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https://www.readbyqxmd.com/read/28526569/total-joint-replacement-for-neglected-posterior-knee-dislocation-following-septic-arthritis-after-arthroscopy
#1
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/28507977/a-sub-acute-septic-arthritis-of-the-knee-a-sequelae-to-thorn-prick-injury-of-patella-a-case-report
#2
R Sivakumar, Prahalad Kumar Singhi, M Chidambaram, V Somashekar, Vinoth Thangamani
INTRODUCTION: Sub-acute septic arthritis of knee following a thorn prick injury to patella is an uncommon condition and seen in active playful children. The child may be afraid to narrate the incident to their parents or examining doctor, so a high index of suspicion is must. The delayed presentation is inevitable. Early synovitis due to the organic biological foreign body may progress to septic arthritis, if untreated may result in knee stiffness or chronic osteomyelitis of patella. CASE REPORT: We report a case of thorn prick injury to the left patella in an 8-years-old boy who neglected the incident of thorn prick while playing with his peer group 10 days ago and presented with features of sub-acute septic arthritis...
November 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28507971/lethal-necrotizing-fasciitis-triggered-by-plaster-case-report-and-review-of-literature
#3
Mohit J Jain, Kinjal Mavani
INTRODUCTION: Plasters have been frequently associated with known complications such as infection, and compartment syndrome or deep vein thrombosis. However, life-threatening complication of necrotizing fasciitis (NF) has not been frequently attributed to plaster. CASE REPORT: We had a case of a 62-year male developing a lethal NF triggered by a below knee plaster for undisplaced fracture medial malleolus after twisting injury. He had no history suggestive of diabetes, renal impairment, and predisposing allergic factors or any comorbidity...
November 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28488017/c-reactive-protein-course-during-the-first-5-days-after-total-knee-arthroplasty-cannot-predict-early-prosthetic-joint-infection
#4
Christoph Windisch, Steffen Brodt, Eric Roehner, Georg Matziolis
INTRODUCTION: Periprosthetic joint infection (PJI) is one of the most devastating major complications after total knee arthroplasty (TKA). The laboratory value C-reactive protein (CRP) is the inflammatory biomarker most suitable for detecting a potential postoperative (p.o.) early infection in orthopaedic surgery. However, on the basis of multiple receiver operating characteristic (ROC) analyses, CRP only has limited sensitivity and specificity. The objective of the present study was to test the hypothesis that, besides the absolute preoperative CRP value, also the absolute postoperative CRP value and its course over the first 5 days after TKA are valid indicators of periprosthetic early infection...
May 9, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28487799/primary-meningococcal-type-c-arthritis-a-case-report-and-literature-review
#5
Maximiliano Barahona, Jaime Catalan, Yoshiro Sato, Jaime Hinzpeter
Acute septic arthritis is a common clinical problem in emergency departments. Primary meningococcal arthritis (PMA) is very rare and few cases are reported in literature. D. B. M. consulted the emergency department for knee pain and fever; analysis showed that the cause was a Neisseria meningitidis type C infection. He received a treatment consisting of 2 arthroscopies and 5 weeks of antibiotics. At five weeks he returned to work and at 2 months he resumed sports (jogging and soccer) without complaints. Primary arthritis of the knee caused by Neisseria meningitidis is very rare...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28487456/deriving-literature-based-benchmarks-for-surgical-complications-in-high-income-countries-a-protocol-for-a-systematic-review-and-meta-analysis
#6
Mary E Brindle, Derek J Roberts, Oluwatomilayo Daodu, Alex Bernard Haynes, Christy Cauley, Elijah Dixon, Claude La Flamme, Paul Bain, William Berry
INTRODUCTION: To improve surgical safety, health systems must identify preventable adverse outcomes and measure changes in these outcomes in response to quality improvement initiatives. This requires understanding of the scope and limitations of available population-level data. To derive literature-based summary estimates of benchmarks of care, we will systematically review and meta-analyse rates of postoperative complications associated with several common and/or high-risk operations performed in five high-income countries (HICs)...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28476929/the-case-of-the-mysterious-vanishing-spleen-autosplenectomy-complicating-pneumococcal-sepsis
#7
Georgina Moritz, Megan Jenkins, Dushyant Shetty, Julie Blundell
A 57-year-old previously healthy fisherman was admitted in fulminant pneumococcal septic shock, with disseminated intravascular coagulation, requiring aggressive management including bilateral below-knee amputations for ischaemic necrosis. He began to recover and was discharged for rehabilitation, however during his convalescence was found to be hypercalcaemic. No malignancy was found on CT scan, but it was noted that his spleen was absent, replaced by a 4 cm smooth-walled, fluid-filled lesion. This was unexpected as an ultrasound in intensive care 10 weeks previously had demonstrated a normal spleen...
May 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28463919/synovial-fluid-cell-count-for-diagnosis-of-chronic-periprosthetic-hip-infection
#8
Carlos A Higuera, Benjamin Zmistowski, Tennison Malcom, Wael K Barsoum, Scott M Sporer, Philipp Mommsen, Daniel Kendoff, Craig J Della Valle, Javad Parvizi
BACKGROUND: There is a paucity of data regarding the threshold of synovial fluid white blood-cell (WBC) count and polymorphonuclear cell (neutrophil) percentage of the WBC count (PMN%) for the diagnosis of chronic periprosthetic joint infection (PJI) after total hip arthroplasty. Despite this, many organizations have provided guidelines for the diagnosis of PJI that include synovial fluid WBC count and PMN%. We attempted to define a threshold for synovial fluid WBC count and PMN% for the diagnosis of chronic PJI of the hip using a uniform definition of PJI and to investigate any variations in the calculated thresholds among institutions...
May 3, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28437497/a-rare-case-of-spontaneous-fusion-of-the-knee
#9
Ola S Ahmed, James P Cashman
To our knowledge, this article is the first report of a case of spontaneous and progressive bony fusion of a knee joint without a prior diagnosis of inflammatory or septic arthritis or surgical arthrodesis.
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28436379/economic-analysis-of-4221-revisions-due-to-periprosthetic-joint-infection-in-poland
#10
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/28418574/inadequacy-of-joint-aspiration-for-detection-of-persistent-periprosthetic-infection-during-two-stage-septic-revision-knee-surgery
#11
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/28407303/rifampicin-reverses-nicardipine-effect-inducing-uncontrolled-essential-hypertension
#12
Elena-Mihaela Cordeanu, Sébastien Gaertner, Alix Faller, Corina Mirea, Jean-Marc Lessinger, Veronique Kemmel, Dominique Stephan
Dihydropyridine calcium-channel blockers are a known substrate for the cytochrome P450 isoform 3A4. Rifampicin, an antitubercular agent, is one of the most potent inducers of hepatic and intestinal CYP3A4 thus increasing dihydropyridine metabolism. We report a case of a 67-year-old hypertensive female treated with a 4-drug antihypertensive regimen including a dihydropyridine (nicardipine 50mg bid), who was admitted for septic arthritis of the knee requiring antibiotic treatment with teicoplanin 400mg od and rifampicin 600mg bid...
April 13, 2017: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/28399605/cementless-total-knee-arthroplasty-in-patients-older-than-75-years
#13
Jared M Newman, Anton Khlopas, Morad Chughtai, Chukwuweike U Gwam, Jaydev B Mistry, George A Yakubek, Steven F Harwin, Michael A Mont
Some surgeons have been hesitant to use cementless fixation for total knee arthroplasty (TKA) in elderly patients due to concerns regarding successful bone biological fixation. Therefore, this study evaluated: (1) implant survivorship, (2) functional outcomes, (3) radiographic outcomes, and (4) complications in patients over 75 years of age who underwent cementless total knee arthroplasty. A total of 134 patients (142 TKAs) older than 75 years at a single institution between June 2008 and June 2014 were retrospectively reviewed...
April 11, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28373088/clinical-presentation-and-treatment-of-septic-arthritis-in-children
#14
I Moro-Lago, G Talavera, L Moraleda, G González-Morán
INTRODUCTION: The aim of this study is to determine the epidemiological features, clinical presentation, and treatment of children with septic arthritis. MATERIAL AND METHOD: A retrospective review was conducted on a total of 141 children with septic arthritis treated in Hospital Universitario La Paz (Madrid) between the years 2000 to 2013. The patient data collected included, the joint affected, the clinical presentation, the laboratory results, the appearance, Gram stain result, and the joint fluid culture, as well as the imaging tests and the treatment...
March 31, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28372918/all-polyethylene-tibial-component-use-for-elderly-low-demand-total-knee-arthroplasty-patients
#15
Kenneth A Gustke, Martin K Gelbke
BACKGROUND: Potential advantages combined with lower cost have prompted a renewed interest in modern all-polyethylene tibial designs. METHODS: A total of 317 Natural Knee total knee arthroplasties with an all-polyethylene tibial component that was performed since 1993 were retrospectively reviewed to confirm that cost savings were not associated with inferior clinical results. They were primarily used in elderly, low-demand patients. The average age at the time of surgery was 80...
March 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28366313/short-to-midterm-outcomes-of-revision-total-knee-arthroplasty-patients-with-a-total-stabilizer-knee-system
#16
Chukwuweike U Gwam, Morad Chughtai, Anton Khlopas, Nequesha Mohamed, Randa K Elmallah, Arthur L Malkani, Michael A Mont
BACKGROUND: Revision total knee arthroplasty (TKA) can often be challenging. The use of a new revision system may aid in providing better stability, improved function, fit, and implant longevity. Therefore, we assessed: (1) survivorship, (2) clinical outcomes, (3) postoperative complications, and (4) radiographic outcomes of patients who underwent revision TKA using this system. METHODS: Patients from 2 hospitals who underwent revision TKA using a newer generation revision knee system between June 2008 and December 2013 for component instability or aseptic loosening were included...
March 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28360506/current-trends-of-microorganisms-and-their-sensitivity-pattern-in-paediatric-septic-arthritis-a-prospective-study-from-tertiary-care-level-hospital
#17
Girish Motwani, Rujuta Mehta, Alaric Aroojis, Sandeep Vaidya
PURPOSE: Early treatment of septic arthritis is essential before irreversible damage to the articular cartilage occurs. Clinicians often start empirical antibiotic therapy for symptomatic relief while awaiting a definitive culture report. In present day parlance with variations in different centres in the private and public sector and rampant antibiotic abuse, a lot of resistance is being seen in the flora and their sensitivity patterns. Hence it is imperative to document and analyze these changing trends...
January 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28348796/diagnostic-difficulty-identifying-apophysomyces-trapeziformis-septic-arthritis-in-a-patient-with-multiple-myeloma
#18
J Bradford Bertumen, Wiley A Schell, Maria Joyce, Christopher Alley, Christopher W Woods
INTRODUCTION: Mucormycosis is a rare fungal infection, but can cause substantial morbidity and mortality in both immunocompromised and immunocompetent patients. Apophysomyces is a mucormycetes species ubiquitous in nature, particularly in soil, decaying wood and other organic matter. Apophysomyces is known to cause cutaneous fungal infections, particularly after penetrating trauma. Septic arthritis is a rare clinical manifestation. CASE PRESENTATION: We describe a case of Apophysomyces trapeziformis causing septic arthritis of the knee of a patient with multiple myeloma...
December 2016: JMM Case Reports
https://www.readbyqxmd.com/read/28342819/ankylosis-of-the-knee-after-septic-arthritis-following-anterior-cruciate-ligament-reconstruction-in-a-13-year-old-male
#19
Bastian Mester, Falk Ullerich, Tobias Ohmann, Martin Glombitza, Christian Schoepp
We present the case of an adolescent male developing anankylosis of the knee after septic arthritis following anterior cruciate ligamentreconstruction (ACLR).The patientwas shifted to our institutionwithpostoperative septic arthritis associated with a systemic septic condition. Before, repeated arthroscopic surgery had beenconductedwithoutany improvement. MRI showed a concomitant osteomyelitis. The infection (Gächter IV, S. aureus) was controlled by an open surgical approach and graft removal.An increasing joint stiffness wasdocumented...
March 22, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28337666/joint-infection-due-to-raoultella-planticola-first-report
#20
E Bonnet, F Julia, G Giordano, J Lourtet-Hascoet
The genus Raoultella has been separated from the genus Klebsiella in 2001. Two main species are responsible for human infections: R. ornithinolytica and R. planticola. The most frequent infections due to R. planticola include cystitis, pneumonia and bacteremia (mostly in immunocompromised hosts). To date, no joint or bone infection has been reported. We describe the first case of septic arthritis due to R. planticola following an arthroscopy with intra-articular injection of corticosteroids. Evolution was favorable after arthroscopic lavage and antibiotic therapy with quinolones...
March 23, 2017: Infection
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