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Infection in orthopedics

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https://www.readbyqxmd.com/read/28437545/union-knee-alignment-and-clinical-outcomes-of-patients-treated-with-autologous-bone-grafting-for-medial-tibial-defects-in-primary-total-knee-arthroplasty
#1
Kunihiro Hosaka, Shu Saito, Teruyasu Oyama, Hirohisa Fujimaki, Eiji Cho, Kanki Ishigaki, Yasuaki Tokuhashi
Autologous bone grafting is an established method to overcome bone deficiencies in primary total knee arthroplasty (TKA). However, recently, metal augments have been used by many surgeons. Although autologous bone grafting is a common technique, few large studies have described its success in achieving bone union in primary TKA. The goal of this study was to evaluate primary TKA with autologous bone grafting for tibial defects. A total of 68 knees that had undergone arthroplasty with autologous bone grafting with more than 1 year of follow-up were evaluated...
April 24, 2017: Orthopedics
https://www.readbyqxmd.com/read/28434696/complete-eradication-of-biofilm-from-orthopedic-materials
#2
Jeffrey T Leary, Matthew M Werger, William H Broach, Lindsey N Shaw, Brandon G Santoni, Thomas L Bernasek, Steven T Lyons
BACKGROUND: Interest exists in finding alternatives to current management strategies in periprosthetic joint infections, which typically include a 2-stage revision with placement of an antibiotic spacer and delayed placement of a new implant. We studied the efficacy of autoclaving, ultrasonication, and mechanical scrubbing for sterilization and biofilm eradication on infected cobalt-chrome discs. METHODS: Strains of Staphylococcus aureus MRSA252 or Staphylococcus epidermidis RP62A were grown on the discs...
March 29, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28430741/utility-of-8%C3%A2-h-and-time-decay-corrected-acquisition-scintigraphy-with-in-vitro-labeled-white-blood-cells-for-the-diagnosis-of-osteoarticular-infection
#3
Edel Noriega Álvarez, Guillermo A Martínez Pimienta, Ana M Benítez Segura, María T Bajén Lázaro, Alba Rodrígez-Gasén, Julio Rodríguez-Rubio Corona, Jaime Mora Salvadó
INTRODUCTION: Except in the spine, labeled white-blood cell scintigraphy (WBCS) with image acquisition up to 24 h is the nuclear medicine test of choice for diagnosing osteoarticular infection. However, distinguishing between inflammation and infection is a challenge. OBJECTIVES: The first aim of this study was to verify earlier research studies that used 4 and 24 h time decay-corrected acquisition (TDCA) to differentiate infection from inflammation. The second aim was to analyze whether 8 h acquisition (1-day protocol) yielded similar results as 20-24 h acquisition...
April 20, 2017: Nuclear Medicine Communications
https://www.readbyqxmd.com/read/28420544/disclosing-agents-for-the-intraoperative-identification-of-biofilms-on-orthopedic-implants
#4
Joshua A Parry, Melissa J Karau, Sanjeev Kakar, Arlen D Hanssen, Robin Patel, Matthew P Abdel
BACKGROUND: Disclosing agents are dyes used in dentistry to colorize plaque (biofilm) and may offer a means for intraoperative detection of biofilms on orthopedic implants. Methylene blue (MB) stains biofilm and is safely used in orthopedic applications. Injection of MB into acutely infected prosthetic knees before debridement may enable visualization of biofilm, which could influence treatment decisions. The aims of this study were to determine if MB could be used to visualize biofilm on total knee arthroplasty (TKA) implants and to determine if MB staining has an antimicrobial effect that might interfere with subsequent culture...
March 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28416968/safety-and-efficacy-of-resistive-polymer-versus-forced-air-warming-in-total-joint-surgery
#5
Melanie F Sandoval, Paul D Mongan, Michael R Dayton, Craig A Hogan
BACKGROUND: Forced-air warming is used as a mechanism to prevent hypothermia and adverse outcomes associated with hypothermia among patients undergoing surgery. Patient safety in healthcare includes the use of devices and technology that minimize potential adverse events to patients. The present study sought to compare the capabilities of patient warming between two different devices that use different mechanisms of warming: forced-air warming and non-air warming. METHODS: One hundred twenty patients undergoing total hip or total knee arthroplasty received patient warming via a forced warming device or non-air warming fabric conductive material...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28414677/a-rare-case-of-tropical-pyomysitis-acquired-on-vacation-in-a-healthy-male
#6
K Poole, T Tran
INTRODUCTION: Pyomyositis has traditionally been considered a tropical disease. Increasing prevalence has been observed in more northern climates, especially with HIV, immunosuppression, and IV drug abuse as predisposing factors. Pyomyositis has the tendency to mimic other conditions, such as muscle contusion, necrotizing fasciitis, or septic arthritis. The rarity of this disease and non-specificity of its symptoms often lead to delay in appropriate diagnosis and treatment. CASE: 24-year-old man, seen 2 days prior in orthopedics clinic and the Emergency Department for persistent gluteal pain thought to be due to right-sided sciatica, was admitted following worsening pain, diffuse generalized weakness with polyarthralgias and myalgias These symptoms were associated with night sweats, shaking chills, and difficulty walking...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28411222/effect-of-antimicrobial-and-physical-treatments-on-growth-of-multispecies-staphylococcal-biofilms
#7
Elizabeth J Stewart, David E Payne, Tianhui Maria Ma, J Scott VanEpps, Blaise R Boles, John G Younger, Michael J Solomon
The prevalence and structure of Staphylococcus aureus and Staphylococcus epidermidis within multispecies biofilms was found to depend sensitively on physical environment and antibiotic dosage. Although these species commonly infect similar sites, such as orthopedic implants, little is known about their behavior in multispecies communities, particularly in response to treatment. This research establishes that S. aureus is much more prevalent than S. epidermidis when simultaneously seeded and grown in unstressed conditions (pH = 7, 37°C) in both laboratory and clinical strains...
April 14, 2017: Applied and Environmental Microbiology
https://www.readbyqxmd.com/read/28410834/wearing-id-badges-in-the-operating-room-environment-is-reconsideration-warranted
#8
Matthew H Hogue, Kris P Heilmann, John J Callaghan
BACKGROUND: Surgical site infection and nosocomial infections in general have appropriately undergone increased scrutiny over the last decade. Numerous studies have documented pathogenic bacterial contamination of personal items such as cell phones, pagers, ties, and pens in the hospital setting. It is our understanding that Joint Commission on Accreditation of Healthcare Organizations requires all personnel to wear an identification badge at all times, which includes the operating room environment...
February 3, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28407424/biofilms-in-orthopedic-infections-a-review-of-laboratory-methods
#9
REVIEW
Alex C Dibartola, Matthew C Swearingen, Jeffrey F Granger, Paul Stoodley, Devendra H Dusane
Bacterial infection after hardware implantation in orthopedic surgery is a devastating issue as it often necessitates increased hospital costs and stays, multiple revision surgeries, and prolonged use of antibiotics. Because of the nature of hardware implantation into the body, these infections are commonly in the form of attached biofilms. The current literature on a range of methodologies to study clinically explanted infected orthopedic hardware, with potential biofilm, in the laboratory setting is limited...
April 2017: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
https://www.readbyqxmd.com/read/28403000/the-combined-use-of-a-neurocutaneous-flap-and-the-ilizarov-technique-for-reconstruction-of-large-soft-tissue-defects-and-bone-loss-in-the-tibia
#10
Jia Xu, Wan-Run Zhong, Liang Cheng, Chun-Yang Wang, Gen Wen, Pei Han, Yi-Min Chai
BACKGROUND: Management of posttraumatic large soft tissue defects and bone loss remains a therapeutic and surgical challenge for orthopedic surgeons. We assessed the use of a neurocutaneous flap and the Ilizarov technique in the reconstruction of severe composite defects in the tibia. METHODS: We retrospectively reviewed 18 consecutive patients with trauma-related soft tissue defects and bone loss. The size of the soft tissue defect ranges from 8 × 9 cm to 14 × 18 cm...
May 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28399322/antibiotic-use-and-kirschner-wire-fixation-in-forefoot-surgery-a-national-survey
#11
Gregory Pace, Samuel Dellenbaugh, Brian Stapinski, Umur Aydogan, Jorge Bustillo, Paul Juliano
In foot and ankle patients, the use of Kirschner wires is common, and the population in the typical foot and ankle practice has higher rates of comorbidities associated with infection. This study assessed national trends regarding the use of postoperative prophylactic antibiotic therapy in patients undergoing foot and ankle surgery treated with percutaneous Kirschner wires. Attending physicians at foot and ankle fellowships were mailed a questionnaire that included 3 clinical vignettes containing questions on the use of postoperative antibiotics in patients treated with percutaneous Kirschner wires...
April 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/28399321/septic-arthritis-of-the-wrist-incidence-risk-factors-and-predictors-of-infection
#12
John D Jennings, Elizabeth Zielinski, Rick Tosti, Asif M Ilyas
Septic arthritis of the wrist can result in permanent damage to the joint, making timely diagnosis crucial to initiate empiric antibiotics and surgical intervention. Although septic arthritis is routinely included in the differential diagnosis of atraumatic wrist pain, the incidence is unknown. Unlike large joints, there is no consensus on cell count values considered pathognomonic for wrist septic arthritis. The goal of this retrospective study was to determine the incidence of wrist septic arthritis and to identify the clinical, serum, and joint fluid values that predict infection...
April 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/28399047/assessing-quality-and-safety-in-pediatric-supracondylar-humerus-fracture-care
#13
Christopher A Iobst, Matthew Stillwagon, Deidre Ryan, Eric Shirley, Steven L Frick
BACKGROUND: Recently, there has been an emphasis on improving quality, safety, and value in the delivery of health care in the United States. The American Board of Orthopedic Surgery (ABOS) has developed a performance improvement questionnaire (PIQ) for orthopaedic surgeons managing pediatric supracondylar humerus fracture (PSCHF). Using the supracondylar PIQ as a guide, this study evaluates the process of measuring the outcomes and variations in care to PSCHF patients among pediatric orthopaedic surgeons...
April 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28396930/initial-management-of-complex-hand-injuries-in-military-or-austere-environments-how-to-defer-and-prepare-for-definitive-repair
#14
Camille Choufani, Olivier Barbier, Antoine Grosset, James Charles Murison, Didier Ollat, Sylvain Rigal, Laurent Mathieu
INTRODUCTION: The damage control orthopedics (DCO) concept is a sequential surgical management strategy indicated when ideal primary treatment is not possible or suitable. DCO principles are routinely applied to hand traumas in wartime practice, but could also be useful in a civilian setting when immediate specialized management cannot be carried out. METHODS: The authors report three typical observations of soldiers treated for a complex hand trauma on the field by orthopedic surgeons from the French Military Health Service (FMHS)...
April 10, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28394796/reply-to-letter-glycopeptides-versus-beta-lactams-for-the-prevention-of-surgical-site-infections-in-cardiovascular-and-orthopedic-surgery-a-meta-analysis
#15
Anas Saleh, Alison K Klika, Wael K Barsoum
No abstract text is available yet for this article.
May 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28394795/glycopeptides-versus-beta-lactams-for-the-prevention-of-surgical-site-infections-in-cardiovascular-and-orthopedic-surgery-a-meta-analysis
#16
E Patchen Dellinger
No abstract text is available yet for this article.
May 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28394747/risk-and-protective-factors-associated-with-surgical-infections-among-spine-patients
#17
REVIEW
Alyssa G Blood, Melanie F Sandoval, Evalina Burger, Katherine Halverson-Carpenter
BACKGROUND: The purpose of the study was to identify patient-specific and procedure-specific risk and protective factors associated with post-operative surgical site infections (SSIs) among surgical spine patients. METHODS: CINAHL, PubMed, Ovid, Medline, and EBSCO databases were searched for articles within the past 10 years (January 2003-March 2015). The keywords and combinations used in the search included: Spine surgery, post-operative infection, risk factors, orthopedic infections...
April 2017: Surgical Infections
https://www.readbyqxmd.com/read/28393309/free-non-vascularized-fibular-graft-for-treatment-of-large-bone-defect-around-the-elbow-in-pediatric-patients
#18
Kamolporn Kaewpornsawan, Perajit Eamsobhana
BACKGROUND: Large bone defect is a challenging problem in orthopedics practice. Several methods are available for bridging of these bone defects, including cancellous bone graft, free vascularized fibula graft, and bone transport with external ring fixator. The aim of this study was to describe our experience in nine pediatric cases of free non-vascularized autogenous fibular strut bone graft in which large bone defect and bone loss of >7 cm was caused by open fracture and infective nonunion around the elbow joint...
April 9, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28390886/epidemiology-and-antibiotic-resistance-of-late-prosthetic-knee-and-hip-infections
#19
Lorenzo Drago, Elena De Vecchi, Monica Bortolin, Luigi Zagra, Carlo L Romanò, Laura Cappelletti
BACKGROUND: Prosthetic joint infections (PJI) are still a major complication of hip and knee arthroplasties. Identification of the causative pathogens and knowledge of their antibiotic susceptibilities are essential for the management of these infections. The main purpose of the study was to identify and compare the causative bacteria of prosthetic knee and hip joint infections in a reference Italian orthopedic center and to characterize antibiotic resistance profiles of bacteria involved...
March 15, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28390756/screening-for-nasal-carriage-of-staphylococcus-aureus-among-patients-scheduled-to-undergo-orthopedic-surgery-incidence-of-surgical-site-infection-by-nasal-carriage
#20
Masaru Nakamura, Tateaki Shimakawa, Shunji Nakano, Takashi Chikawa, Shinji Yoshioka, Masahiro Kashima, Shunichi Toki, Koichi Sairyo
BACKGROUND: Staphylococcus aureus (S. aureus), including MRSA, is considered to be the leading cause of surgical site infection (SSI) after orthopedic surgery. We screened for nasal carriers of S. aureus among patients who were scheduled to undergo orthopedic surgery at our hospital to reveal the effect of nasal S. aureus carriage on SSI. Our study design clearly has the intent of finding S. aureus nasal carriage and eradicating MRSA when found, and this strategy is to verify whether it's effective for preventing orthopedic surgical infections...
April 5, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
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