluem, Jean Bahebeck
INTRODUCTION: Total hip arthroplasty (THA) remains controversial in active tuberculosis (TB) infection because of the risks of septic loosening and reactivation of the infection. We present a rare case of THA in a patient positive for the human immunodeficiency virus (HIV) with active tuberculous coxitis. The aim of this work is to share our experience and our preliminary results. CASE REPORT: The patient was a 53-year-old Black African woman, positive for the HIV, who was operated for implantation of a THA via the Hardinge approach indicated for a severe painful hip with restriction of joint movement and limp...
November 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28506674/removal-of-an-infected-hip-arthroplasty-is-a-high-risk-surgery-putting-morbidity-into-context-with-other-major-nonorthopedic-operations
#17
James A Browne, Jourdan M Cancienne, Wendy M Novicoff, Brian C Werner
BACKGROUND: Two-stage revision remains the most common approach to periprosthetic joint infection of total hip arthroplasty (THA) in the United States. The postoperative risks associated with removal of an infected prosthesis and placement of a spacer have not been thoroughly studied. METHODS: Patients who underwent THA implant removal and spacer placement for infection were identified in a large administrative database. Morbidity and mortality rates were assessed for the 90-day postoperative period and readmission rates were assessed at 30 days postoperatively...
April 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28502355/how-to-diagnose-and-treat-infection-in-total-ankle-arthroplasty
#18
REVIEW
Yousef Alrashidi, Ahmed E Galhoum, Martin Wiewiorski, Mario Herrera-Pérez, Raymond Y Hsu, Alexej Barg, Victor Valderrabano
Periprosthetic infection after total ankle arthroplasty (TAA) is a serious complication, often requiring revision surgery, including revision arthroplasty, conversion to ankle arthrodesis, or even amputation. Risk factors for periprosthetic ankle infection include prior surgery at the site of infection, low functional preoperative score, diabetes, and wound healing problems. The clinical presentation of patients with periprosthetic ankle joint infection can be variable and dependent on infection manifestation: acute versus chronic...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28502347/ankle-arthrodesis-versus-total-ankle-arthroplasty
#19
REVIEW
Joel Morash, David M Walton, Mark Glazebrook
Reoperation rates are higher in total ankle arthroplasties (TAAs) compared with ankle arthrodesis. Infection rates for primary TAAs are 1.4% to 2.4%. The survival rate of TAA is approximately 75% to 90% at 10 years. Arc of motion is maintained with TAAs compared with ankle arthrodesis. Ankle arthrodesis increases arc of motion through the talonavicular joint. Several factors are strong reasons to favor ankle fusion rather than TAA. TAA and ankle arthrodesis are effective treatments of end-stage ankle arthritis but the choice must be tailored to individual patients...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28497248/-aseptic-loosening-of-total-ankle-replacement-one-stage-revision-ankle-arthroplasty
#20
G Pagenstert, M D Wimmer, M Jacxsens, C L Saltzman, A Barg
OBJECTIVE: To revise one or both loosened prosthesis components, to achieve postoperative pain relief, and preserve ankle range of motion. INDICATIONS: Aseptic loosening of the tibial and/or talar ankle prosthesis components without substantial bone defect of the tibial or talar bone stock. CONTRAINDICATIONS: General surgical or anesthesiological risks, infections, critical soft tissue conditions, nonmanageable hindfoot instability, neurovascular impairment of the lower extremity, neuroarthropathy (e...
May 11, 2017: Operative Orthopädie und Traumatologie
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