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Infection in orthopedics

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https://www.readbyqxmd.com/read/28336047/posttraumatic-reconstruction-of-the-foot-and-ankle-in-the-face-of-active-infection
#1
REVIEW
Brandon Jonard, Erin Dean
Posttraumatic infection of the foot and ankle is a challenging issue for orthopedic surgeons. Making the diagnosis often requires combining laboratory and radiologic testing, patient examination, and history. Patient comorbidities should be identified and optimized whenever possible. Treatment must combine effective antibiotic therapy with thorough debridement of the infected zone. Reconstruction often requires a 2-staged approach using antibiotic spacers and temporary external fixation, with the goal of obtaining a functional, pain-free limb that is free of infection...
April 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28336041/double-edged-sword-musculoskeletal-infection-provoked-acute-phase-response-in-children
#2
REVIEW
Michael Benvenuti, Thomas An, Emilie Amaro, Steven Lovejoy, Gregory Mencio, Jeffrey Martus, Megan Mignemi, Jonathan G Schoenecker
The acute phase response has a crucial role in mounting the body's response to tissue injury. Excessive activation of the acute phase response is responsible for many complications that occur in orthopedic patients. Given that infection may be considered continuous tissue injury that persistently activates the acute phase response, children with musculoskeletal infections are at markedly increased risk for serious complications. Future strategies that modulate the acute phase response have the potential to improve treatment and prevent complications associated with musculoskeletal infection...
April 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28336038/role-of-systemic-and-local-antibiotics-in-the-treatment-of-open-fractures
#3
REVIEW
David C Carver, Sean B Kuehn, John C Weinlein
The orthopedic community has learned much about the treatment of open fractures from the tremendous work of Ramon Gustilo, Michael Patzakis, and others; however, open fractures continue to be very difficult challenges. Type III open fractures continue to be associated with high infection rates. Some combination of systemic and local antibiotics may be most appropriate in these high-grade open fractures. Further research is still necessary in determining optimal systemic antibiotic regimens as well as the role of local antibiotics...
April 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28321991/atomic-layer-deposition-of-a-silver-nanolayer-on-advanced-titanium-orthopedic-implants-inhibits-bacterial-colonization-and-supports-vascularized-de-novo-bone-ingrowth
#4
Aine Devlin-Mullin, Naomi M Todd, Zahra Golrokhi, Hua Geng, Moritz A Konerding, Nigel G Ternan, John A Hunt, Richard J Potter, Chris Sutcliffe, Eric Jones, Peter D Lee, Christopher A Mitchell
Joint replacement surgery is associated with significant morbidity and mortality following infection with either methicillin-resistant Staphylococcus aureus (MRSA) or Staphylococcus epidermidis. These organisms have strong biofilm-forming capability in deep wounds and on prosthetic surfaces, with 10(3) -10(4) microbes resulting in clinically significant infections. To inhibit biofilm formation, we developed 3D titanium structures using selective laser melting and then coated them with a silver nanolayer using atomic layer deposition...
March 21, 2017: Advanced Healthcare Materials
https://www.readbyqxmd.com/read/28320508/staged-minimally-invasive-plate-osteosynthesis-of-proximal-tibial-fractures-with-acute-compartment-syndrome
#5
Joon-Woo Kim, Chang-Wug Oh, Jong-Keon Oh, Hee-Soo Kyung, Kyeong-Hyeon Park, Hee-June Kim, Jae-Wook Jung, Young-Soo Jung
PURPOSE: High-energy proximal tibial fractures often accompany compartment syndrome and are usually treated by fasciotomy with external fixation followed by secondary plating. However, the initial soft tissue injury may affect bony union, the fasciotomy incision or external fixator pin sites may lead to postoperative wound infections, and the staged procedure itself may adversely affect lower limb function. We assess the results of staged minimally invasive plate osteosynthesis (MIPO) for proximal tibial fractures with acute compartment syndrome...
March 11, 2017: Injury
https://www.readbyqxmd.com/read/28295126/gluteus-maximus-advancement-flap-procedure-for-reconstruction-of-posterior-soft-tissue-deficiency-in-revision-total-hip-arthroplasty
#6
Benjamin F Ricciardi, Peter W Henderson, Alexander S McLawhorn, Geoffrey H Westrich, Mathias P Bostrom, Lloyd B Gayle
The current study describes the surgical technique and early outcomes of a gluteus maximus advancement flap procedure for the treatment of posterior soft tissue insufficiency among patients with complex revision total hip arthroplasty. This retrospective case series was conducted with a prospective, single-institution arthroplasty registry. Patients who underwent a gluteus maximus advancement flap procedure in the setting of revision total hip arthroplasty between January 2012 and January 2016 were eligible for inclusion (N=7)...
March 14, 2017: Orthopedics
https://www.readbyqxmd.com/read/28293511/de-novo-reconstruction-of-a-hybrid-patella-by-staged-fabrication-of-a-microvascular-bone-transplant-with-an-osteointegrated-prosthetic-socket
#7
Goetz A Giessler, Christian Hendrich
Total patellectomy is sometimes unavoidable but usually results in severely impaired function, pain, and instability in the affected knee. Any patellar prosthetic solutions rely on a certain amount of remaining bone and therefore are not applicable after total patellectomy. Traditionally, reconstruction of a neopatella by avascular or allogeneic bone grafts is hampered by mechanical failure, resorption, or infection. We developed a new, 3-stage approach to reconstruct a hybrid patella composed of a revascularized scapula tip transplant fabricated with a prosthetic socket...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28293156/indications-of-implant-removal-a-study-of-83-cases
#8
Muhammad Haseeb, Muhammad Farooq Butt, Tariq Altaf, Khalid Muzaffar, Anil Gupta, Aleena Jallu
INTRODUCTION: Fracture fixation has become advanced with the advent of new and custom metal implants for each type of bone/fracture. After union though, the implant ceases to be important and may be removed. Routine removal is advocated by some and opposed by others. Nevertheless, some patients require removal of the hardware because of various implant-related problems. Our study was aimed at identifying the most common causes for implant removal. OBJECTIVE: To investigate the common indications of orthopedic implant removal surgeries...
January 2017: International Journal of Health Sciences
https://www.readbyqxmd.com/read/28292539/prevention-of-infection-in-orthopedic-prosthetic-surgery
#9
REVIEW
Ioana Chirca, Camelia Marculescu
Total joint arthroplasty is a generally safe orthopedic procedure; however, infection is a potentially devastating complication. Multiple risk factors have been identified for development of prosthetic joint infections. Identification of patients at risk and preoperative correction of known risk factors, such as smoking, diabetes mellitus, anemia, malnutrition, and decolonization of Staphylococcus carriers, represent well-established actions to decrease the infection risk. Careful operative technique, proper draping and skin preparation, and appropriate selection and dosing of antimicrobials for perioperative prophylaxis are also very important in prevention of infection...
March 11, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28288878/outcomes-and-complications-of-percutaneous-versus-open-repair-of-acute-achilles-tendon-rupture-a-meta-analysis
#10
REVIEW
Bo Yang, Yang Liu, Shunli Kan, Di Zhang, Hong Xu, Feifei Liu, Guangzhi Ning, Shiqing Feng
BACKGROUND: Acute Achilles tendon rupture (AATR) is a frequent injury occurring dominantly in young to middle-aged males. Outcomes and complications between percutaneous and open repair are still controversial. Thus, the purpose of this meta-analysis is to evaluate the outcomes and complications of these two operative methods. MATERIALS AND METHODS: We searched multiple databases: PubMed, Web of Science, EMBASE and the Cochrane Library up to October 2016. Two reviewers independently screened the studies for eligibility, evaluated the quality and extracted data from eligible studies, with confirmation by cross-checking...
March 11, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28280714/anti-biofilm-activity-of-a-long-chain-fatty-aldehyde-from-antarctic-pseudoalteromonas-haloplanktis-tac125-against-staphylococcus-epidermidis-biofilm
#11
Angela Casillo, Rosanna Papa, Annarita Ricciardelli, Filomena Sannino, Marcello Ziaco, Marco Tilotta, Laura Selan, Gennaro Marino, Maria M Corsaro, Maria L Tutino, Marco Artini, Ermenegilda Parrilli
Staphylococcus epidermidis is a harmless human skin colonizer responsible for ~20% of orthopedic device-related infections due to its capability to form biofilm. Nowadays there is an interest in the development of anti-biofilm molecules. Marine bacteria represent a still underexploited source of biodiversity able to synthesize a broad range of bioactive compounds, including anti-biofilm molecules. Previous results have demonstrated that the culture supernatant of Antarctic marine bacterium Pseudoalteromonas haloplanktis TAC125 impairs the formation of S...
2017: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/28274617/predictive-model-of-surgical-time-for-revision-total-hip-arthroplasty
#12
Albert Wu, Michael J Weaver, Marilyn M Heng, Richard D Urman
BACKGROUND: Maximizing operating room utilization in orthopedic and other surgeries relies on accurate estimates of surgical control time (SCT). A variety of case and patient-specific variables can influence the duration of surgical time during revision total hip arthroplasty (THA). We hypothesized that these variables are better predictors of actual SCT (aSCT) than a surgeon's own prediction (pSCT). METHODS: All revision THAs from October 2008 to September 2014 from one institution were accessed...
February 7, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28274250/prosthetic-joint-infection-development-of-an-evidence-based-diagnostic-algorithm
#13
Heinrich M L Mühlhofer, Florian Pohlig, Karl-Georg Kanz, Ulrich Lenze, Florian Lenze, Andreas Toepfer, Sarah Kelch, Norbert Harrasser, Rüdiger von Eisenhart-Rothe, Johannes Schauwecker
BACKGROUND: Increasing rates of prosthetic joint infection (PJI) have presented challenges for general practitioners, orthopedic surgeons and the health care system in the recent years. The diagnosis of PJI is complex; multiple diagnostic tools are used in the attempt to correctly diagnose PJI. Evidence-based algorithms can help to identify PJI using standardized diagnostic steps. METHODS: We reviewed relevant publications between 1990 and 2015 using a systematic literature search in MEDLINE and PUBMED...
March 9, 2017: European Journal of Medical Research
https://www.readbyqxmd.com/read/28267910/-surgical-management-of-spinal-deformity-in-a-patient-with-escobar-syndrome-review-of-the-literature
#14
M C Hernández-Hernández, J A Canales-Nájera, J S De La Cruz-Álvarez, M E Tena-Zanabria, J Matus-Jiménez
BACKGROUND: The non-lethal variant of the Escobar or multiple pterygium syndrome is an entity of autosomal recessive inheritance linked to the X chromosome; it is characterized by multiple pterygia (hence its name) located mainly in the neck (95%) and armpits (55%), as well as other orthopedic malformations such as a vertical talus, congenital hip dislocation, and congenital scoliosis. OBJECTIVE: To present an optional surgical technique for the management of severe spinal deformities...
July 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28245906/definition-of-infection-after-fracture-fixation-a-systematic-review-of-randomized-controlled-trials-to-evaluate-current-practice
#15
REVIEW
W J Metsemakers, K Kortram, M Morgenstern, T F Moriarty, I Meex, R Kuehl, S Nijs, R G Richards, M Raschke, O Borens, S L Kates, C Zalavras, P V Giannoudis, M H J Verhofstad
INTRODUCTION: One of the most challenging musculoskeletal complications in modern trauma surgery is infection after fracture fixation (IAFF). Although infections are clinically obvious in many cases, a clear definition of the term IAFF is crucial, not only for the evaluation of published research data but also for the establishment of uniform treatment concepts. The aim of this systematic review was to identify the definitions used in the scientific literature to describe infectious complications after internal fixation of fractures...
February 20, 2017: Injury
https://www.readbyqxmd.com/read/28244328/facile-preparation-of-poly-lactic-acid-brushite-bilayer-coating-on-biodegradable-magnesium-alloys-with-multiple-functionalities-for-orthopedic-application
#16
Lei Zhang, Jia Pei, Haodong Wang, Yongjuan Shi, Jialin Niu, Feng Yuan, Hua Huang, Hua Zhang, Guangyin Yuan
Recently magnesium and its alloys have been proposed as a promising next generation orthopedic implant material, whereas the poor corrosion behavior, potential cytotoxicity, and the lack of efficient drug delivery system have limited its further clinical application, especially for the local treatment of infections or musculoskeletal disorders and diseases. In this study, we designed and developed a multifunctional bilayer composite coating of poly(lactic acid)/brushite with high interfacial bonding strength on a Mg-Nd-Zn-Zr alloy, aiming to improve the biocorrosion resistance and biocompatibility of the magnesium-based substrate, as well as to further incorporate the biofunctionality of localized drug delivery...
March 22, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28241725/-minimally-invasive-tarsal-sinus-incision-combined-with-manipulative-reduction-and-internal-fixation-for-calcaneal-fractures-of-sanders-type%C3%A2-and-%C3%A2
#17
M Chen, K Deng, W H Zeng, J J Zeng, Q S Zhong, Z M Han
Objective: To evaluate the method and curative effect of plate fixation or percutaneous screws for the treatment of calcaneal fractures of Sanders type Ⅱ and Ⅲ via a minimally invasive sinus tarsi incision combined with a variety of manipulative reduction methods. Methods: Twenty-one patients with closed calcaneal fractures treated in the Department of Orthopedics, the First Affiliated Hospital of Nanchang University from January 2014 to January 2016 were collected. There were 15 men and 6 women, with an average age of 39...
March 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28240815/antimicrobial-and-immunomodulatory-surface-functionalized-electrospun-membranes-for-bone-regeneration
#18
Asha Mathew, Cedryck Vaquette, Saeed Hashimi, Irani Rathnayake, Flavia Huygens, Dietmar W Hutmacher, Saso Ivanovski
Guided bone regeneration (GBR) is a surgical procedure utilizing occlusive membranes for providing space maintenance and enabling selective repopulation of the damaged area. While this technique is effective in regenerating bone, bacterial infiltration occurs frequently and can compromise the regenerative outcome. In this study, the authors describe the development and characterization of a GBR membrane made of medical grade polycaprolactone (mPCL) electrospun fibers with antibacterial and immunomodulatory properties...
February 27, 2017: Advanced Healthcare Materials
https://www.readbyqxmd.com/read/28235982/-transcutaneous-osseointegration-after-limb-amputation-a-review-over-27-years
#19
Horst-Heinrich Aschoff
Intramedullary, bone-anchored (osseointegrated), transcutaneous docking of artificial limbs has been in clinical use for more than 25 years. This system of prosthetic limb attachment is a valuable treatment option in the rehabilitation of patients after limb amputation. Only a few centers are systematically investigating this topic worldwide so that current knowledge on this special treatment option is still limited; however, mainstream medical opinion still regards percutaneous skeletal prosthetic docking with some skepticism...
February 24, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28235527/a-patient-with-postpolio-syndrome-developed-cauda-equina-syndrome-after-neuraxial-anesthesia-a-case-report
#20
Wei-Cheng Tseng, Zhi-Fu Wu, Wen-Jinn Liaw, Su-Yang Hwa, Nan-Kai Hung
Combined spinal anesthesia and postoperative epidural analgesia is widely used in orthopedic surgery. Uncommon but serious neurologic complications of neuraxial anesthesia (NA) include direct trauma during needle or catheter insertion, central nervous system infections, and neurotoxicity of local anesthetics. Cauda equina syndrome (CES) is a rare complication after NA but can result in severe neurologic deterioration that may require surgical intervention. We present a case of a 69-year-old woman with postpolio syndrome who developed CES after combined spinal anesthesia and postoperative epidural analgesia...
February 2017: Journal of Clinical Anesthesia
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