Impact of Perioperative Dexamethasone Administration on Infection and Implant Osseointegration in a Preclinical Model of Orthopedic Device-Related Infection.

Glucocorticoids may be given prior to major orthopedic surgery to decrease postoperative nausea, vomiting, and pain. Additionally, many orthopedic patients may be on chronic glucocorticoid therapy. The aim of our study was to investigate whether glucocorticoid administration influences Orthopedic-Device-Related Infection (ODRI) in a rat model.

Comparison of two different antiseptics regarding intracutaneous microbial load after preoperative skin cleansing in total knee and hip arthroplasties.

Periprosthetic infections (PPIs) are a serious concern in total knee and hip arthroplasty, and they have an increasing incidence. To prevent PPI, preoperative skin disinfection, as a key element of antisepsis, represents an important part of infection prevention. However, no specific antiseptic agent is endorsed by the relevant guidelines.

Hip Adductor Muscle Abscess Descending From Septic Symphysitis.

Hip adductor muscle abscesses that descend from an infected symphysis pubis are rare but cause serious morbidity. We present a case of a 73-year-old male patient with unilateral hip adductor muscle abscess that descended from septic symphysitis caused by . Surgical debridement of the adductor compartment could not clear the infection and secondary debridement of the symphysis was necessary to eradicate .

Less soft tissue release in total knee arthroplasty for anteromedial compared to posteromedial knee osteoarthritis.

In total knee arthroplasty (TKA), the aim of achieving a mechanically straight leg axis as well as symmetrical and equally wide gaps has become established as the gold standard in terms of surgical technique. In contrast to TKA unicompartmental knee arthroplasty (UKA) is performed in anteromedial osteoarthritis (AMOA) and does not normally require releases. This raises the hypothesis whether the type of osteoarthritis (AMOA vs.

Meta-analysis of the efficacy of preoperative skin preparation with alcoholic chlorhexidine compared to povidone iodine in orthopedic surgery.

Preoperative skin preparation is an effective method to prevent surgical site infections (SSI). Alcoholic chlorhexidine (CHG) and povidone iodine (PV-I) are the most widely used antiseptic agents. This meta-analysis aims to determine their efficacy in reducing natural bacterial skin flora in clean orthopedic surgery.

The different failure modes of the connecting elements of the modular hip arthroplasty revision stem Revitan.

Introduction: Fracture of the femoral stem is the cause of ~1 % of revisions after total hip arthroplasty. The risk increases intrinsically with modularity, whereby modularity is particularly useful in revision arthroplasty. We present 7 cases of failure of a specific modular, tapered, fluted, titanium alloy Revitan stem and analyse the different failure modes.

Septic arthritis of the knee due to : look for the thorn.

We report on a patient with septic arthritis of the knee with after a penetrating black locust thorn injury. Antibiotics alone or in combination with an arthroscopy may be insufficient for achieving source control. Accurate medical history and open debridement with a search for a thorn fragment are key to successful treatment.

Calcium dobesilate (Doxium®) in bone marrow edema syndrome and suspected osteonecrosis of the hip joint - A case series.

Osteonecrosis of the femoral head is a disease that leads to gradual degeneration of the hip joint causing immobility and a devastating impairment of quality of life. Early stage disease is characterised by a bone marrow edema of the proximal femur, a sight it shares with bone marrow edema syndrome. Although total hip arthroplasty offers quick symptom relief and functionally appealing results the treatment remains challenging, with its particularly young patients and considering limited non-invasive treatment options.

Short proximal components in modular revision stems carry a higher risk for stem fractures.

Introduction: Fractures of modular hip revision stems are not uncommon. The current study examined implant-related factors on stem fracture. We hypothesised that in a modular stem the fracture risk is increased with the use of a short proximal implant component.

Intraoperative loading of calcium phosphate-coated implants with gentamicin prevents experimental Staphylococcus aureus infection in vivo.

Orthopedic device-related infection (ODRI) is a potentially devastating complication arising from the colonization of the device with bacteria, such as Staphylococcus aureus. The aim of this study was to determine if intraoperative loading of a clinically approved calcium phosphate (CaP) coating with gentamicin can protect from ODRI in vivo. First, CaP-coated titanium aluminium niobium (TAN) discs were used to investigate the adsorption and release kinetics of gentamicin in vitro.

Fracture of a Femoral Revision Stem following a Technical Failure.

We report about a fracture of a modular, uncemented femoral revision stem (Zimmer, Revitan®) due to a not previously described intraoperative technical problem. During implantation, a small ring, part of the proximal part of the trial stem, was left on the distal part of the definite stem. Following this, the top screwcap of the proximal part of the definite stem could not be tightened properly.

Femoroacetabular impingement causes osteoarthritis of the hip by migration and micro-instability of the femoral head.

Femoroacetabular impingement is the condition whereby parts of the proximal femur mechanically collide with the acetabular rim leading to adjacent and contrecoup acetabular damage. Evidence is growing that at least for cam impingement, and perhaps less so for pincer impingement, there is a relation to the development of osteoarthritis. It has been demonstrated that surgery for impingement can improve function and decrease pain.

Retroversion of the contralateral adult acetabulum after previous Perthes' disease.

Retroversion of the adult acetabulum following a previous Legg-Calvé-Perthes disease (LCPD) is found in 30-40% of the patients. It is known that in LCPD there may also be morphologic changes in the nonaffected controlateral acetabulum. We investigated the prevalence of retroversion of the contralateral acetabulum in a group of adult patients with a history of LCPD.

Partial resurfacing with varus osteotomy for an osteochondral defect of the femoral head.

Osteochondral defects of the femoral head represent a major challenge and various modern treatment options exist. We report a 16-year-old male with a large (3 x 3 cm) osteochondral defect of the femoral head that was treated with a partial resurfacing prosthesis combined with a high varus osteotomy, performed by surgical dislocation of the hip. Two years after surgery the patient was progressing well without complications.

Hip deformity in symptomatic adult Perthes' disease.

Only a limited number of patients that suffered from Legg-Calvé-Perthes' disease (LCPD) develop pain in early adulthood. Classical hinged abduction is well known and is thought to be responsible for secondary lateral insufficiency of the acetabulum, which may become painful. Another possible explanation, which was put forward more recently, is anterior femoroacetabular impingement.

Towards a better understanding of the aetiology of Legg-Calvé-Perthes' disease: acetabular retroversion may cause abnormal loading of dorsal femoral head-neck junction with restricted blood supply to the femoral epiphysis.

The most accepted part of the aetiology of Perthes' disease is an intermittent arterial occlusion. Many different reports now also suggest that some mechanical factor plays a role. In search of mechanical differences between normal hips and Perthes hips, many secondary morphologic differences of the proximal femur and the acetabulum are known.