Noise-Induced Hearing Loss in Orthopaedic Surgery: A Review Article.

There are many sources of noise production in the operating room, including conversations among the surgical team, background music, electric monitors and alarms, surgical power tools, surgical instrument clattering and hammering, and suction devices. These sources introduce occupational hazards by producing damaging noise levels that exceed noise exposure level guidelines set by the National Institute of Occupational Safety and Health and the Health and Safety Executive. Noise-induced hearing loss affects up to 50% of orthopaedic staff, but few preventative measures are regularly followed in the orthopaedic setting.

The effects of pre-operative anti-osteoporotic use on total joint arthroplasty complications: A national database study.

Background: The current study aims to analyze the effect of pre-operative non-bisphosphonate anti-osteoporotic drugs on complication and revision rates following total joint arthroplasty (TJA).

Methods: A retrospective cohort analysis of the PearlDiver (PearlDiver Technologies, Colorado Springs, CO) database was performed. The database was queried to identify all patients who underwent total hip arthroplasty (THA) or total knee arthroplasty (TKA) with history of hip or knee osteoarthritis and either osteopenia or osteoporosis.

A Proposed Patient Selection Algorithm for Total Joint Arthroplasty Same-Day Discharge From an Ambulatory Surgery Center.

Background: Identifying appropriate patients for same-day discharge (SDD) total joint arthroplasty (TJA) is critical for maintaining optimal patient safety and outcomes. This study investigated patient outcomes after SDD TJA at a single ambulatory surgery center (ASC) and proposes a TJA patient-selection algorithm based on findings and existing literature.

Methods: A retrospective chart review of 660 patients was performed between July 2019 and October 2021 for all patients who underwent primary TJA in a single ASC.

Silver carboxylate-TiO/polydimethyl siloxane is a safe and effective antimicrobial with significant wound care potential.

Introduction: With the rise in antibiotic resistance, new methodologies are needed to combat musculoskeletal infections. Silver is an antimicrobial that can be synthesized in different forms, but its pharmacokinetics are difficult to control. This study details the antibacterial efficacy and cellular cytotoxicity of a formulation consisting of silver carboxylate (AgCar) released through a titanium dioxide/polydimethylsiloxane matrix with a predictable release profile on , , human-derived primary osteoblasts.

Ultrasound assisted synthesis of hybrid quinoline anchored with 4-R-benzenesulfonamide moiety with potential antimicrobial activity.

We present in this paper a direct and efficient study regarding synthesis and spectral characterization of three series of hybrid quinoline anchored with 4-R-benzenesulfonamide moiety, with potential antimicrobial activity, by using ultrasound (US) irradiation and conventional methods (CV). The synthesis pathway is efficient and direct, in two steps: an initial -acylation of 8-aminoquinoline followed by metal complexation with variously M metals (Cd, Co, Cu, Ni, Pd, Zn). For both type of reactions, -acylation and complexation, under US irradiations the synthesis have some undeniable advantages: the most relevant being the higher yields, a dramatically decrease for reaction time (with about 150 (one hundred fifty) folds for complexation) comparative with conventional methods (CV) (therefore the spent energy decrease in the same way), a decrease of the amount of used solvents.

Chronic obstructive pulmonary disease is an independent risk factor for increased opioid use in total hip arthroplasty: A retrospective PearlDiver study.

Background: Total hip arthroplasty (THA) has become an incredibly common procedure due to its' predictability and high success rate. The success of surgery is related to strict indications and careful optimization of medical comorbidities to decrease risk and improve outcomes. Chronic obstructive pulmonary disease (COPD) has been associated with increased medical and surgical complications.

The Immediate Impact of Total Knee Arthroplasty Removal From the Medicare Inpatient-Only List on Patient Derived Functional Outcomes and Hospital Satisfaction.

Background: Total knee arthroplasty (TKA) is the standard of treatment for end-stage knee osteoarthritis. On January 1, 2018, the Centers for Medicare and Medicaid (CMS) officially removed TKA from their inpatient-only list. The clinical impact of this change is not fully understood yet.

Mechanically stable rifampin antibiotic cement inhibits Pseudomonas aeruginosa biofilm surface growth.

Rifampin has been proven to be effective in the treatment of prosthetic infections due to its ability to intercalate into biofilms. The use of rifampin in antibiotic spacers is not well described, which would be especially important in the local periprosthetic environment where parenteral doses have poor penetration. The null hypothesis tests if rifampin use in polymethyl methacrylate (PMMA) cement will show no clinically significant impact on mechanical strength at antibiotic concentrations that remain bactericidal.

Medial Calcar Restoration Using Femoral Head Autograft in Conversion Hip Arthroplasty for Failed Fixation after an Unstable Intertrochanteric Hip Fracture: A Case Report and Technique Description.

Introduction: The calcar femorale helps manage compressive loads on the femoral head and is an essential component in determining intertrochanteric (IT) femur fracture stability. Fracture fixation can be complicated when primary fixation techniques, such as cephalomedullary nailing fail. Unstable IT femur fractures involving disruption of the medial calcar present additional fixation challenges.

The Effect of Surgical Approach on the Outcomes of Same-Day Discharge Outpatient Total Hip Arthroplasty at a Single Ambulatory Surgery Center.

Background: Primary total hip arthroplasty (THA) is increasingly being performed in the outpatient setting. However, there is little known regarding the differences in same-day discharge (SDD) rates and complications of operative approach in same-day total hip arthroplasty in the ambulatory surgery center (ASC) setting.

Methods: A retrospective chart review was performed between July 2019 and October 2021 for all patients who underwent primary THA in a single freestanding ASC.

Benzoquinoline Derivatives: An Attractive Approach to Newly Small Molecules with Anticancer Activity.

This study presents the synthesis, structural characterization, and in vitro evaluation of anticancer activity of some newly benzo[]quinoline derivatives. The synthesis is facile and efficient, involving two steps: quaternization of nitrogen heterocycle followed by a [3+2] dipolar cycloaddition reaction. The synthesized compounds were characterized by FTIR, NMR, and X-ray diffraction on monocrystal in the case of compounds and .

Staphylococcal biofilm: penetration and bioavailability of vancomycin with or without rifampin.

We measured antibiotic penetration and bioavailability in staphylococcus biofilms using simulated humanized concentrations of fluorescent vancomycin plus or minus rifampin. Vancomycin percent recovery across biofilm layers was:upper = 46%, middle = 40%, and lower = 33%. Vancomycin plus rifampin was not significantly different (P = 0.

Local anesthetic with monitored anesthesia care in cephalomedullary nailing of proximal femur fractures.

Introduction: Proximal femur fractures have high rates of morbidity, mortality, and perioperative complications. Limiting anesthesia, especially in the elderly population, is a priority from a medical perspective. The goal of the current study is to present a technique of using local anesthetic with monitored anesthesia care (MAC) for the fixation of intertrochanteric (IT) femur fractures with cephalomedullary nailing (CMN), provide early clinical results in a small series of patients, and evaluate the safety, efficiency, and anesthetic efficacy of our technique.

Silver Carboxylate as an Antibiotic-Independent Antimicrobial: A Review of Current Formulations, Efficacy, and Clinical Relevance.

The increasing prevalence of multi-drug resistant pathogens has led to a renewed focus on the use of silver as an antibiotic-independent antimicrobial. Unfortunately, the use of many silver formulations may be limited by an uncontrolled release of silver with the potential for significant cytotoxic effects. Silver carboxylate (AgCar) has emerged as an alternative formulation of silver with the potential to mitigate these concerns while still displaying significant bactericidal activity.

Silver Carboxylate-Eluting Titanium-Dioxide Polydimethylsiloxane Coating Inhibits Multi-Drug-Resistant and Vancomycin-Resistant Adherence and Proliferation on Orthopedic Trauma Fixation and Spinal Fusion Materials.

Vancomycin-resistant and multi-drug-resistant (MDR) are rising contributors to spinal fusion and fracture-associated infections (FAI), respectively. These MDR bacteria can form protective biofilms, complicating traditional antibiotic treatment. This study explores the effects of the antibiotic-independent antimicrobial silver carboxylate (AgCar)-doped coating on the adherence sand proliferation of these pathogens on orthopedic implant materials utilized in spinal fusion and orthopedic trauma fixation.

Quinoline-imidazole/benzimidazole derivatives as dual-/multi-targeting hybrids inhibitors with anticancer and antimicrobial activity.

Two new classes of hybrid quinoline-imidazole/benzimidazole derivatives (the hybrid QIBS salts and QIBC cycloadducts) were designed and synthesized to evaluate their anticancer and antimicrobial activity. The strategy adopted for synthesis is straight and efficient, in four steps: N-acylation, N-alkylation, quaternization and a Huisgen 3 + 2 cycloaddition. The in vitro single-dose anticancer assay of forty six hybrid quinoline-benzimidazole compounds reveal that one QIBS salt (11h), has an excellent quasi nonselective activity against all type of cancer cell with an excellent PGI in the area of 90-100% and very good lethality.

Comparison of periprosthetic joint infection rates in the direct anterior approach and non-anterior approaches to primary total hip arthroplasty: a systematic review and meta-analysis.

Background: Periprosthetic joint infection is a serious complication and devastating mode of failure of total hip arthroplasty. Various surgical approaches exist for total hip arthroplasty, including the increasingly popularised direct anterior approach. There is no clear consensus on which approach is least associated with periprosthetic joint infection.

The Case of Disappearing Tibia in Rheumatoid Knee Tenosynovitis.

Introduction: Knee pain and osteoarthritis are frequent patient complaints, with a rapidly increasing prevalence. By comparison, the prevalence of rheumatoid arthritis (RA) is significantly lower at around 1%. Inflammatory arthropathies, like RA, are difficult to differentiate from infection, crystal arthropathies, or malignancy.

Does fusion length matter? Total hip arthroplasty dislocation after extension of lumbosacral fusion: a case report.

Case: Hip-spine syndrome is a complex challenge for orthopedic surgeons. We present a 60-year-old female with a history of spinal fusion and total hip arthroplasty. The patient underwent extension of the previous fusion with sacropelvic fixation, and 5 months later she presented with left posterior prosthetic hip dislocation which required sedation and closed reduction.

The Effect of Early versus Late Manipulation Under Anesthesia on Opioid Use, Surgical Complications, and Revision Following Total Knee Arthroplasty.

Previous studies of early versus late manipulation under anesthesia (MUA) do not report on postoperative opioid utilization or revisions and focused on small single-institution retrospective cohorts. The PearlDiver Research Program (www.pearldiverinc.