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Infection in orthopedics

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https://www.readbyqxmd.com/read/28549361/-leukocyte-esterase-as-a-diagnostic-tool-for-an-infectious-disease-of-the-knee
#1
S U Ceja-Picazo, S Fuentes-Figueroa, A H Rivera-Villa, A R Hernández-Salgado, R Torres-González, A M Pérez, J A Hernández-García, J M Pérez-Atanasio
BACKGROUND: Articular infection is an orthopedic challenge due to its difficult diagnosis and devastating results. Various diagnostic studies exist: culture, ESR, CRP, count of leukocytes, among others, but none is specific, they all take more than 30 minutes to complete, and require complex infrastructure. In this study, we determine the sensitivity and specificity of the leukocyte esterase for detection of an infectious process joint in Mexican population. MATERIAL AND METHODS: During November 2015 to April 2016, we obtained synovial fluid from two groups of patients: one with a diagnosis of synovial joint infection with or without implant, and the control group, without infection but with degenerative pathology of the knee...
November 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28548484/controlled-release-of-naringin-in-metal-organic-frameworks-mofs-loaded-mineralized-collagen-coating-to-simultaneously-enhance-osseointegration-and-antibacterial-activity
#2
Mengfei Yu, Dongqi You, Junjun Zhuang, Suya Lin, Lingqing Dong, Shengtao Weng, Bin Zhang, Kui Cheng, Wen-Jian Weng, Huiming Wang
Two important goals in orthopedic implants research are to promote osseointegration and prevent infection. However, much of previous efforts have been paid on the design of coatings either to enhance osseointegration while ignoring antibacterial activity or vice versa, to prevent infection while ignoring bone integration. Here, we designed a multifunctional mineralized collagen coating on titanium with the aid of metal-organic frameworks (MOFs) nanocrystals to control the release of naringin, a Chinese herbal medicine which could promote osseointegration and prevent bacterial infection...
May 26, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28547573/results-of-lumbar-spondylodeses-using-different-bone-grafting-materials-after-transforaminal-lumbar-interbody-fusion-tlif
#3
Nicolas Heinz vonderHoeh, Anna Voelker, Christoph-Eckhard Heyde
PURPOSE: Can a mixture of hydroxyapatite (HA) and autologous bone from decompression sites produce similar results when used for transforaminal lumbar interbody fusion (TLIF)? In the current literature, autologous iliac crest bone grafts (ICBGs) have been reported the gold standard for this procedure. Indeed, to date, no clinical data have confirmed that a mixture of equal volumes of HA and local autologous bone produce similar results in term of fusion as the same volume of autologous ICBG alone...
May 25, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28540567/-the-significance-of-biofilm-for-the-treatment-of-infections-in-orthopedic-surgery-2017-update
#4
REVIEW
C Scheuermann-Poley, C Wagner, J Hoffmann, A Moter, C Willy
BACKGROUND: The increase in endoprosthetic and osteosynthetic surgical treatment is associated with a simultaneous increase in implant-associated infections (surgical site infections, SSI). Biofilms appear to play a significant role in the diagnosis and treatment of these infections and heavily contaminated wounds. This article aims to provide a current overview of biofilm and its relevance in orthopedic surgery. MATERIALS AND METHODS: A computer-assisted literature search of MedLine (PubMed) was performed using key word combinations with "biofilm" (as of March 2017)...
May 24, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28540116/using-care-bundles-to-improve-surgical-outcomes-and-reduce-variation-in-care-for-fragility-hip-fracture-patients
#5
Stephanie Bandara, Genni Lynch, Cameron Cooke, Paul Varghese, Nicola Ward
INTRODUCTION: Fragility hip fractures constitute a large proportion of orthogeriatric admissions to orthopedic wards. This study looked at reducing variation in care in fragility hip fracture patients using a novel approach with care bundles. The care bundle comprises 5 elements targeted at providing adequate analgesia, early mobilization, improving recognition of delirium, and decreasing rates of urinary infections. METHODS: A total of 198 patients who sustained a fragility hip fracture during the intervention period were included in the study...
June 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28538379/unilateral-versus-bilateral-pedicle-screw-fixation-with-posterior-lumbar-interbody-fusion-for-lumbar-degenerative-diseases-a-meta-analysis
#6
Huan Liu, Ying Xu, Si-Dong Yang, Tao Wang, Hui Wang, Feng-Yu Liu, Wen-Yuan Ding
BACKGROUND: Both unilateral pedicle screw fixation with posterior lumbar interbody fusion (PLIF) and bilateral pedicle screw fixation with PLIF are used to treat lumbar degenerative diseases (LDD). However, which one is a better treatment for LDD remains considerable controversy. Therefore, the focus of this meta-analysis was to assess the merits and shortcomings of efficacy of these 2 surgical procedures for LDD. METHODS: An extensive search of literature was performed in Pubmed/MEDLINE, Embase, CNKI, and WANFANG databases on unilateral versus bilateral pedicle screw fixation with PLIF fusion for LDD, from January 2007 to January 2017 and language was restricted to Chinese or English...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28537526/composite-biomaterial-as-a-carrier-for-bone-active-substances-for-metaphyseal-tibial-bone-defect-reconstruction-in-rats
#7
Peter Frederik Horstmann, Deepak Raina, Hanna Isaksson, Werner Hettwer, Lars Lidgren, Michael Mørk Petersen, Magnus Tägil
Restoring lost bone is a major challenge in orthopedic surgery. Currently available treatment-strategies all have shortcomings, like risk of infection, non-union and excessive resorption. Our primary aim was to study if a commercially available gentamicin-containing composite calcium sulphate/hydroxyapatite biomaterial (GBM) could serve as a carrier for local delivery of bone morphogenic protein-2 (BMP-2) and zoledronic acid (ZA) in a tibia defect-model in rats. Empty and allograft-filled defects were used as controls...
May 24, 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/28532076/sustained-drug-release-from-surface-modified-uhmwpe-for-acetabular-cup-lining-in-total-hip-implant
#8
R Manoj Kumar, Pallavi Gupta, Sandan Kumar Sharma, Akshat Mittal, Manish Shekhar, Vijayesh Kumar, B V Manoj Kumar, Partha Roy, Debrupa Lahiri
Despite sterilization and aseptic procedure, bacterial infection remains a key challenge in total hip arthroplasties. This fact emphasizes the urgent need for development of new implant systems, which should releases the drug in a controlled manner without sparing its mechanical and tribological properties. In this study, the lining material of the acetabular cup, in total hip implant, has been modified for sustained release of drugs, which should be available throughout the site of implantation to fight the post-operation bacterial infection...
August 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28530768/perioperative-management-of-rheumatoid-medications-in-orthopedic-surgery
#9
Kunal Sindhu, Brian Cohen, Joseph A Gil
Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disorder known to cause progressive joint destruction. Over time, untreated RA can lead to pain and increasing disability, making orthopedic intervention necessary. The treatment of RA revolves around a variety of medications that blunt the overall immune response. However, this may increase the risk of infection and impair wound healing. Given the nature of this disease, orthopedists frequently encounter patients with RA in the operative setting. To optimize surgical outcomes, orthopedists must carefully manage and pay special attention to the adverse side effects of the complicated medication regimens of these patients perioperatively...
May 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/28529866/which-orthopaedic-patients-are-infected-with-gram-negative-non-fermenting-rods
#10
Omid Jamei, Shpresa Gjoni, Besa Zenelaj, Benjamin Kressmann, Wilson Belaieff, Didier Hannouche, Ilker Uçkay
Background : 1(st) and 2(nd) generation cephalosporins used for perioperative prophylaxis in orthopaedic surgery do not cover non-fermenting Gram-negative rods (NFR). Methods: Epidemiological cohort study of adult patients operated for orthopedic infections between 2004 and 2014 with perioperative cefuroxim or vancomycin prophylaxis. Exclusion of polyneuropathic ischemic foot infections and septic bursitis cases. Results: Of the total 1840 surgical procedures in the study, 430 grew Gram-negative pathogens (23%), of which 194 (11%) were due to NFR and 143 (8%) to Pseudomonas aeruginosa...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529861/local-intra-wound-administration-of-powdered-antibiotics-in-orthopaedic-surgery
#11
REVIEW
Andrew N Fleischman, Matthew S Austin
Surgical site infection (SSI) is one of the most common complications after orthopaedic surgery, leading to significant morbidity and its associated costs. Surgical guidelines strongly recommend the use of systemic antibiotic prophylaxis to reduce the risk for developing SSI. Locally administered powdered antibiotics have the potential to provide remarkably high intra-wound concentrations without risk for systemic toxicity. However, a paucity of high quality evidence in the orthopaedic literature has prevented widespread adoption of this technique...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28527684/patient-perceptions-regarding-outpatient-hip-and-knee-arthroplasties
#12
R Michael Meneghini, Mary Ziemba-Davis
BACKGROUND: There has been increasing interest in outpatient total joint arthroplasty (TJA) in the orthopedic community, but how patients feel about outpatient TJA is unknown. The purpose of this study was to understand patient perspectives on hip and knee replacements performed in an outpatient setting. METHODS: We surveyed 110 consecutive patients scheduled for primary TJA in an academic suburban arthroplasty practice regarding their knowledge and perceptions of outpatient TJA...
April 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28526202/capnocytophaga-canimorsus-an-underestimated-cause-of-periprosthetic-joint-infection
#13
Marcel Orth, Patrick Orth, Konstantinos Anagnostakos
BACKGROUND: Periprosthetic joint infection (PJI) is a major clinical problem in orthopedic surgery. Capnocytophaga canimorsus (C. canimorsus) is an unusual and hardly detectable bacterium. A review of the literature indicates that C. canimorsus affects mainly immunocompromised patients. It has not been reported to cause periprosthetic joint infections in immunocompetent patients so far. This case report aims to raise awareness of C. canimorsus in orthopedic surgery with special regard to joint arthroplasty...
May 16, 2017: Knee
https://www.readbyqxmd.com/read/28520517/nanoantibiotics-a-new-paradigm-for-the-treatment-of-surgical-infection
#14
Joseph S Fernandez-Moure, Michael Evangelopoulos, Kayla Colvill, Jeffrey L Van Eps, Ennio Tasciotti
Infections following orthopedic device implantations often impose a substantial health burden and result in high medical costs. Currently, preventative methods are often employed following an orthopedic implant to reduce risk of infection; however, contamination of the surgical site can still occur. Although antibiotics have demonstrated a substantial reduction in bacterial growth and maintenance, biofilm formation around the implant can often minimize efficacy of the antibiotic. Recently, nanotechnology has garnered significant interest, resulting in the development of several antibiotic delivery strategies that exhibit extended release and increased efficacy...
May 18, 2017: Nanomedicine
https://www.readbyqxmd.com/read/28511590/temperature-rise-in-kirschner-wires-inserted-using-two-drilling-methods-forward-and-oscillation
#15
Scott Richard Anderson, Serkan Inceoglu, Montri D Wongworawat
BACKGROUND: Kirschner wires (K-wires) are commonly used in orthopedic surgery. However, the loosening of the pins can lead to delayed or improper healing or infection. Wire loosening can occur by thermal necrosis that occurs due to heat produced during wire insertion. Although the parameters that affect temperature rise in cortical bone during wire insertion and drilling have been studied, the effect of drilling mode (oscillation versus forward) is unknown. The purpose of this study was to compare the temperature changes occurring in cortical bone during wire insertions by oscillating and forward drills...
May 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28507884/a-retrospective-analysis-of-complications-associated-with-bone-morphogenetic-protein-2-in-anterior-lumbar-interbody-fusion
#16
Kevork Hindoyan, Justin Tilan, Zorica Buser, Jeremiah R Cohen, Darrel S Brodke, Jim A Youssef, Jong-Beom Park, S Tim Yoon, Hans-Joerg Meisel, Jeffrey C Wang
STUDY DESIGN: Retrospective review. OBJECTIVE: The aim of our study was to quantify the frequency of complications associated with recombinant human bone morphogenetic protein 2 (rhBMP-2) use in anterior lumbar interbody fusion (ALIF). METHODS: The orthopedic subset of the Medicare database (PearlDiver) was queried for this retrospective cohort study using International Statistical Classification of Diseases 9 (ICD-9) and Current Procedure Terminology (CPT) codes for ALIF procedures with and without rhBMP-2 between 2005 and 2010...
April 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28507069/saers-is-responsive-to-cellular-respiratory-status-and-regulates-fermentative-biofilm-formation-in-staphylococcus-aureus
#17
Ameya A Mashruwala, Casey M Gries, Tyler D Scherr, Tammy Kielian, Jeffrey M Boyd
Biofilms are multicellular communities of microorganisms living as a quorum rather than as individual cells. The bacterial human pathogen Staphylococcus aureus uses oxygen as a terminal electron acceptor during respiration. Infected human tissues are hypoxic or anoxic. We recently reported that impaired respiration elicits a programmed cell lysis (PCL) phenomenon in S. aureus leading to the release of cellular polymers that are utilized to form biofilms. PCL is dependent upon the AtlA murein hydrolase and is regulated, in part, by the SrrAB two-component regulatory system (TCRS)...
May 15, 2017: Infection and Immunity
https://www.readbyqxmd.com/read/28499164/mechanical-properties-and-antibiotic-release-characteristics-of-poly-methyl-methacrylate-based-bone-cement-formulated-with-mesoporous-silica-nanoparticles
#18
Kumaran Letchmanan, Shou-Cang Shen, Wai Kiong Ng, Poddar Kingshuk, Zhilong Shi, Wilson Wang, Reginald B H Tan
The influence of mesoporous silica nanoparticles (MSNs) loaded with antibiotics on the mechanical properties of functional poly(methyl methacrylate)-(PMMA) based bone cements is investigated. The incorporation of MSNs to the bone cements (8.15wt%) shows no detrimental effects on the biomechanical properties of the freshly solidified bone cements. Importantly, there are no significant changes in the compression strength and bending modulus up to 6 months of aging in PBS buffer solution. The preserved mechanical properties of MSN-functionalized bone cements is attributed to the unchanged microstructures of the cements, as more than 96% of MSNs remains in the bone cement matrix to support the cement structures after 6 months of aging...
May 2, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28498071/assessment-of-malpractice-claims-due-to-spinal-epidural-abscess
#19
J Mason DePasse, Roy Ruttiman, Adam E M Eltorai, Mark A Palumbo, Alan H Daniels
OBJECTIVE Spinal epidural abscesses (SEAs) can be difficult to diagnose and may result in neurological compromise or even death. Delays in diagnosis or treatment may worsen the prognosis. While SEA presents a high risk for litigation, little is known about the medicolegal ramifications of this condition. An enhanced understanding of potential legal implications is important for practicing spine surgeons, emergency medicine physicians, and internists. METHODS The VerdictSearch database, a large legal-claims database, was queried for "epidural abscess"-related legal cases...
May 12, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28487001/effect-of-medicare-s-nonpayment-policy-on-surgical-site-infections-following-orthopedic-procedures
#20
Jereen Z Kwong, Yingjie Weng, Micaela Finnegan, Robyn Schaffer, Austin Remington, Catherine Curtin, Kathryn M McDonald, Jay Bhattacharya, Tina Hernandez-Boussard
OBJECTIVE Orthopedic procedures are an important focus in efforts to reduce surgical site infections (SSIs). In 2008, the Centers for Medicare and Medicaid (CMS) stopped reimbursements for additional charges associated with serious hospital-acquired conditions, including SSI following certain orthopedic procedures. We aimed to evaluate the CMS policy's effect on rates of targeted orthopedic SSIs among the Medicare population. DESIGN We examined SSI rates following orthopedic procedures among the Medicare population before and after policy implementation compared to a similarly aged control group...
May 10, 2017: Infection Control and Hospital Epidemiology
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