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Infection in orthopedics

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https://www.readbyqxmd.com/read/29318379/osteoinduction-and-conduction-through-absorbable-bone-substitute-materials-based-on-calcium-sulfate-in-vivo-biological-behavior-in-a-rabbit-model
#1
D Pförringer, N Harrasser, H Mühlhofer, M Kiokekli, A Stemberger, M van Griensven, M Lucke, R Burgkart, A Obermeier
Calcium sulfate (CS) can be used as an antibiotically impregnated bone substitute in a variety of clinical constellations. Antibiotically loaded bone substitutes find specific application in orthopedic and trauma surgery to prevent or treat bone infections especially in relation to open bone defects. However, its use as a structural bone graft reveals some concerns due to its fast biodegradation. The addition of calcium carbonate and tripalmitin makes CS formulations more resistant to resorption leaving bone time to form during a prolonged degradation process...
January 9, 2018: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/29317156/surgical-space-suits-increase-particle-and-microbiological-emission-rates-in-a-simulated-surgical-environment
#2
Praveen Vijaysegaran, Luke D Knibbs, Lidia Morawska, Ross W Crawford
BACKGROUND: The role of space suits in the prevention of orthopedic prosthetic joint infection remains unclear. Recent evidence suggests that space suits may in fact contribute to increased infection rates, with bioaerosol emissions from space suits identified as a potential cause. This study aimed to compare the particle and microbiological emission rates (PER and MER) of space suits and standard surgical clothing. METHODS: A comparison of emission rates between space suits and standard surgical clothing was performed in a simulated surgical environment during 5 separate experiments...
December 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29306970/preoperative-decolonization-to-reduce-infections-in-urgent-lower-extremity-repairs
#3
Daniel S Urias, Merin Varghese, Thomas Simunich, Shawna Morrissey, Russell Dumire
PURPOSE: Medical implants and surgical site infections (SSIs) can be a burden on both patients and healthcare systems with a significant rise in morbidity, mortality and costs. Preoperatively, our practice of a chlorohexidine gluconate (CHG) washcloth bath or solution shower was supplemented with nasal painting using povidone-iodine skin and nasal antiseptic (PI-SNA). We sought to measure the effectiveness in reducing SSIs in patients undergoing repair of lower extremity fractures. METHODS: A retrospective review of trauma patients undergoing orthopedic operations conducted at Conemaugh Memorial Medical Center from 10/1/2012 through 9/30/2016...
January 6, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29305635/-therapeutic-strategies-for-joint-infections
#4
U-J Gerlach
Joint infections represent a severe complication that results in irreversible joint destruction when left untreated or treated inadequately. The reasons for joint infections include endogenous hematological and exogenous factors. In the patient cohort described here, the empyema was almost exclusively acquired through iatrogenic measures (e.g. arthroscopic operations, punctures and intra-articular infections) or as a result of fractures close to the joint and penetrating injuries. Acute joint empyema is an orthopedic emergency, which must be immediately surgically treated because irreversible cartilage damage can rapidly occur due to the pathophysiological process...
January 5, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29297810/sarcocystis-neurona-associated-meningoencephalitis-in-a-pacific-walrus-odobendus-rosmarus-divergens
#5
Lana Krol, Vanessa Fravel, Diana G Procter, Kathleen M Colegrove
A 21-yr-old intact male walrus ( Odobendus rosmarus divergens) presented with acute onset of shifting lameness, initially associated with breeding behaviors. Further clinical signs manifested, including muscle tremors, anorexia, hematuria, and coughing. Diagnostics were limited, as the animal would not offer behaviors for voluntary sample collection. Signs were addressed with anti-inflammatories, anticonvulsants, and antibiotics. The walrus developed cluster seizures and ultimately, respiratory and cardiac arrest...
December 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/29295590/proposal-of-a-novel-natural-biomaterial-the-scleral-ossicle-for-the-development-of-vascularized-bone-tissue-in-vitro
#6
Marta Checchi, Jessika Bertacchini, Giulia Grisendi, Alberto Smargiassi, Antonella Sola, Massimo Messori, Carla Palumbo
Recovering of significant skeletal defects could be partially abortive due to the perturbations that affect the regenerative process when defects reach a critical size, thus resulting in a non-healed bone. The current standard treatments include allografting, autografting, and other bone implant techniques. However, although they are commonly used in orthopedic surgery, these treatments have some limitations concerning their costs and their side effects such as potential infections or malunions. On this account, the need for suitable constructs to fill the gap in wide fractures is still urgent...
December 25, 2017: Biomedicines
https://www.readbyqxmd.com/read/29286460/novel-diagnostics-in-revision-arthroplasty-implant-sonication-and-multiplex-polymerase-chain-reaction
#7
Gunnar T R Hischebeth, Sascha Gravius, Johanna K Buhr, Ernst Molitor, Matthias D Wimmer, Achim Hoerauf, Isabelle Bekeredjian-Ding, Thomas M Randau
In orthopedic patients, foreign body-associated infections, especially periprosthetic joint infections (PJIs), are a devastating complication of arthroplasty. Infection requires complex treatment, may result in long hospitalization and causes considerable costs. Multiple surgical revisions can be necessary in these patients, with a loss in function as well as in quality of life. The routine preoperative diagnostics include blood examination for C-reactive protein (CRP) and other biomarkers, as well as joint aspirate analysis for cell count, differentiation, and culture...
December 3, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29284901/risk-factors-for-the-surgical-field-infections-after-the-osteosynthes-of-tibia-diaphysis
#8
Adnana Talic, Fuad Dzankovic, Adnan Papovic, Emina Omerhodzic
Introduction: Infections occurring in the wound as a consequence of the surgery represent the surgical field infections (SFI). Tibia diaphysis fractures are common due to its exposure to the external force. Clinical signs include: pain, swelling, lower leg deformity and skin changes. Tibia in the lower extremities has an eccentric position - from the front inner side it is covered only with the skin and from the back and the outer by muscle mass. The most common pathogens are: Staphylococcus aureus, Coagulase negative Staphylococcoc aureus or S...
October 2017: Medical Archives
https://www.readbyqxmd.com/read/29279933/effect-of-antibiotic-prophylaxis-on-surgical-site-infections-following-removal-of-orthopedic-implants-used-for-treatment-of-foot-ankle-and-lower-leg-fractures-a-randomized-clinical-trial
#9
Manouk Backes, Siem A Dingemans, Marcel G W Dijkgraaf, H Rogier van den Berg, Bart van Dijkman, Jochem M Hoogendoorn, Pieter Joosse, Ewan D Ritchie, W Herbert Roerdink, Judith P M Schots, Nico L Sosef, Ingrid J B Spijkerman, Bas A Twigt, Alexander H van der Veen, Ruben N van Veen, Jefrey Vermeulen, Dagmar I Vos, Jasper Winkelhagen, J Carel Goslings, Tim Schepers
Importance: Following clean (class I, not contaminated) surgical procedures, the rate of surgical site infection (SSI) should be less than approximately 2%. However, an infection rate of 12.2% has been reported following removal of orthopedic implants used for treatment of fractures below the knee. Objective: To evaluate the effect of a single dose of preoperative antibiotic prophylaxis on the incidence of SSIs following removal of orthopedic implants used for treatment of fractures below the knee...
December 26, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29274863/total-knee-arthroplasty-with-the-medial-pivot-knee-system-clinical-and-radiological-outcomes-at-9-5-years-mean-follow-up
#10
M Dehl, Y Bulaïd, M Chelli, B Ramy, A Gabrion, E Havet, P Mertl
INTRODUCTION: The "ball-in-socket" design of the Medial-Pivot Knee System (MicroPort Orthopedics, Arlington, Tennessee, USA) aims to reproduce normal knee kinematics by medializing its rotational axis. The goal of this study was to measure knee range of motion (ROM) with this implant after a mean follow-up of 10 years and to report the survivorship and long-term clinical and radiological outcomes. We hypothesized the prosthetic knee would have at least 120 flexion at 10 years. MATERIAL AND METHODS: This was retrospective, single-centre study of 74 Medial-Pivot knees implanted in 71 patients (average age of 69 years) between May 2005 and November 2007...
December 21, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29274860/primary-pyomyositis-in-children
#11
M M Elzohairy
BACKGROUND: Pyomyositis PM is defined as a primary pyogenic infection of the striated skeletal muscle; although it has many dystrophic musculoskeletal complications, it is always misdiagnosed by many orthopedic surgeons. HYPOTHESIS: PM is rare in temperate climates and usually considered to be a tropical disease, until recent times, after globalization, it is possible to occur in the subtropical climate as in our country. MATERIAL AND METHODS: In the present series, the results of 15 children patients with primary pyomyositis have been reviewed...
December 21, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29250294/use-of-barbed-suture-for-wound-closure-in-electrophysiology-device-procedures
#12
Alexander Khodak, Adam S Budzikowski
BACKGROUND: Barbed suture use in surgical fields such as gynecology and orthopedic surgery has been associated with faster wound closure, improved cosmesis, increased cost-effectiveness and potentially decreased rates of infection. However, the use of barbed suture in electrophysiology device procedures has not been reported. OBJECTIVE: This study aims to (1) investigate the safety and effectiveness of barbed suture in wound closure in patients after EP implantable cardioverter defibrillators and loop recorders (CIED) procedures, (2) to determine whether these sutures have an advantage in device implant procedures by improving incision integrity, (3) and to find out whether these sutures would potentially lead to lower rates of infections compared to non-barbed sutures...
April 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29248992/antibiotics-and-open-fractures-of-the-lower-extremity-less-is-more
#13
B Bankhead-Kendall, T Gutierrez, J Murry, D Holland, V Agrawal, K Almahmoud, C Pearcy, M S Truitt
PURPOSE: Infectious complications in open lower extremity fractures contribute to significant morbidity. Historically, orthopedic guidelines have recommended Grade III fractures receive a first generation cephalosporin and an aminoglycoside. Despite these guidelines, few studies have evaluated the utility of adding an aminoglycoside in this patient population. At our trauma center, we have a unique trauma service where half of our surgeons treat Grade III open fractures with a cephalosporin alone and half use a cephalosporin + aminoglycoside...
December 16, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29248258/selection-implementation-and-interpretation-of-patient-centered-shoulder-and-elbow-outcomes
#14
REVIEW
Richard J Hawkins, Charles A Thigpen
The movement toward a value-based health care market requires comparison of physicians, hospitals, and health systems. Traditionally, process-based measures such as infection and readmission rates have been used. However, these events are uncommon in shoulder and elbow surgery, thus limiting their utility. Patient-reported outcomes (PROs) are a promising measure of quality and have been proposed as a potential metric to compare surgeon performance. However, there are over 25 different PROs for shoulder and elbow conditions...
December 13, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29247818/epidemiology-of-malpractice-claims-in-the-orthopedic-and-trauma-surgery-department-of-a-french-teaching-hospital-a-10-year-retrospective-study
#15
C Agout, P Rosset, J Druon, J Brilhault, L Favard
INTRODUCTION: Orthopedic and trauma surgery is the specialty for which claims for compensation are most often filed. Little data exists on the subject in France, especially in a teaching hospital. We conducted a retrospective study aimed at 1) identifying the epidemiological characteristics of patients filing claims against the orthopedic surgery and traumatology department of a teaching hospital in France, 2) analyzing the surgical procedures involved, the type of legal proceedings, and the financial consequences...
December 13, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29245290/operative-versus-nonoperative-treatment-of-displaced-intra-articular-calcaneal-fractures-a-meta-analysis-of-current-evidence-base
#16
REVIEW
Ning Wei, Peizhi Yuwen, Wei Liu, Yanbin Zhu, Wenli Chang, Chen Feng, Wei Chen
BACKGROUND: The relative efficacy of operative and nonoperative treatments for the displaced intra-articular calcaneal fractures (DIACF) remains uncertain. OBJECT: We conducted a meta-analysis to compare the effectiveness of operative and nonoperative treatments in treating patients with DIACF. METHODS: Databases including Cochrane Library, Medline, Embase, CBM, CNKI, and Google Scholar were searched. After independent study selection by 2 authors, data were extracted and collected independently...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29241815/litigation-in-orthopedic-surgery-what-can-we-do-to-prevent-it-systematic-analysis-of-126-legal-actions-involving-four-university-hospitals-in-france
#17
J Mouton, R Gauthé, M Ould-Slimane, S Bertiaux, S Putman, F Dujardin
INTRODUCTION: Orthopedic surgery produces 20% of medical malpractice claims. However only a few studies have examined the reasons for and consequences of these disputes, and they have usually been limited to a single hospital. This led us to perform a retrospective analysis of the claims at four teaching hospitals in northwestern France. The goals were 1) to describe the circumstances that led to these claims and recommend ways to prevent them, and 2) to describe the conduct of the proceedings and their financial and social outcomes...
December 11, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29234656/amputation-risk-after-the-revascularization-procedures-in-sarcoma-resections
#18
Luiz Eduardo Moreira Teixeira, Thiago Marques Leão, Daniel Barbosa Regazzi, Cláudio Beling Gonçalves Soares
Objective: The objective of this study is to evaluate the efficacy of vascular reconstructive surgery after resection of bone and soft tissue tumors in extremities and the risk of progression to amputation. Methods: This is a retrospective, observational data collection from medical records of patients who underwent resection of bone and soft tissue tumors in the period of 2002-2015. Thirteen patients met the inclusion criteria, which evaluated the correlations between certain factors (gender, tumor type, location, reconstruction, revascularization and patency, infection) with amputation in the postoperative period...
November 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/29234317/panton-valentine-leucocidin-pvl-as-a-potential-indicator-for-prevalence-duration-and-severity-of-staphylococcus-aureus-osteomyelitis
#19
Bei Jiang, Yinan Wang, Zihan Feng, Lei Xu, Li Tan, Shuang Zhao, Yali Gong, Cheng Zhang, Xiaoqiang Luo, Shu Li, Xiancai Rao, Yizhi Peng, Zhao Xie, Xiaomei Hu
Staphylococcus aureus is the most common cause of the difficult-to-treat osteomyelitis (OM). To better diagnose and manage S. aureus OM, especially for severe and long duration cases, indicators for risk prediction and severity evaluation are needed. Here, 139 clinical S. aureus isolates from orthopedic infections were divided into OM group (60 isolates from 60 OM patients) and non-OM group (79 isolates from 79 non-OM patients). Molecular types, antimicrobial susceptibility, and virulence factor profiles were evaluated and compared between the two groups to identify potential indicators associated with the prevalence of S...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29216700/-assessment-of-pain-function-and-complications-after-minimelly-invasive-decompression-of-morton%C3%A2-s-neuroma-using-a-dorsal-approach-in-16-patients
#20
F Sancho-Barroso, J Strassburger-Weidmann, V Castillo-Anaya
BACKGROUND: The purpose of this paper is to assess pain, function and complications after decompression of Mortons neuroma using a minimally invasive dorsal approach. METHOD AND RESULTS: 16 patients who underwent 19 decompressions were followed-up for 18 months. Pain was assessed with the visual analog scale (VAS), and function was assessed with the American Orthopedic Foot and Ankle Society (AOFAS) scale. Data was analyzed with the Student t test for related samples, which yielded a p value 0...
May 2017: Acta Ortopédica Mexicana
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