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https://www.readbyqxmd.com/read/28944144/osteomyelitis-due-to-multiple-rare-infections-in-a-patient-with-idiopathic-cd4-lymphocytopenia
#1
Nitin Gupta, Sayantan Banerjee, Timitrov, Rohini Sharma, Shambo Guha Roy, Trupti M Shende, Mohammed Tahir Ansari, Gagandeep Singh, Neeraj Nischal, Naveet Wig, Manish Soneja
A 26-year-old male patient presented with features suggestive of osteomyelitis involving the entire left femur, hip joint and knee joint. Culture from the debrided tissue grew Acinetobacter spp. and he was treated with sensitivity based antibiotics but the symptoms did not resolve. The synovial biopsy showed multinucleated giant cells and acid fast bacilli on Ziehl Neelsen stain. Cartridge based nucleic acid amplification test (GeneXpert) was negative. The Mycobacteria growth indicator tube culture was found to be positive for Mycobacterium abscessus...
August 2017: Intractable & Rare Diseases Research
https://www.readbyqxmd.com/read/28942397/catastrophic-cement-reaction-following-cementation-for-megaprosthesis-for-proximal-femoral-fracture
#2
Muhammad Nouman Baig, William Curtin, Michael Andrew Callaghan, Colin G Murphy
Bone cement implantation syndrome (BCIS) is a well-described and potentially fatal complication of orthopaedic surgery involving pressurised bone cement. Although also described for certain spinal procedures, it is most commonly associated with cemented hip and knee arthroplasty and with cemented hemiarthroplasty following neck of femur fracture in particular.Donaldson et alproposed the definition of BCIS as a syndrome "characterized by hypoxia, hypotension or both and/or unexpected loss of consciousness occurring around the time of cementation, prosthesis insertion, reduction of the joint or, occasionally, limb tourniquet deflation in a patient undergoing cemented bone surgery"...
September 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28934878/surgical-preparation-for-articular-cartilage-regeneration-in-the-osteoarthritic-knee-joint
#3
Joerg Mika, Thomas O Clanton, Catherine G Ambrose, Raimund W Kinne
PURPOSE: Autologous chondrocyte implantation (ACI) is a treatment option even in early osteoarthritis (OA). Surgical preparation for ACI should avoid penetration of the subchondral bone plate to prevent hemorrhage, fibrin clot formation, and subsequent activation of the inflammatory response. HYPOTHESIS: Current surgical procedures with ring curettes preserve the integrity of the subchondral bone plate, even in patients with OA. METHODS: Subchondral femoral bone plates ( n = 40) of OA knees undergoing total knee arthroplasty were prepared in vivo using standard, non-brute-force debridement for ACI...
October 2017: Cartilage
https://www.readbyqxmd.com/read/28933329/-mid-term-to-long-term-results-of-revision-total-hip-arthroplasty-using-the-oval-shaped-acetabular-cup-tc-type
#4
E Šťastný, T Trč, J Frýdl, Z Kopečný, T Philippou, J Lisý
INTRODUCTION The purpose of our paper is to evaluate the mid-term to long-term results and to confirm the basic criteria of a high-quality revision implant: safe bridging of bone defects, achievement of reliable primary fixation of revision acetabular cup, achievement of good secondary stability with documentable osteointegration of cup and demonstration of remodelling of transplanted bone tissue in the area of defects and in spaces between the implant ribs. MATERIAL AND METHODS Altogether 36 patients (38 cups) were evaluated who had undergone revision hip arthroplasty in the period from 2004 to 2010...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28918664/outcomes-of-surface-replacement-proximal-interphalangeal-joint-arthroplasty-using-the-self-locking-finger-joint-implant-minimum-two-years-follow-up
#5
Issei Komatsu, Yoshiya Arishima, Hirotomo Shibahashi, Toshihito Yamaguchi, Yoshitaka Minamikawa
BACKGROUND: The Self Locking Finger Joint (SLFJ) implant is a new type of surface replacement implant. The purpose of this study was to evaluate midterm clinical outcomes of the proximal interphalangeal (PIP) arthroplasty with the SLFJ implant. METHODS: We retrospectively studied 26 PIP joint arthroplasties using the SLFJ implant in 17 patients with osteoarthritis or posttraumatic osteoarthritis. Preoperative and postoperative range of motion, grip strength and key pinch, radiographic findings, and complications were evaluated...
September 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28918227/bone-remodeling-of-the-distal-femur-after-uncemented-total-knee-arthroplasty-a-2-year-prospective-dxa-study
#6
Mikkel Rathsach Andersen, Nikolaj S Winther, Thomas Lind, Henrik M Schrøder, Michael Mørk Petersen
Loss of bone stock as a response to the bone trauma, immobilization, and stress shielding related to joint replacement surgery increases the risk of fracture of the distal femur after total knee arthroplasty. Previous studies of uncemented femoral components have reported very high levels of bone loss in the distal femur. This study investigates the adaptive bone remodeling of the distal femur after uncemented total knee arthroplasty. We performed a 2-year follow-up of 53 patients (mean age 61.5 [38-70] years, F/M = 27/26, body mass index 29...
September 13, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28917431/results-of-toccata-%C3%A2-resurfacing-pip-joint-arthroplasty-a-series-of-32%C3%A2-cases-at-a-mean-follow-up-of-5-9%C3%A2-years
#7
W Kim, B Renaud, P Dumontier, J-L Condamine
The objective of this study was to evaluate the long-term results of proximal interphalangeal (PIP) resurfacing arthroplasty for treating osteoarthritis: the PIP Toccata implant(®). This was a retrospective study of 32 out of 33 PIP arthroplasty cases performed with a dorsolateral or a Chamay approach by two surgeons after a minimum follow-up of 24 months. Patients were reviewed using a standardized assessment of pain, function, mobility and radiological changes. The average follow-up was 5.9 years. The mean active range of motion was 67° (15-95)...
September 13, 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28915961/short-stem-total-hip-arthroplasty-potential-explanations-for-persistent-post-surgical-thigh-pain
#8
Isabel A C Baert, Enrique Lluch, Francis Van Glabbeek, Rudy Nuyts, Salim Rufai, Joanna Tuynman, Filip Struyf, Mira Meeus
Short stem uncemented femoral implants were developed with the aim of preserving proximal bone stock for future revisions, improving biomechanical reconstruction, aiding insertion through smaller incisions and potentially decreasing or limiting the incidence of thigh pain. Despite all the advantages of short stem designs, it remains unclear whether they are able to limit post-surgical thigh pain. In patients with short stem hip arthroplasty and persistent thigh pain, it is of the utmost importance to understand the potential etiologies of this chronic pain for selecting the appropriate treatment strategy...
September 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28910722/analysis-of-in-vivo-articular-cartilage-contact-surface-of-the-knee-during-a-step-up-motion
#9
Peng Yin, Jing-Sheng Li, Willem A Kernkamp, Tsung-Yuan Tsai, Seung-Hoon Baek, Ali Hosseini, Lin Lin, Peifu Tang, Guoan Li
BACKGROUND: Numerous studies have reported on the tibiofemoral articular cartilage contact kinematics, however, no data has been reported on the articular cartilage geometry at the contact area. This study investigated the in-vivo tibiofemoral articular cartilage contact biomechanics during a dynamic step-up motion. METHODS: Ten healthy subjects were imaged using a validated magnetic resonance and dual fluoroscopic imaging technique during a step-up motion. Three-dimensional bone and cartilage models were constructed from the magnetic resonance images...
September 8, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28899856/release-of-the-tourniquet-immediately-after-the-implantation-of-the-components-reduces-the-incidence-of-deep-vein-thrombosis-after-primary-total-knee-arthroplasty
#10
P Zan, M O Mol, J J Yao, L Fan, D Yang, K Liu, G Li
AIMS: The length of the tourniquet time during total knee arthroplasty (TKA) is related to the incidence of post-operative deep vein thrombosis (DVT). Our aim in this study was to investigate the effect of the early release of the tourniquet on the incidence of DVT in patients undergoing TKA. METHODS: A total of 200 patients who underwent TKA between November 2015 and November 2016 were prospectively enrolled. The tourniquet was inflated before surgery and released immediately after the introduction of the components (early release group)...
September 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28899386/improved-clinical-outcome-measures-of-knee-pain-and-function-with-concurrent-resolution-of-subchondral-bone-marrow-edema-lesion-and-joint-effusion-in-an-osteoarthritic-patient-following-pentosan-polysulphate-sodium-treatment-a-case-report
#11
Matthew J Sampson, Margie Kabbani, Ravi Krishnan, Michael Nganga, Annika Theodoulou, Jeganath Krishnan
BACKGROUND: At present, there are no registered products for the treatment of subchondral Bone Marrow Edema Lesion (BML) and associated knee pain. Patients who do not respond to current anti-inflammatory therapies are left with limited treatment options, and may resort to operative management with Total Knee Arthroplasty (TKA). We report the use of Pentosan Polysulphate Sodium (PPS) for the treatment of BMLs of the knee. CASE PRESENTATION: We report the case of a 70-year-old female with knee osteoarthritis presenting with a high level of knee pain, scoring 8 on the Numerical Rating Scale (NRS), and functional limitation demonstrating a poor Lysholm Knee Score of 37...
September 12, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28884332/subchondral-mesenchymal-stem-cells-from-osteoarthritic-knees-display-high-osteogenic-differentiation-capacity-through-microrna-29a-regulation-of-hdac4
#12
Wei-Shiung Lian, Ren-Wen Wu, Mel S Lee, Yu-Shan Chen, Yi-Chih Sun, Shing-Long Wu, Huei-Jing Ke, Jih-Yang Ko, Feng-Sheng Wang
Subchondral bone deterioration and osteophyte formation attributable to excessive mineralization are prominent features of end-stage knee osteoarthritis (OA). The cellular events underlying subchondral integrity diminishment remained elusive. This study was undertaken to characterize subchondral mesenchymal stem cells (SMSCs) isolated from patients with end-stage knee OA who required total knee arthroplasty. The SMSCs expressed surface antigens CD29, CD44, CD73, CD90, CD105, and CD166 and lacked CD31, CD45, and MHCII expression...
September 7, 2017: Journal of Molecular Medicine: Official Organ of the "Gesellschaft Deutscher Naturforscher und Ärzte"
https://www.readbyqxmd.com/read/28872528/quantitative-measurement-of-osseous-pathology-in-advanced-glenohumeral-osteoarthritis
#13
Joseph P Iannotti, Bong-Jae Jun, Thomas E Patterson, Eric T Ricchetti
BACKGROUND: Osteoarthritis of the glenohumeral joint has typical patterns of deformity as described by Walch et al. However, more severe glenoid pathology may be difficult to classify. The purpose of this study was to use 3-dimensional computed tomography (3-D CT) imaging analysis to define common pathologic subtypes that can be differentiated from the current Walch classification. METHODS: We performed quantitative measurements of premorbid and pathologic anatomy using preoperative 3-D CT scans from 155 cases of advanced glenohumeral osteoarthritis that underwent anatomic or reverse total shoulder arthroplasty...
September 6, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28869116/teriparatide-administration-increases-periprosthetic-bone-mineral-density-after-total-knee-arthroplasty-a-prospective-study
#14
Tatsuya Suzuki, Fumio Sukezaki, Takashi Shibuki, Yoichi Toyoshima, Takashi Nagai, Katsunori Inagaki
BACKGROUND: Teriparatide is a currently available therapeutic agent for osteoporosis. Previous studies have reported that teriparatide affects periprosthetic bone mineral density (BMD) after total knee arthroplasty (TKA). However, little agreement has been reached concerning the treatment of periprosthetic BMD after TKA with teriparatide. Moreover, BMD in the femoral and tibial sides of the joints together has never been examined. We investigated the efficacy of teriparatide to inhibit BMD loss in the femoral and tibial side and considered complications such as migration and periprosthetic fractures after TKA...
July 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28865948/a-new-topical-hemostatic-agent-tt-173-reduces-blood-loss-in-a-sheep-model-of-total-knee-arthroplasty
#15
Alberto Centeno, Santiago Rojas, Belén Arias, Ignasi Miquel, Pilar Sánchez, Claudia Ureta, Esther Rincón, Ramón López, Jesús Murat
BACKGROUND: Total knee arthroplasty is associated with blood loss during the intervention and may require allogenic blood transfusion. Treatments such as tranexamic acid and fibrin sealants improved the bleeding control in several clinical trials, but the hemorrhage associated with the intervention is still significant. Thus far, very few studies have evaluated hemostatic treatments in animal models of total knee arthroplasty. This work describes a sheep model of bleeding associated with total knee arthroplasty and investigates a new class of hemostatic treatment based on recombinant tissue factor...
August 30, 2017: Knee
https://www.readbyqxmd.com/read/28865425/silver-coated-modular-megaendoprostheses-in-salvage-revision-arthroplasty-after-periimplant-infection-with-extensive-bone-loss-a-pilot-study-of-34-patients
#16
Dirk Zajonz, Undine Birke, Mohamed Ghanem, Torsten Prietzel, Christoph Josten, Andreas Roth, Johannes K M Fakler
BACKGROUND: Hip and knee replacements in patients with bone defects after infection correlates with high rates of reinfection. In this vulnerable patient population, the prevention of reinfection is to be considered superordinate to the functionality and defect bridging. The use of silver coating of aseptic implants as an infection prophylaxis is already proven; however, the significance of these coatings in septic reimplantation of large implants is still not sufficiently investigated...
September 2, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28865300/technical-feasibility-of-personalized-articulating-knee-joint-distraction-for-treatment-of-tibiofemoral-osteoarthritis
#17
T Struik, J E N Jaspers, N J Besselink, P M van Roermund, S Plomp, M J Rudert, F P J G Lafeber, S C Mastbergen
BACKGROUND: Knee osteoarthritis is a highly prevalent degenerative joint disorder characterized by joint tissue damage and pain. Knee joint distraction has been introduced as a joint preserving surgical procedure to postpone knee arthroplasty. An often used standard externally fixation device for distraction poses a burden to patients due to the absence of joint flexion during the 6weeks treatment. Therefore, a personalized articulating distraction device was developed. The aim of this study was to test technical feasibility of this device...
August 12, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28860400/mid-term-outcomes-of-77-modular-radial-head-prostheses
#18
P Laumonerie, N Reina, D Ancelin, S Delclaux, M E Tibbo, N Bonnevialle, P Mansat
AIMS: Radial head arthroplasty (RHA) may be used in the treatment of non-reconstructable radial head fractures. The aim of this study was to evaluate the mid-term clinical and radiographic results of RHA. PATIENTS AND METHODS: Between 2002 and 2014, 77 RHAs were implanted in 54 men and 23 women with either acute injuries (54) or with traumatic sequelae (23) of a fracture of the radial head. Four designs of RHA were used, including the Guepar (Small Bone Innovations (SBi)/Stryker; 36), Evolutive (Aston Medical; 24), rHead RECON (SBi/Stryker; ten) or rHead STANDARD (SBi/Stryker; 7) prostheses...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28860399/effect-of-pre-operative-expectations-on-the-outcomes-following-total-shoulder-arthroplasty
#19
I Swarup, C M Henn, J T Nguyen, D M Dines, E V Craig, R F Warren, L V Gulotta, R F Henn
AIMS: Few studies have evaluated the relationship between patients' pre-operative expectations and the outcome of orthopaedic procedures. Our aim was to determine the effect of expectations on the outcome after primary anatomical total shoulder arthroplasty (TSA). We hypothesised that patients with greater expectations would have better outcomes. PATIENTS AND METHODS: Patients undergoing primary anatomical TSA completed the Hospital for Special Surgery's Shoulder Expectations Survey pre-operatively...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28860397/diagnosis-of-prosthetic-joint-infection-with-alpha-defensin-using-a-lateral-flow-device-a-multicentre-study
#20
MULTICENTER STUDY
P Berger, M Van Cauter, R Driesen, J Neyt, O Cornu, J Bellemans
AIMS: The purpose of this current multicentre study is to analyse the presence of alpha-defensin proteins in synovial fluid using the Synovasure lateral flow device and to determine its diagnostic reliability and accuracy compared with the prosthetic joint infection (PJI) criteria produced by the Musculoskeletal Infection Society (MSIS). PATIENTS AND METHODS: A cohort of 121 patients comprising 85 total knee arthroplasties and 36 total hip arthroplasties was prospectively evaluated between May 2015 and June 2016 in three different orthopaedic centres...
September 2017: Bone & Joint Journal
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