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Orthopedic Infections

Laura Nigi, Cecilia Fondelli, Gianmarco de Donato, Giancarlo Palasciano, Carlo Setacci, Francesco Dotta
Diabetic foot ulcer is a costly and serious complication of diabetes mellitus and is the major cause of non-traumatic limb amputations worldwide. Its development is primarily the result of diabetic neuropathy and/or peripheral arterial disease with accompanied bone abnormalities and is complicated by invasive infection. The management of this clinical condition focuses on identification of the "at-risk" foot, treatment of the ulcerated foot, and prevention of further complications. As diabetic foot ulcer represents the sum of multiple etiologies, its treatment requires a multidisciplinary team, which can result in a significant reduction in the incidence of ulcers, infections and amputations...
June 2018: Seminars in Vascular Surgery
Narumi Ueda, Kenichi Oe, Tomohisa Nakamura, Koji Tsuta, Hirokazu Iida, Takanori Saito
BACKGROUND: We assessed whether combining the conventional culture and implant sonicate fluid culture (SFC) methods increased the diagnostic accuracy of orthopedic implant-associated infection (OIAI). METHODS: Consecutive patients (n = 66) undergoing implant removal (OIAI, 17; non-OIAI, 49) were evaluated prospectively. We analyzed 493 samples (39 preoperative joint aspirates, 243 peri-implant tissue specimens, 124 implant sonication, 67 controls, and 20 water bath samples)...
February 20, 2019: Journal of Arthroplasty
Lisa Oezel, Carina Büren, Armin O Scholz, Joachim Windolf, Ceylan D Windolf
Cerament (Bonesupport Holding, Lund, Sweden) is a bioresorbable synthetic bone substitute consisting of calcium sulfate and hydroxyapatite which is successfully used as a bone graft in bone defects or in delayed and non-unions after fractures. Besides, calcium sulfate/ hydroxyapatite (CAS/HA) could have, attributed to its composition and osteoinductive properties, have great importance in the treatment of bone infections with critical size defects (CSD). Aim of the study was to evaluate the effects of antibiotic infused CAS/HA on inflammation and bone healing in an implant-associated osteitis mice model...
2019: PloS One
Lucieny da Silva Pontes, Bianca Callegari, Lizandra Magno, Anderson Moraes, Bruno Giovanni Silva, Kaio Manso, Brenison Barros, Ana Paula Araújo, Maria Clara Silva, George Alberto Dias, Beatriz Helena Vasconcelos, Anselmo Costa E Silva, Rosana Maria Libonati, Givago Silva Souza
Balance disorders have been poorly investigated and somewhat neglected in people infected with the human immunodeficiency virus, especially in children, whose have intrinsic and extrinsic risk factors that may compromise the balance. To evaluate the foot plantar pressures and the balance in children with acquired immunodeficiency. We recruited 53 children aged between 6 and 15 years: 33 healthy children, and 20 children with positive serology for the human immunodeficiency virus. A physical examination included anthropometric, reflexes, tactile sensitivity of the foot and orthopedic evaluation...
March 13, 2019: Scientific Reports
Trisha N Peel
The association between biofilm-forming microorganisms and prosthetic joint infection influences all aspect of management including approaches to diagnosis, management and prevention. This article will provide an overview of new anti-biofilm strategies for management of prosthetic joint infection.
2019: Frontiers in Microbiology
L Morata, J Cobo, M Fernández-Sampedro, P Guisado Vasco, E Ruano, J Lora-Tamayo, M Sánchez Somolinos, P González Ruano, A Rico Nieto, A Arnaiz, M Estébanez Muñoz, M E Jiménez-Mejías, A B Lozano Serrano, E Múñez, D Rodriguez-Pardo, R Argelich, A Arroyo, J M Barbero, F Cuadra, A Del Arco, M D Del Toro, L Guio, D Jimenez-Beatty, N Lois, O Martin, R M Martínez Alvarez, F J Martinez-Marcos, L Porras, M Ramírez, J Vergas García, A Soriano
Background : Dalbavancin is a lipoglycopeptide with potent activity against gram-positive microorganisms, with a long half-life, favorable safety profile and a high bone concentration which makes it an interesting alternative for osteoarticular infections. Patients and Methods : Multicentric retrospective study of all patients with an osteoarticular infection (septic arthritis, spondylodiscitis, osteomyelitis or orthopedic implant related infections) treated with at least one dose of dalbavancin between 2016 and 2017 in 30 institutions in Spain...
March 11, 2019: Antimicrobial Agents and Chemotherapy
Michelle S Junker, Alex Kurjatko, Matthew C Hernandez, Stephanie F Heller, Brian D Kim, Henry J Schiller
BACKGROUND: Surgical stabilization of rib fractures (SSRF) can be used to improve pulmonary mechanics; however, hardware infection is a morbid complication. Antibiotic impregnated beads have been used to suppress infection in orthopedic practices. We aimed to determine the efficacy of antibiotic beads for infected and at-risk SSRF hardware. METHODS: This is a single institution retrospective review of adults (18 years or older) that received SSRF between 2009 and 2017...
February 28, 2019: American Journal of Surgery
Gabriel Birgand, Christine Azevedo, Stephane Rukly, Roger Pissard-Gibollet, Gaëlle Toupet, Jean-François Timsit, Jean-Christophe Lucet
OBJECTIVES: We longitudinally observed and assessed the impact of the operating room (OR) staff movements and door openings on surrogates of the exogenous infectious risk using a new technology system. DESIGN AND SETTING: This multicenter observational study included 13 ORs from 10 hospitals, performing planned cardiac and orthopedic surgery (total hip or knee replacement). Door openings during the surgical procedure were obtained from data collected by inertial sensors fixed on the doors...
March 12, 2019: Infection Control and Hospital Epidemiology
Jing Yang, Ruohui Tang, Jin Yi, Yueqi Chen, Xianghe Li, Tao Yu, Jun Fei
Skeletal homeostasis is closely effectuated by the regulation of bone formation and bone resorption. Osteoclasts are multinuclear giant cells responsible for bone resorption. Overactivated osteoclasts and excessive bone resorption result in various lytic bone diseases, such as osteoporosis, osteoarthritis, periprosthetic infection, and inflammatory aseptic loosening of orthopedic implants. In consideration of the severe side effects caused by the currently available drugs, exploitation of novel drugs has gradually attracted attention...
March 11, 2019: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
Marta Santos Silva, Ricardo Rodrigues-Pinto, Cláudia Rodrigues, Sara Morais, José Costa E Castro
PURPOSE: Knee arthropathy is a frequent complication affecting hemophilic patients, which can cause severe pain and disability. When conservative measures fail, total knee arthroplasty (TKA) may be performed. METHODS: Eighteen TKA were performed in 15 patients with hemophilia during a 24-year period in a Hemophilia Comprehensive Care Center. All patients were evaluated by a multidisciplinary team constituted by a hematologist, an orthopedic surgeon, and a physical medicine and rehabilitation physician...
January 2019: Journal of Orthopaedic Surgery
Suphatchaya Lamkhao, Manlika Phaya, Chutima Jansakun, Nopakarn Chandet, Kriangkrai Thongkorn, Gobwute Rujijanagul, Phuwadol Bangrak, Chamnan Randorn
The prevention of implant-associated infections has been increasing clinically in orthopedic surgery. Hydroxyapatite with antibacterial properties was synthesized using a microwave-assisted combustion method. High crystallinity at low temperature can be achieved using this method. The synthesized hydroxyapatite exhibited a superior clear zone for both Gram-positive and Gram-negative bacteria. Electron spin resonance (ESR) and X-ray photoelectron spectroscopy (XPS) were used for the radical investigation. The application of intelligent ink testing and an antioxidant assay using DPPH reduction were also used to confirm the existence of radicals...
March 8, 2019: Scientific Reports
Małgorzata Kus-Liśkiewicz, Joanna Rzeszutko, Yaroslav Bobitski, Adriana Barylyak, Ganna Nechyporenko, Viktor Zinchenko, Jacek Zebrowski
The recent studies on fluorapatite and hydroxyapatite, in the context of their medical applications, have shown that the former has relatively higher thermal stability and better mechanical properties than the latter. Moreover, the presence of fluoride ions is relevant for protection of teeth from dental caries since they stimulate processes of mineralization and crystallization. In this report, a silver modified fluorapatite (FAP/Ag), considered as a novel biomedical compound, was tested for its bactericidal, fungicidal and cytotoxicity activity...
April 1, 2019: Journal of Biomedical Nanotechnology
Yang Yang, Xiaoxiao Zhou, Mengqin Zhang, Yichi Zhou, Bin Wang, Chiting Yuan
BACKGROUND: The extensile lateral approach (ELA) has been widely used to treat displaced intra-articular calcaneal fractures (DIACFs) and remains the gold standard procedure. Orthopedic surgeons are extremely concerned of the high rate of wound complications. This study intended to report a new surgical technique of the lateral wall osteotomy combined with an embedded biodegradable implant for treating DIACFs and assess clinical and radiological results. METHODS: From May 2013 to December 2015, a total of 17 patients with 19 calcaneal fractures underwent surgical treatment using our new technique...
March 6, 2019: Journal of Orthopaedic Surgery and Research
Dioscaris R Garcia, David Deckey, Jack M Haglin, Toby Emanuel, Cory Mayfield, Adam E M Eltorai, Carole Sl Spake, John D Jarrell, Christopher T Born
BACKGROUND: Normal skin microbiota influence susceptibility to surgical infections. The distribution of skin bacteria differs by anatomic site, and given the right conditions, almost any of these bacteria can become an opportunistic pathogen. METHODS: This paper provides a thorough review of the most commonly encountered bacteria in various regions of the body and their isolation from operative incisions at those locations. These data may be useful in optimizing targeted antibiotic therapy for surgical site infections and provide a better understanding of the skin biome distribution at specific surgical sites...
March 6, 2019: Surgical Infections
Nathan J Jacobson, Robert E Van Demark, Bradley Reeves
Osteomyelitis pubis is a rare orthopedic infection, accounting for less than 1-2 percent of all hematogenous osteomyelitis. Osteomyelitis pubis generally affects children, elderly patients who have undergone genitourinary procedures, and parenteral drug users. Interestingly, cases of acute osteomyelitis pubis have also been documented in previously young, healthy athletes. The diagnosis is often difficult to differentiate from osteitis pubis, which is a self-limiting, painful inflammatory condition affecting the symphysis pubis...
December 2018: South Dakota Medicine: the Journal of the South Dakota State Medical Association
Ryan P Trombetta, Mark J Ninomiya, Ihab M El-Atawneh, Emma K Knapp, Karen L de Mesy Bentley, Paul M Dunman, Edward M Schwarz, Stephen L Kates, Hani A Awad
Osteomyelitis is a chronic bone infection that is often treated with adjuvant antibiotic-impregnated poly(methyl methacrylate) (PMMA) cement spacers in multi-staged revisions. However, failure rates remain substantial due to recurrence of infection, which is attributed to the poor performance of the PMMA cement as a drug release device. Hence, the objective of this study was to design and evaluate a bioresorbable calcium phosphate scaffold (CaPS) for sustained antimicrobial drug release and investigate its efficacy in a murine model of femoral implant-associated osteomyelitis...
February 22, 2019: Pharmaceutics
Yan Fang Cheng, Jie Yu Zhang, Yun Bing Wang, Chang Ming Li, Zhi Song Lu, Xue Feng Hu, Li Qun Xu
The titanium (Ti) and its alloys have been widely used for dental and orthopedic implants. However, the Ti-based implants may suffer from bacterial infection, which would result in insufficient healing, implant failure and repeated surgical intervention. It is of great interest to inhibit the bacterial adhesion and colonization on the Ti-based implants by introducing proper surface coatings. In this work, a simple method was employed to synthesize the water-soluble catechol-containing chitosan (CACS). The CACS coatings can be deposited onto various substrate surfaces and exhibit substrate-independent behavior...
May 2019: Materials Science & Engineering. C, Materials for Biological Applications
Balaji Murugesan, Mayakrishnan Arumugam, Nithya Pandiyan, Muthulakshmi Veerasingam, Jegatheeswaran Sonamuthu, Selvam Samayanan, Sundrarajan Mahalingam
The multifunctional biological active material design for bone tissue engineering is essential to induce osteoblast cell proliferation and attachment. Adhesion of bacteria on biomaterials to produce biofilms can be major contributors to the pathogenesis of implant material associated infections. This research work focuses on NPF& NBF elemental doping and functionalization of reduced graphene oxide using an imidazolium-based ionic liquid such as BMIM PF6 and BMIM BF4 by hydrothermal method. The resulting tri doped reduced graphene oxide (NPF-rGO and NBF-rGO) composite was further used as a scaffold for bone tissue engineering and anti-biofilm activities...
May 2019: Materials Science & Engineering. C, Materials for Biological Applications
Marissa McGaffey, Alex Zur Linden, Nathanael Bachynski, Michelle Oblak, Fiona James, J Scott Weese
Certain 3D printed metals and surface finishes may be better suited for canine patient specific orthopedic implants on the basis of minimizing potential bacterial biofilm growth. Thirty disks each of titanium alloy, stainless steel, and cobalt chromium alloy were 3D printed via laser powder bed fusion. Fifteen disks of each metal were subsequently polished. After incubation with a robust biofilm-forming methicillin-resistant Staphylococcus pseudintermedius isolate, disks were rinsed and sonicated to collect biofilm bacteria...
2019: PloS One
Joseph W Gorvetzian, Ryan P Kunkel, Christopher P Demas
Objective: To determine whether use of absorbable antibiotic-imbued beads in chronic soft tissue wounds presents a viable therapeutic modality. Approach: Retrospective analysis of all cases utilizing calcium sulfate antibiotic beads was conducted. Cases comprised complex wound and breast reconstruction performed by the senior author (C.P.D.) over 4 years at the University of New Mexico Hospital. All-cause need for reoperation and reoperation for infection in the 90 days following bead-assisted surgery were compared to traditional surgical intervention in the 90-day period preceding bead-assisted surgery...
February 1, 2019: Advances in Wound Care
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