Can Periprosthetic Joint Infection of Tumor Prostheses Be Controlled With Debridement, Antibiotics, and Implant Retention?

Background: Two-stage revision for periprosthetic joint infection (PJI) in patients who have undergone segmental replacement of the distal femur or proximal tibia after tumor resection can be associated with considerable morbidity, pain, and risk of complications because the procedure often results in removal of long, well-fixed stems from the diaphysis. A less-aggressive surgical approach, such as debridement, antibiotics, and implant retention (DAIR), may be attractive to patients and surgeons because of less morbidity, but the likelihood of eradicating infection in comparison to the traditional two-stage revision is not well established for oncology patients. Furthermore, the relative risk of subsequent amputation for DAIR versus two-stage revision has not been defined for this population.

The risk of neurological deterioration while using neoadjuvant denosumab on patients with giant cell tumor of the spine presenting with epidural disease: a meta-analysis of the literature.

Background Context: Giant cell tumor (GCT) of bone is most commonly a benign but locally aggressive primary bone tumor. Spinal GCTs account for 2.7% to 6.

Advances in Virtual Cutting Guide and Stereotactic Navigation for Complex Tumor Resections of the Sacrum and Pelvis: Case Series with Short-Term Follow-Up.

Primary malignancies of the sacrum and pelvis are aggressive in nature, and achieving negative margins is essential for preventing recurrence and improving survival after en bloc resections. However, these are particularly challenging interventions due to the complex anatomy and proximity to vital structures. Using virtual cutting guides to perform navigated osteotomies may be a reliable method for safely obtaining negative margins in complex tumor resections of the sacrum and pelvis.

The Effect of Povidone-Iodine Irrigation on the Efficacy of Antibiotic Cement In Vitro.

Povidone-iodine is a common antiseptic demonstrating success in reducing infection rates in primary arthroplasty; however, recent data suggest that its use in revision arthroplasty may increase infection rates. This study evaluated the effect of povidone-iodine solution on antibiotic cement and investigated the connection between povidone-iodine and increased infection rates in revision arthroplasty. Sixty antibiotic cement samples (ACSs) were formed using gentamicin-impregnated cement.

Spontaneous Extensor Pollicis Longus Rupture Associated With an Extensor Digitorum Brevis Manus.

A 64-year-old left-handed man with no history of rheumatoid arthritis or distal radius fracture presented with spontaneous loss of thumb interphalangeal joint extension. Intraoperatively, the patient was found to have a variant extensor indicis proprius with extensor digitorum brevis manus. Prior extensor digitorum communis ruptures have been reported in the literature secondary to the distal extensor digitorum brevis manus muscle belly, but there are no prior reports of extensor pollicis longus rupture.

Utility of Repeat MRI in Patients With Degenerative Cervical Disease.

Existing guidelines regarding indications for initial cervical spine magnetic resonance imaging (MRI) do not indicate when to perform repeat MRI in patients with previously documented degenerative disease. This study evaluates the efficacy of repeat MRI in patients with previously diagnosed degenerative cervical disease. Between 2013 and 2018, 153 patients (102 women, 51 men; mean age, 55 years; range, 19-81 years) without a history of trauma or surgery underwent cervical spine MRI 2 or more times at our institution indicated for symptoms of neck pain with or without radiculopathy.

Relationship to drill bit diameter and residual fracture resistance of the distal tibia.

Background: The etiology of bone refractures after screw removal can be attributed to residual drill hole defects. This biomechanical study compared the torsional strength of bones containing various sized cortical drill defects in a tibia model.

Methods: Bicortical drill hole defects of 3 mm, 4 mm, and 5 mm diameters were tested in 26 composite tibias versus intact controls without a drill defect.

How Does Tibial Pin Placement in Navigated Total Knee Arthroplasty Affect the Torsional Strength of the Tibia?

Introduction: Surgical navigation technology has recently become more prevalent for total knee arthroplasty. Surgical navigation typically requires pin placement in the proximal tibia diaphysis to stabilize the bone-tracking hardware, and there have been several recent reports of fractures through these residual navigation pin holes. The objective of this biomechanical study was to determine whether a difference exists in the torsional bone strength of a 5-mm navigation pin hole drilled at a single location in three different orientations: unicortical, bicortical, and transcortical.

Extraction of a Bent Tibial Nail After Refracture: A Case Report.

Case: A 65-year-old man previously treated by intramedullary nailing for a left tibial shaft fracture presented 6 years later with an open refracture of his left tibia after a motorcycle accident. Treatment required extraction of the bent nail before revision nailing.

Conclusions: Extraction of deformed intramedullary devices is a skill that will continue to be demanded of orthopaedic surgeons.

Early microRNA expression profile as a prognostic biomarker for the development of pelvic inflammatory disease in a mouse model of chlamydial genital infection.

Unlabelled: It is not currently possible to predict the probability of whether a woman with a chlamydial genital infection will develop pelvic inflammatory disease (PID). To determine if specific biomarkers may be associated with distinct chlamydial pathotypes, we utilized two Chlamydia muridarum variants (C. muridarum Var001 [CmVar001] and CmVar004) that differ in their abilities to elicit upper genital tract pathology in a mouse model.

Aortic arch advancement for aortic coarctation and hypoplastic aortic arch in neonates and infants.

Background: The optimal treatment for infants with aortic coarctation and hypoplastic aortic arch is controversial. The goal of this study was to report the short-term and mid-term outcomes of aortic arch advancement (AAA) in infants with hypoplastic aortic arch.

Methods: All infants who underwent AAA at our institution from 1995 to 2012 were included.