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Infection in orthopedics

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https://www.readbyqxmd.com/read/27910709/management-of-infections-associated-with-neurosurgical-implanted-devices
#1
Anna Conen, Christoph A Fux, Peter Vajkoczy, Andrej Trampuz
Neurosurgical devices are increasingly used. With it, neurosurgical device-related infections gain relevance. As biofilms are involved in implant-associated infections the diagnosis and treatment is challenging and requires specific anti-biofilm concepts and management algorithms. Areas covered: The literature concerning the management of neurosurgical device-associated infections is scarce and heterogeneous treatment concepts are discussed, but no standardized diagnostic and treatment procedures exist. Therefore, we emphasize extrapolating management strategies predominantly from orthopedic device-associated infections, where the concept is better established and clinically validated...
December 2, 2016: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/27907013/development-and-implementation-of-the-ebola-traveler-monitoring-program-and-clinical-outcomes-of-monitored-travelers-during-october-may-2015-minnesota
#2
Aaron DeVries, Pamela Talley, Kristin Sweet, Susan Kline, Patricia Stinchfield, Pritish Tosh, Richard Danila
BACKGROUND: In October 2014, the United States began actively monitoring all persons who had traveled from Guinea, Liberia, and Sierra Leone in the previous 21 days. State public health departments were responsible for monitoring all travelers; Minnesota has the largest Liberian population in the United States. The MDH Ebola Clinical Team (ECT) was established to assess travelers with symptoms of concern for Ebola virus disease (EVD), coordinate access to healthcare at appropriate facilities including Ebola Assessment and Treatment Units (EATU), and provide guidance to clinicians...
2016: PloS One
https://www.readbyqxmd.com/read/27890840/infected-iliac-pseudoaneursym-after-cardiac-catheterization-complicated-by-girdlestone-pseudoarthroplasty-for-recurrent-infection-of-hip-prosthesis
#3
Christopher Horn, Victoria Wang, Michael Williams, Donald Jacobs
We report a massive infected pseudoaneurysm of the right external iliac artery in the setting of Girdlestone pseudoarthroplasty (GSA) for chronic infection. Around the time of her GSA the patient underwent cardiac catheterization with resultant pseudoaneurysm formation. Infection was likely due to spread from her previous chronic infection. Delay in presentation occurred due to attribution of her symptoms to her GSA. The patient underwent ligation of the right external iliac artery and hip disarticulation and was discharged on antibiotics...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27890407/postoperative-tachycardia-clinically-meaningful-or-benign-consequence-of-orthopedic-surgery
#4
Alana E Sigmund, Yixin Fang, Matthew Chin, Harmony R Reynolds, Leora I Horwitz, Ezra Dweck, Eduardo Iturrate
OBJECTIVE: To determine the clinical significance of tachycardia in the postoperative period. PATIENTS AND METHODS: Individuals 18 years or older undergoing hip and knee arthroplasty were included in the study. Two data sets were collected from different time periods: development data set from January 1, 2011, through December 31, 2011, and validation data set from December 1, 2012, through September 1, 2014. We used the development data set to identify the optimal definition of tachycardia with the strongest association with the vascular composite outcome (pulmonary embolism and myocardial necrosis and infarction)...
November 24, 2016: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/27890310/same-day-total-hip-arthroplasty-performed-at-an-ambulatory-surgical-center-90-day-complication-rate-on-549-patients
#5
Gregg R Klein, Jason M Posner, Harlan B Levine, Mark A Hartzband
BACKGROUND: There is an increasing interest in outpatient total hip arthroplasty (THA), as there are perceived benefits to the patient, insurer, and overall healthcare system. However, the safety of outpatient total joint arthroplasty has not been studied. METHODS: Five hundred forty-nine patients who underwent mini-posterior THA at a freestanding independent ambulatory surgical center (ASC) were reviewed. All patients were discharged to home on the day of surgery...
October 20, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27889092/current-quality-measurement-tools-are-insufficient-to-assess-complications-in-orthopedic-surgery
#6
Arjun S Sebastian, Stephanie F Polites, Amy E Glasgow, Elizabeth B Habermann, Robert R Cima, Sanjeev Kakar
PURPOSE: The American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) is a clinically-derived, validated tool to track outcomes in surgery. The Agency for Healthcare Research and Quality Patient Safety Indicators (AHRQ-PSI) are a set of computer algorithms run on administrative data to identify adverse events. The purpose of this study is to compare complications following orthopedic surgery identified by ACS-NSQIP and AHRQ-PSI. METHODS: Patients between 2010 and 2012 who underwent orthopedic procedures (arthroplasty, spine, trauma, foot and ankle, hand, and upper extremity) at our tertiary-care, academic institution were identified (n = 3,374)...
November 23, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27886680/timing-of-operative-debridement-in-open-fractures
#7
REVIEW
Joshua C Rozell, Keith P Connolly, Samir Mehta
The optimal treatment of open fractures continues to be an area of debate in the orthopedic literature. Recent research has challenged the dictum that open fractures should be debrided within 6 hours of injury. However, the expedient administration of intravenous antibiotics remains of paramount importance in infection prevention. Multiple factors, including fracture severity, thoroughness of debridement, time to initial treatment, and antibiotic administration, among other variables, contribute to the incidence of infection and complicate identifying an optimal time to debridement...
January 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/27877097/preoperative-antibiotic-orders-protocol-initiated-pharmacist-order-entry
#8
Ben B Hyde, Richard K Ogden, Ron D Berger, Brad W VanBrimmer, Leslie M Stach
OBJECTIVE: To evaluate the antibiotic selection of preoperative orders before and after a pharmacist order entry protocol for patients with methicillin-resistant Staphylococcus aureus (MRSA) colonization. METHODS: A retrospective chart review of orthopedic surgery procedures on patients with MRSA colonization at a free-standing, academic pediatric hospital, between February 2010 and February 2012. RESULTS: Procedures that were performed pre protocol (n = 27) implementation had a 63% rate of appropriate antibiotic selection compared to 81% in the postprotocol group (n = 32; p = 0...
September 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/27876255/patient-and-perioperative-variables-affecting-30-day-readmission-for-surgical-complications-after-hip-and-knee-arthroplasties-a-matched-cohort-study
#9
Benjamin F Ricciardi, Kathryn K Oi, Steven B Daines, Yuo-Yu Lee, Amethia D Joseph, Geoffrey H Westrich
BACKGROUND: Changes in reimbursement for total hip and knee arthroplasties (THA and TKA) have placed increased financial burden of early readmission on hospitals and surgeons. Our purpose was to characterize factors of 30-day readmission for surgical complications after THA and TKA at a single, high-volume orthopedic specialty hospital. METHODS: Patients with a diagnosis of osteoarthritis and who were readmitted within 30 days of their unilateral primary THA or TKA procedure between 2010 and 2014...
October 21, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27875955/detection-the-mycoplasma-pneumonia-in-synovial-fluid-of-children-with-negative-culture-arthritis-a-cross-sectional-study-in-tehran-iran
#10
Samileh Noorbakhsh, Mohammad Reza Shokrollahi, Farideh Ebrahimi Taj, Vida Zarabi, Azardokht Tabatabaei
BACKGROUND: arthritis could be caused by different etiologies ranging from rheumatologic diseases to infectious conditions. Therefore, early diagnosis of etiology and treatment is important. The purpose of this study was to determine the the M.pneumonia in synovial fluid of children with arthritis by 2 methods (serology and qualitative PCR). Methods & materials: this trial was carried out as a cross sectional study in pediatric and orthopedic ward of Rasoul-e Akram hospital in Tehran, Iran...
November 21, 2016: Infectious Disorders Drug Targets
https://www.readbyqxmd.com/read/27874910/short-versus-long-cephalomedullary-nails-for-pertrochanteric-hip-fracture
#11
Nicholas B Frisch, Nickolas J Nahm, Jad G Khalil, Clifford M Les, Stuart T Guthrie, Michael A Charters
This study compared patients who underwent treatment with short or long cephalomedullary nails with integrated cephalocervical screws and linear compression. Patients with AO/OTA 31-A2 or A3 pertrochanteric fractures treated with either short (n=72) or long (n=97) InterTAN (Smith & Nephew, Memphis, Tennessee) cephalomedullary nails were reviewed. Information on perioperative measures (estimated blood loss, surgical time, and fluoroscopy time) and postoperative orthopedic complications (infection, implant failure, screw cutout, and periprosthetic femur fracture) was included...
November 22, 2016: Orthopedics
https://www.readbyqxmd.com/read/27871962/penile-implant-review-of-a-no-touch-technique
#12
REVIEW
J Francois Eid
INTRODUCTION: Over 25% of the more than 725,000 cases of nosocomial infection in the United States are related to an implantable device. Despite the standard typical strategies available, infection rates for breast implants, cerebrospinal shunts, and penile implants remain unacceptably high. This paper will review use of a "no-touch" technique in varied surgical procedures from orthopedic fracture repair, cerebrospinal fluid shunt placement, and breast reconstruction/augmentation to penile prosthesis implantation...
July 2016: Sexual Medicine Reviews
https://www.readbyqxmd.com/read/27870814/the-contemporary-microbiology-and-rates-of-concomitant-osteomyelitis-in-acute-septic-arthritis
#13
Jessica Branson, Jesus G Vallejo, Anthony R Flores, Kristina G Hulten, Edward O Mason, Sheldon L Kaplan, J Chase McNeil
BACKGROUND: Septic arthritis (SA) and acute osteomyelitis (AO) are among the most common serious bacterial infections of childhood. Knowledge of the microbiology of SA is critical to treatment. Awareness of the presence of attendant AO is also important to guide clinical management. We sought to describe the current microbiology of SA in children as well as describe clinical features associated with coexisting AO. MATERIALS AND METHODS: Patients with SA were identified from the infectious diseases consult service records from 2010-2014...
November 18, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27869175/an-antibacterial-and-absorbable-silk-based-fixation-material-with-impressive-mechanical-properties-and-biocompatibility
#14
Chenglong Shi, Xiaobing Pu, Guan Zheng, Xinglong Feng, Xuan Yang, Baoliang Zhang, Yu Zhang, Qingshui Yin, Hong Xia
Implant-associated infections and non-absorbing materials are two important reasons for a second surgical procedure to remove internal fixation devices after an orthopedic internal fixation surgery. The objective of this study was to produce an antibacterial and absorbable fixation screw by adding gentamicin to silk-based materials. The antibacterial activity was assessed against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) in vitro by plate cultivation and scanning electron microscopy (SEM)...
November 21, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27869063/screening-patients-undergoing-total-hip-or-knee-arthroplasty-with-perioperative-urinalysis-and-the-effect-of-a-practice-change-on-antimicrobial-use
#15
Samuel Bailin, Nicolas Noiseux, Jean M Pottinger, Birgir Johannsson, Ambar Haleem, Sarah Johnson, Loreen A Herwaldt
OBJECTIVE To identify predictors of treatment for urinary tract infections (UTI) among patients undergoing total hip (THA) or knee (TKA) arthroplasties and to assess an intervention based on these predictors. DESIGN We conducted a retrospective cohort study of 200 consecutive patients undergoing THA/TKA between February 21, 2011, and June 30, 2011, to identify predictors of treatment for UTI and a prospective cohort study of 50 patients undergoing these procedures between May 21, 2012, and July 17, 2012, to assess the association of signs or symptoms and UTI treatment...
November 21, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27860210/limitation-of-the-antibiotic-eluting-bone-graft-substitute-an-example-of-gentamycin-impregnated-calcium-sulfate
#16
Chang-Chin Wu, Yang-Kai Huang, Wei-Jen Chang, Yun-Ching Wu, Chen-Chie Wang, Kai-Chiang Yang
Patients with inadequate volume of alveolar processes or bone defects commonly require graft substitutes in oral, maxillofacial or orthopedic surgery. Ridge augmentation and reconstruction of facial bony defects with bone graft materials achieve better outcomes in functional and aesthetic rehabilitation. The injectable calcium sulfate filler is used widely in intra-operative applications. Calcium sulfate bone filler has been shown to upregulate bone formation-related mRNA genes in vitro and improve osseointegration in vivo...
November 18, 2016: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/27855775/use-of-closed-suction-drain-after-primary-total-knee-arthroplasty-an-overrated-practice
#17
Gaurav M Sharma, Gauresh Palekar, Dilip D Tanna
PURPOSE: The age-old practice of closed suction drain following orthopedic procedures has been challenged since past few decades. Our aim was to assess the effectiveness of closed suction drain after total knee arthroplasty. MATERIALS AND METHODS: One hundred twenty patients (135 knees) with primary Total Knee Arthroplasty were divided into a study group (no drain) and a control group (drain used). Inclusion criteria were grade 3 and grade 4 osteoarthritis of the knee...
2016: SICOT-J
https://www.readbyqxmd.com/read/27855612/99mtc-labeled-white-blood-cell-scan-as-a-guide-to-open-biopsy-in-the-management-of-hip-and-knee-prosthesis-infection-preliminary-results
#18
Mauro Liberatore, Giuseppe Gentile, Giulia Anna Follacchio, Viviana Frantellizzi, Giuseppe De Vincentis, Francesco Monteleone, Christos Anagnostou, Francesco Maria Drudi, Vittorio Calvisi
The aim of the present prospective study was to evaluate the usefulness of labeled leukocyte scan as a guide to open biopsy for the management of hip and knee prosthesis infection in patients without loosening of orthopedic device. Twenty-six patients with suspected hip (24) and knee (2) prosthesis infection underwent routine analysis of blood, plain radiography and 99m Tc-HMPAO labelled leukocyte scan (WBCS). On these basis, patients were subdivided in the following groups: bone infection without loosening (n°=14), septic loosening (n°=8), superficial infection (n°=2), no infection (n°=2)...
November 17, 2016: Current Radiopharmaceuticals
https://www.readbyqxmd.com/read/27855064/rifampin-based-combination-therapy-is-active-in-foreign-body-osteomyelitis-after-prior-rifampin-monotherapy
#19
Cassandra L Brinkman, Suzannah M Schmidt-Malan, Jayawant N Mandrekar, Robin Patel
Staphylococcal prosthetic joint infections (PJIs) are associated with biofilm formation, making them difficult to treat; if managed with débridement and implant retention, rifampin-based therapy is usually employed. Rifampin resistance potentially challenges PJI treatment. In investigating the effects of rifampin monotherapy on methicillin-resistant Staphylococcus aureus (MRSA) foreign body osteomyelitis in rats, we previously demonstrated that rifampin resistance was selected but that it disappeared 14 days following rifampin monotherapy (1) and that rifampin resistance occurred less frequently following two rounds than one round of rifampin monotherapy (2)...
November 14, 2016: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27847845/long-term-results-functional-outcomes-and-complications-after-open-reduction-and-internal-fixation-of-neglected-and-displaced-greater-tuberosity-of-humerus-fractures
#20
Morteza Nakhaei Amroodi, Vahid Behshad, Paniz Motaghi
BACKGROUND: Humerus fractures include 5% to 8% of total fractures. Non-union and delayed union of GT (GT) fractures is uncommon; however they present a challenge to the orthopedic surgeons. Significant controversy surrounds optimal treatment of neglected fractures. The purpose of this article was to perform a comparative study to evaluate the outcomes of open reduction and internal fixation (ORIF) of neglected GT fractures. METHODS: We retrospectively evaluated the results of surgical intervention in 12 patients with displaced nonunion of GT fractures who were referred to our center...
October 2016: Archives of Bone and Joint Surgery
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