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Infection in orthopedics

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https://www.readbyqxmd.com/read/28819603/bilateral-ankle-fusion-in-leak-syndrome-induced-deformity-a-case-report
#1
Luis Sobral, Ana C Ângelo, Afonso Caetano, Joaquim Rodeia, Isabel Rosa
INTRODUCTION: Systemic capillary leak syndrome (SCLS) is a rare condition of unknown etiology defined by sudden episode of hypotension, high hematocrit, and low serum protein concentration due to capillary hyperpermeability. Several treatments have been published for this pathology and eventual compartment syndrome but not for the disabling consequences. This clinical case highlights the negative orthopedic consequences of a severe systemic attack and reports a subsequent deformity treatment option that resulted in the patient quality of life improvement...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28817534/radius-regeneration-after-open-fracture-and-extrusion-a-case-report
#2
Kristopher B McCall, David Y Chong
A pediatric patient presenting with an open forearm fracture with segmental defect is rare, and the pediatric orthopedic literature to guide treatment is sparse. There are several described methods to treat the defect, including bone grafting and bone transport techniques. In addition, there are reports of fibular regeneration after resection if the periosteum is left intact. We present a case report of complete regeneration of over half of a pediatric radial shaft with an intact periosteum, after traumatic extrusion from an open fracture...
August 16, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28811110/characterizing-the-diagnosis-and-treatment-of-allergic-contact-dermatitis-to-2-octyl-cyanoacrylate-used-for-skin-closure-in-elective-orthopedic-surgery
#3
Brian P Chalmers, Heath P Melugin, Peter K Sculco, Jennifer J Schoch, Rafael J Sierra, Mark W Pagnano, Michael J Stuart, Michael J Taunton
BACKGROUND: While studies have shown that postoperative wound complications can predispose to deep infection following orthopedic surgery, the best form of skin closure has not been elucidated. Furthermore, the unique risks and benefits of each type of wound closure have not been studied. The goal of this study is to present the diagnosis and treatment of patients with allergic contact dermatitis (ACD) from 2-octyl cyanoacrylate, a skin adhesive commonly used in wound closure. METHODS: Twenty-nine patients with ACD to 2-octyl cyanoacrylate (Prineo, Ethicon, NJ) following elective orthopedic surgeries from 2013 to 2016 were retrospectively reviewed; this occurred in 29 of 6088 units of Prineo used at our institution, for an estimated incidence of 0...
July 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28809623/how-to-choose-between-the-implant-materials-steel-and-titanium-in-orthopedic-trauma-surgery-part-2-biological-aspects
#4
S M Perren, P Regazzoni, A A Fernandez
BIOLOGICAL ASPECTS OF STEEL AND TITANIUM AS IMPLANT MATERIAL IN ORTHOPEDIC TRAUMA SURGERY The following case from the ICUC database, where a titanium plate was implanted into a flourishing infection, represents the clinical experience leading to preferring titanium over steel. (Fig. 1) (6). Current opinions regarding biological aspects of implant function. The "street" opinions regarding the biological aspects of the use of steel versus titanium as a surgical trauma implant material differ widely. Statements of opinion leaders range from "I do not see any difference in the biological behavior between steel and titanium in clinical application" to "I successfully use titanium implants in infected areas in a situation where steel would act as foreign body "sustaining" infection...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28799523/bactericidal-activity-of-the-ti-13nb-13zr-alloy-against-different-species-of-bacteria-related-with-implant-infection
#5
John-Jairo Aguilera-Correa, Ana Conde, Maria-Angeles Arenas, Juan-Jose de-Damborenea, Miguel Marin, Antonio L Doadrio, Jaime Esteban
The Ti-6Al-4V alloy is one of the most commonly used in orthopedic surgery. Despite its advantages, there is an increasing need to use new titanium alloys with no toxic elements and improved biomechanical properties, such as Ti-13Nb-13Zr. Prosthetic joint infections (PJI) are mainly caused by Gram-positive bacteria; however, Gram-negative bacteria are a growing problem due to associated multidrug resistance. In this study, the bacterial adherence and viability on the Ti-13Nb-13Zr alloy have been compared to that of the Ti-6Al-4V alloy using 16 collection and clinical strains of bacterial species related to PJI: Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, and Pseudomonas aeruginosa...
August 11, 2017: Biomedical Materials
https://www.readbyqxmd.com/read/28794175/a-comparative-genomics-study-of-staphylococcus-epidermidis-from-orthopedic-device-related-infections-correlated-with-patient-outcome
#6
Virginia Post, Llinos G Harris, Mario Morgenstern, Leonardos Mageiros, Matthew D Hitchings, Guillaume Méric, Ben Pascoe, Samuel K Sheppard, R Geoff Richards, T Fintan Moriarty
Staphylococcus epidermidis has emerged as an important opportunistic pathogen causing orthopedic device-related infections (ODRIs). This study investigated the association of genome variation and phenotypic features of the infecting S. epidermidis isolate with the clinical outcome of the infected patient. S. epidermidis isolates were collected from 104 patients with ODRI. Their clinical outcome was evaluated, after an average of 26 months, as either "cured" or "not cured". The isolates were tested for antibiotic susceptibility and biofilm formation...
August 9, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28790538/comparison-of-plate-nail-and-external-fixation-in-the-management-of-diaphyseal-fractures-of-the-humerus
#7
Michele Bisaccia, Luigi Meccariello, Giuseppe Rinonapoli, Giuseppe Rollo, Marco Pellegrino, Andrea Schiavone, Cristina Ibáñez Vicente, Pellegrino Ferrara, Marco Filipponi, Auro Caraffa
INTRODUCTION: Humeral shaft fractures are quite common in orthopedics and represent 1-3% of adult fractures. The surgical treatment is the a better choice in order to obtain a reduction and stable alignment and to prevent the complications. The goal of this study was to compare the three techniques (IMN, LCP and EF) in the treatment of diaphyseal fractures of the humerus in the adult patient. MATERIALS AND METHODS: We examined 79 patients with diaphyseal fractures of the humerus...
April 2017: Medical Archives
https://www.readbyqxmd.com/read/28790468/management-of-the-infected-total-hip-arthroplasty
#8
D'jon Lopez, Isabel Leach, Elinor Moore, Alan R Norrish
In the United Kingdom approximately 80,000 total hip arthroplasties are undertaken on an average each year. The popularity and demand for this operation are continually increasing. Our understanding of arthroplasty surgery and its complications has evolved greatly, and as a result infection rates are undeniably at an all-time low. The increasing volume of operations being performed does, however, mean that we still continue to see an increased number of cases of infection. There is no doubt that periprosthetic joint infection (PJI) poses a complex clinical and diagnostic predicament to clinicians...
July 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28782240/electrophoretic-deposition-of-mgo-nanoparticles-imparts-antibacterial-properties-to-poly-l-lactic-acid-for-orthopedic-applications
#9
Daniel J Hickey, Divya Muthusamy, Thomas J Webster
Bacterial infection of implanted biomaterials is a serious problem that increases health care costs and negatively affects a considerable fraction of orthopedic procedures. In this field, magnesium oxide nanoparticles (MgO NPs) have emerged as a promising material to combat bacterial infection while maintaining or improving bone cell functions. Here, MgO NPs were electrophoretically deposited onto poly-L-lactic acid (PLLA) sheets to achieve a coating of highly exposed MgO NPs that directly influenced cell-substrate interactions at short time scales...
August 7, 2017: Journal of Biomedical Materials Research. Part A
https://www.readbyqxmd.com/read/28781018/high-early-major-complication-rate-after-revision-for-mechanically-assisted-crevice-corrosion-in-metal-on-polyethylene-total-hip-arthroplasty
#10
Brian J McGrory, Anna H Jorgensen
BACKGROUND: Failed total hip arthroplasty caused by mechanically assisted crevice corrosion (MACC) has serious consequences such as adverse local tissue reaction. Revision is currently indicated for significant hip pain, stiffness, and dysfunction; hip instability; progressive bone loss; and soft tissue destruction. Outcomes of this revision surgery are not yet completely understood. METHODS: We examined the surgical outcomes at a minimum of 6 months (average, 25; range, 7-68 months) in a cohort of 27 consecutive patients who underwent revision total hip arthroplasty for MACC associated with a single implant vendor and taper type...
July 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28763892/-efficacy-and-safety-of-drainage-after-total-knee-arthroplasty
#11
F Jing, H M Li, X D Yang, B Li, J Ji, Y L Li, C J Sun
Objective: To determine whether suction drainage is safe and effective compared with no-drainage in total knee arthroplasty. Methods: The literature search was based on PubMed, MEDLINE, EMBASE, Highwire, the Cochrane Library, CBM, CNKI, VIP and WFSD.The data were analysed using RevMan 5.3.Fourteen randomised controlled trials involving 1 009 knees were included in our analysis. Results: Suction drainage increases the rate and volume of blood transfusion.No-drainage group increases the rate of wound problems (OR=1...
July 18, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28760123/is-locked-compressive-intramedullary-nailing-for-adult-humerus-shaft-fractures-advantageous
#12
Fatih Duygun, Cengiz Aldemir
OBJECTIVES: This study aims to evaluate the radiological and functional outcomes of locked compressive intramedullary nailing (IMN) cases in adult humerus shaft fractures. PATIENTS AND METHODS: A total of 24 patients (12 males, 12 females; mean age 42 years; range 23 to 55 years) with humerus fractures were treated with locked compressive IMN at the Orthopedics and Traumatology Clinic, Antalya Training and Research Hospital between December 2009 and March 2015. Fluoroscopy was used only to check fracture reduction before the reaming procedure...
August 2017: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/28755960/hospitalization-before-surgery-and-subsequent-risk-of-infective-complications-after-radical-cystectomy-a-population-based-analysis
#13
Emanuele Zaffuto, Raisa Pompe, Helen Davis Bondarenko, Marco Moschini, Paolo Dell'Oglio, Giorgio Gandaglia, Nicola Fossati, Shahrokh F Shariat, Francesco Montorsi, Alberto Briganti, Pierre I Karakiewicz
INTRODUCTION: The length of stay prior to surgery increases the risk of postoperative infections (PIs) in several surgical settings, such as cardiac, orthopedic, and general surgery. However, data for urological oncology procedures are limited. We examined PI rates after radical cystectomy (RC) according to the length of stay prior to RC (LOSPRC). MATERIALS AND METHODS: A total of 24,242 patients with bladder cancer treated with RC between 1998 and 2013 were abstracted from the National Inpatients Sample database...
July 26, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28735803/transfusion-thresholds-for-major-orthopedic-surgery-a-systematic-review-and-meta-analysis
#14
Matthew D Mitchell, Joel S Betesh, Jaimo Ahn, Eric L Hume, Samir Mehta, Craig A Umscheid
BACKGROUND: More than a million surgeries are performed annually in the United States for hip or knee arthroplasty or hip fracture stabilization. One-fifth of these patients have blood transfusions during their hospital stay. Increases in transfusion rates have caused concern about increased adverse events from unnecessary transfusions. METHODS: We systematically reviewed randomized trials examining the effect of restrictive vs liberal transfusion thresholds on patients having major orthopedic surgery...
July 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28735655/an-intramedullary-nail-coated-with-antibiotic-and-growth-factor-nanoparticles-an-individualized-state-of-the-art-treatment-for-chronic-osteomyelitis-with-bone-defects
#15
Roberto Berebichez-Fridman, Pablo Montero-Olvera, Ricardo Gómez-García, Enrique Berebichez-Fastlicht
Among various infections, chronic osteomyelitis is one of the most challenging in terms of treatment. This infection is more common among patients with open fractures and those who have undergone elective orthopedic procedures. The treatment of osteomyelitis requires high antibiotic doses and an aggressive and multifaceted surgical approach. The use of parenteral antibiotics alone, without debridement, is not sufficiently effective, due to the formation of sequestra and the low vascularity of the affected area...
August 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28735323/gas-gangrene-of-different-origin-associated-with-clostridium-perfringens-type-a-in-three-patients-simultaneously-hospitalized-in-a-single-department-of-orthopedics-and-traumatology-in-poland
#16
Monika Brzychczy-Włoch, Dorota Ochońska, Anna Piotrowska, Małgorzata Bulanda
The objective of the study was to perform a comparative analysis of phenotypic and genetic similarity, determination of resistance profiles, detection of toxin-encoding genes and molecular typing of Clostridium perfringens isolates originating from patients with gas gangrene. The study encompassed three patients with a clinical and microbiological diagnosis of gas gangrene who were hospitalized in one of the hospitals of the Kujawsko-Pomorskie province in the same period of time between 8(th) April 2015 and 20(th) April 2015...
January 2, 2017: Polish Journal of Microbiology
https://www.readbyqxmd.com/read/28731325/bioinspired-and-biomimetic-agnps-gentamicin-embedded-silk-fibroin-coatings-for-robust-antibacterial-and-osteogenetic-applications
#17
Wenhao Zhou, Zhaojun Jia, Pan Xiong, Jianglong Yan, Yangyang Li, Ming Li, Yan Cheng, Yufeng Zheng
With the progressively increasing demand for orthopedic Ti implants, the balance between two primary complications restricting implant applications is needed to be solved: the lack of bone tissue integration and biomedical device-associated infections (BAI), where emergence of multiresistance bacteria make it worse. Notably, a combination of silver nanoparticles (AgNPs) and a kind of antibiotic can synergistically inhibit bacterial growth, where a low concentration of AgNPs has been confirmed to promote the proliferation and osteogenesis of osteoblasts...
August 9, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28730548/orthopedic-infections-caused-by-obligatory-anaerobic-gram-negative-rods-report-of-two-cases
#18
Marta Kierzkowska, Piotr Pedzisz, Ireneusz Babiak, Jakub Janowicz, Mateusz Kulig, Anna Majewska, Anna Sawicka-Grzelak, Grazyna Mlynarczyk
Anaerobic bone and joint infections are uncommon, although the number of anaerobic infections is presumably underestimated because of difficulties with isolation and identification of obligate anaerobes. This study describes two cases of complicated Bacteroides fragilis peri-implant infection of the lumbar spine, infection of the hip and osteomyelitis. Bacteria were identified with the use of a mass spectrometer, VITEK MS system. Drug susceptibility was performed with the use of E-test. The EUCAST breakpoints were used for interpretation with B...
July 20, 2017: Medical Microbiology and Immunology
https://www.readbyqxmd.com/read/28724376/sonication-contribution-to-identifying-prosthetic-joint-infection-with-ralstonia-pickettii-a-case-report-and-review-of-the-literature
#19
Rares Mircea Birlutiu, Mihai Dan Roman, Razvan Silviu Cismasiu, Sorin Radu Fleaca, Crina Maria Popa, Manuela Mihalache, Victoria Birlutiu
BACKGROUND: In the context of an increase number of primary and revision total hip and total knee arthroplasty performed yearly, an increased risk of complication is expected. Prosthetic joint infection (PJI) remains the most common and feared arthroplasty complication. Ralstonia pickettii is a Gram-negative bacterium, that has also been identified in biofilms. It remains an extremely rare cause of PJI. There is no report of an identification of R. pickettii on an extracted spacer loaded with antibiotic...
July 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28717976/-trauma-surgery-in-pacific-small-island-developing-states-sids
#20
REVIEW
H Oberli, C Martin
BACKGROUND: The small developing countries in the Pacific are grouped together as Small Island Development States (SIDS) because they face similar problems which they cannot cope with nationally. They are developing countries, so-called low and lower middle income countries (LMIC), are economically weak and the islands of the different nations are widely scattered. Approximately 80% of the 10 million inhabitants live in rural regions. EPIDEMIOLOGY AND SURGICAL CAPACITY: Over 40% of patients in the surgical departments of hospitals are hospitalized for injuries, and this tendency is increasing...
July 17, 2017: Der Unfallchirurg
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