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Infection in orthopedics

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https://www.readbyqxmd.com/read/28934880/three-dimensional-bioprinting-and-its-potential-in-the-field-of-articular-cartilage-regeneration
#1
Vivian H M Mouser, Riccardo Levato, Lawrence J Bonassar, Darryl D D'Lima, Daniel A Grande, Travis J Klein, Daniel B F Saris, Marcy Zenobi-Wong, Debby Gawlitta, Jos Malda
Three-dimensional (3D) bioprinting techniques can be used for the fabrication of personalized, regenerative constructs for tissue repair. The current article provides insight into the potential and opportunities of 3D bioprinting for the fabrication of cartilage regenerative constructs. Although 3D printing is already used in the orthopedic clinic, the shift toward 3D bioprinting has not yet occurred. We believe that this shift will provide an important step forward in the field of cartilage regeneration. Three-dimensional bioprinting techniques allow incorporation of cells and biological cues during the manufacturing process, to generate biologically active implants...
October 2017: Cartilage
https://www.readbyqxmd.com/read/28934543/long-term-results-of-intercalary-endoprosthetic-short-segment-fixation-following-extended-diaphysectomy
#2
Nicholas S Tedesco, Alexandra L Van Horn, Robert M Henshaw
Intercalary endoprosthetic reconstruction following diaphyseal resection of osseous tumors offers functional advantages through preservation of native joints adjacent to the resected defect. Use of such implants is restricted by the amount of bone available for stem fixation adjacent to the defect. This study aimed to determine whether short osseous segment fixation with acceptable outcomes and complication rate can be reliably achieved with a customized intercalary endoprosthesis following extended diaphysectomy...
September 21, 2017: Orthopedics
https://www.readbyqxmd.com/read/28934542/complications-associated-with-pelvic-external-fixation
#3
Christopher McDonald, Reza Firoozabadi, M L Routt, Conor Kleweno
An external fixator is an essential tool for treating unstable pelvic ring injuries but its use carries risks, including pin-site infections and injury to the lateral femoral cutaneous nerve (LFCN). Surgeons currently lack data regarding these risks for patient counseling. This study aimed to identify the incidence of and risk factors for superficial and deep pin-site infection and LFCN damage. Fifty-two patients who underwent pelvic external fixation with anterior pin placement as part of definitive treatment for unstable pelvic ring disruption were retrospectively evaluated to identify factors associated with the development of infection...
September 21, 2017: Orthopedics
https://www.readbyqxmd.com/read/28919748/antibacterial-properties-of-pekk-for-orthopedic-applications
#4
Mian Wang, Garima Bhardwaj, Thomas J Webster
Orthopedic implant infections have been steadily increasing while, at the same time, antibiotics developed to kill such bacteria have proven less and less effective with every passing day. It is clear that new approaches that do not rely on the use of antibiotics are needed to decrease medical device infections. Inspired by cicada wing surface topographical features, nanostructured surfaces represent a new approach for imposing antibacterial properties to biomaterials without using drugs. Moreover, new chemistries with altered surface energetics may decrease bacterial attachment and growth...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/28919606/current-trends-of-using-antimicrobials-and-their-sensitivity-pattern-in-infectious-cases-at-department-of-orthopedics-in-a-tertiary-care-hospital
#5
M M Sarker, S K Saha, S Saha, A N Naushad, S Ajmery, P Roy, M S Chowdhury, L Mukta
This cross-sectional descriptive study was carried out to analyse the current trends of using antimicrobials at orthopaedics department in different surgical procedures and observe the antimicrobial sensitivity pattern of infective organisms in postoperative wound infection cases at the department of Orthopaedics, Mymensingh Medical College Hospital with collaboration of department of Pharmacology and Therapeutics in Mymensingh Medical College, Mymensingh from January 2016 to December 2016. Among 253 orthopaedics surgical cases Penicillins, Cephalosporins, and Aminoglycoside group were commonly prescribed antimicrobials that had been use postoperatively in most of the Orthopaedics cases...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28918266/nanomedicine-for-safe-healing-of-bone-trauma-opportunities-and-challenges
#6
REVIEW
Shahed Behzadi, Gaurav A Luther, Mitchel B Harris, Omid C Farokhzad, Morteza Mahmoudi
Historically, high-energy extremity injuries resulting in significant soft-tissue trauma and bone loss were often deemed unsalvageable and treated with primary amputation. With improved soft-tissue coverage and nerve repair techniques, these injuries now present new challenges in limb-salvage surgery. High-energy extremity trauma is pre-disposed to delayed or unpredictable bony healing and high rates of infection, depending on the integrity of the soft-tissue envelope. Furthermore, orthopedic trauma surgeons are often faced with the challenge of stabilizing and repairing large bony defects while promoting an optimal environment to prevent infection and aid bony healing...
September 4, 2017: Biomaterials
https://www.readbyqxmd.com/read/28914105/bone-and-subcutaneous-adipose-tissue-pharmacokinetics-of-vancomycin-in-total-knee-replacement-patients
#7
Mats Bue, Mikkel Tøttrup, Pelle Hanberg, Otto Langhoff, Hanne Birke-Sørensen, Theis M Thillemann, Torben L Andersson, Kjeld Søballe
Background and purpose - The incidence of orthopedic methicillin-resistant Staphylococcus aureus (MRSA) infections is increasing. Vancomycin may therefore play an increasingly important role in orthopedic perioperative antimicrobial prophylaxis. Studies investigating perioperative bone and soft tissue concentrations of vancomycin are sparse and challenged by a lack of appropriate methods. We assessed single-dose plasma, subcutaneous adipose tissue (SCT) and bone concentrations of vancomycin using microdialysis in male patients undergoing total knee replacement...
September 15, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28904182/finegoldia-magna-isolated-from-orthopedic-joint-implant-associated-infections
#8
Bo Söderquist, Sanna Björklund, Bengt Hellmark, Anders Jensen, Holger Brüggemann
Background: The anaerobic Gram-positive coccus Finegoldia magna is a rare cause of infections of bone and joints. The aim of this study was to describe the microbiological and clinical characteristics of orthopedic implant-associated infections caused by F. magnaMethods: We retrospectively analyzed samples consisting of anaerobic Gram-positive cocci and samples already identified as F. magna from patients with orthopedic infections. The isolates found were determined to species level by MALDI-TOF MS. The antibiotic susceptibility pattern was determined by Etest...
September 13, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28902923/molecular-microbiological-and-clinical-characterization-of-clostridium-difficile-isolates-from-tertiary-care-hospitals-in-colombia
#9
Clara Lina Salazar, Catalina Reyes, Santiago Atehortua, Patricia Sierra, Margarita María Correa, Daniel Paredes-Sabja, Emma Best, Warren N Fawley, Mark Wilcox, Ángel González
In Colombia, the epidemiology and circulating genotypes of Clostridium difficile have not yet been described. Therefore, we molecularly characterized clinical isolates of C.difficile from patients with suspicion of C.difficile infection (CDI) in three tertiary care hospitals. C.difficile was isolated from stool samples by culture, the presence of A/B toxins were detected by enzyme immunoassay, cytotoxicity was tested by cell culture and the antimicrobial susceptibility determined. After DNA extraction, tcdA, tcdB and binary toxin (CDTa/CDTb) genes were detected by PCR, and PCR-ribotyping performed...
2017: PloS One
https://www.readbyqxmd.com/read/28891865/opioid-prescription-levels-and-postoperative-outcomes-in-orthopedic-surgery
#10
Crispiana Cozowicz, Ashley Olson, Jashvant Poeran, Eva E Mörwald, Nicole Zubizarreta, Federico P Girardi, Alexander P Hughes, Madhu Mazumdar, Stavros G Memtsoudis
Given the basic need for opioids in the perioperative setting, we investigated associations between opioid prescription levels and postoperative outcomes using population based data of orthopedic surgery patients. We hypothesized that increased opioid amounts would be associated with higher risk for postoperative complications. Data was extracted from the national Premier Perspective database (2006-2013); N=1,035,578 lower joint arthroplasties and N= 220,953 spine fusions. Multilevel multivariable logistic regression models measured associations between opioid dose prescription and postoperative outcomes, studied by quartile of dispensed opioid dose...
September 1, 2017: Pain
https://www.readbyqxmd.com/read/28888524/total-knee-arthroplasty-after-opening-versus-closing-wedge-high-tibial-osteotomy-a-135-case-series-with-minimum-5-year-follow-up
#11
Matthieu Ehlinger, Adrien D'ambrosio, Pascal Vie, Sylvain Leclerc, François Bonnomet, Paul Bonnevialle, Sébastien Lustig, Sébastien Parratte, Michel Colmar, Jean-Noël Argenson
INTRODUCTION: High tibial osteotomy (HTO) is effective in treating isolated medial osteoarthritis of the knee, but subsequent deterioration is inevitable, and total knee arthroplasty (TKA) is then an option. The present study sought to compare TKA following medial opening-wedge HTO (OW-HTO) versus lateral closing-wedge HTO (CW-HTO) in terms of intraoperative data and clinical results. The study hypothesis was that there is no significant difference in clinical results or complications in TKA following OW-HTO or CW-HTO...
September 6, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28885895/meta-analysis-of-comparative-trials-evaluating-a-prophylactic-single-use-negative-pressure-wound-therapy-system-for-the-prevention-of-surgical-site-complications
#12
Vicki Strugala, Robin Martin
BACKGROUND: We report the first meta-analysis on the impact of prophylactic use of a specific design of negative pressure wound therapy (NPWT) device on surgical site complications. METHODS: Articles were identified in which the specific single-use NPWT device (PICO(⋄), Smith & Nephew) was compared with standard care for surgical site infection (SSI), dehiscence, or length of stay (LOS). Risk ratio (RR) ±95% confidence interval (CI) (SSI; dehiscence) or mean difference in LOS ±95% CI was calculated using RevMan v5...
September 8, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28881529/-results-for-the-treatment-of-fresh-type-thoracolumbar-vertebral-fracture-according-to-the-intraoperative-ct-scan
#13
Y W Li, H J Wang, Y S Wang, W Cui
Objective: To evaluate the value of intraoperative CT scanning in the treatment of fresh thoracolumbar burst fractures. Methods: From January 2008 to January 2015 , 161 patients with thoracolumbar fractures in Department of Orthopedics, Luohe City Central Hospital, were divided into two groups: 79 cases were treatment group which were treated with intraoperative CT scan and decompression mode was determined according to CT scan results during the period from October 2012 to January 2015. 82 patients as the observation group were treated without intraoperative CT scan and direct laminectomy were performed during the period...
September 5, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28881121/the-predictable-factors-of-the-postoperative-kyphotic-change-of-sagittal-alignment-of-the-cervical-spine-after-the-laminoplasty
#14
Jun Seok Lee, Dong Wuk Son, Su Hun Lee, Dong Ha Kim, Sang Weon Lee, Geun Sung Song
OBJECTIVE: Laminoplasty is an effective surgical method for treating cervical degenerative disease. However, postoperative complications such as kyphosis, restriction of neck motion, and instability are often reported. Despite sufficient preoperative lordosis, this procedure often aggravates the lordotic curve of the cervical spine and straightens cervical alignment. Hence, it is important to examine preoperative risk factors associated with postoperative kyphotic alignment changes. Our study aimed to investigate preoperative radiologic parameters associated with kyphotic deformity post laminoplasty...
September 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28877804/use-of-antibiotic-impregnated-absorbable-beads-and-tissue-coverage-of-complex-wounds
#15
MULTICENTER STUDY
Terris L White, Alfred T Culliford, Martin Zomaya, Gary Freed, Christopher P Demas
The treatment of complex wounds is commonplace for plastic surgeons. Standard management is debridement of infected and devitalized tissue and systemic antibiotic therapy. In cases where vital structures are exposed within the wound, coverage is obtained with the use of vascularized tissue using both muscle and fasciocutaneous flaps. The use of nondissolving polymethylmethacrylate and absorbable antibiotic-impregnated beads has been shown to deliver high concentrations of antibiotics with low systemic levels of the same antibiotic...
November 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28870735/percutaneous-osteotomies-in-hallux-valgus-a-systematic-review
#16
REVIEW
Ana Bia, Francisco Guerra-Pinto, Bruno S Pereira, Nuno Corte-Real, Xavier Martin Oliva
Percutaneous and minimally invasive surgery is one of the greatest advances in the operating field of orthopedic since the late 1990s. The potential advantages include a shorter operative time, quicker recovery, and reduced hospital stay compared with traditional open surgery. However, scientific validation of the safety and efficacy of hallux valgus (HV) percutaneous surgery remains inconclusive. The objective of the present study was to systematically review the published data and clinical evidence for percutaneous HV surgery, evaluate the scientific method of the reports, and clarify the indications, safety, efficacy, and potential risks of these surgical techniques...
September 1, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28870053/-domestic-external-fixator-application-in-the-treatment-of-limb-deformities-7-289-cases-application-report
#17
S H Qin, B F Guo, X J Zheng, S F Jiao, H T Xia, A M Peng, Q Pan, J C Zang, Z J Wang
Objective: To discuss the clinical application and effects of domestic external fixator in the treatment of patients with malformations of limbs. Methods: A total of 7 289 patients with malformation of limbs who had been operated in Qin Sihe orthopedic surgery team from January 1989 to June 2016 were retrospective analyzed. The patients were treated with domestic external fixator, including 4 033 males and 3 256 females, aging from 2 to 82 years with a mean age of 23.4 years. There were 2 732 patients using Ilizarov external fixator, 4 713 patients using hybrid external fixator, 57 patients using monobrachial external fixator, 232 patients using Ilizarov external fixator and hybrid external fixator...
September 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28865450/elution-kinetics-of-vancomycin-and-gentamicin-from-carriers-and-their-effects-on-mesenchymal-stem-cell-proliferation-an-in-vitro-study
#18
Tomas Kucera, Lenka Ryskova, Tomas Soukup, Jana Malakova, Eva Cermakova, Pavel Mericka, Jakub Suchanek, Pavel Sponer
BACKGROUND: Musculoskeletal infections remain a major complication in orthopedic surgery. The local delivery of antibiotics provides the high levels required to treat an infection without systemic toxicity. However, the local toxicity of antibiotic carriers to the mesenchymal stem cells, as a result of both the peak concentrations and the type of carrier, may be significant. METHODS: To address this concern, the elution kinetics of vancomycin and gentamicin from several commercially available antibiotic carriers and several carriers impregnated by a surgeon (10 ml of each sterile carrier were manually mixed with a 500 mg vancomycin and an 80 mg gentamicin solution, and the duration of impregnation was 30 min) were assessed...
September 2, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28864264/a-self-reported-needs-assessment-survey-of-pediatric-orthopaedic-education-in-haiti
#19
Rameez A Qudsi, Heather J Roberts, Abhiram R Bhashyam, Elena Losina, Donald S Bae, Francel Alexis, George S Dyer
OBJECTIVE: The burden of musculoskeletal disease remains high in low-income countries, with a high rate of pediatric disease. Efforts continue for orthopedic education, but there is little guidance on local needs and desires. Our aim was to determine the specific content and modalities that would be most useful for pediatric orthopedic educational programs abroad, and we demonstrate a practical method of identifying country-specific educational deficits through a self-reported needs survey in Haiti...
August 29, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28862357/high-early-post-operative-complication-rate-after-elective-aseptic-orthopedic-implant-removal-of-upper-and-lower-limb
#20
Arnold J Suda, Eva Heilgeist, Marco Tinelli, Oliver E Bischel
The necessity of orthopedic implant removal is under intense discussion and even if it is performed as an elective procedure, the risk of complications is present. Aim of the study was to identify parameters responsible for an increased risk of early post-operative complications after elective aseptic orthopedic implant removal. We reviewed 1545 cases of aseptic and elective orthopedic implant removal between 2009 and 2011. The patient's demographic data, time and duration of operation, patient's comorbidities and presence of complications in the first four weeks after implant removal were evaluated...
September 1, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
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