The Efficacy of Calcium Sulfate/Hydroxyapatite (CaS/HA) Gentamicin in Osteomyelitis Treatment: A Case Series.

Background: Osteomyelitis is a challenging condition caused by infection and inflammation of the bone, presenting a significant economic burden to healthcare systems. Calcium sulfate/hydroxyapatite (CaS/HA) is a bone void filler composed of 60% calcium sulfate and 40% hydroxyapatite. This case series aimed to report the efficacy and infection-related outcomes of CaS/HA combined with Gentamicin (CaS/HA-G) in treating osteomyelitis.

The role of cannabis on total hip and knee surgeries outcomes: a systematic review and meta-analysis.

Purpose: Cannabis refers to medications derived from the Cannabis plant. Cannabis has long been used to treat a wide range of conditions. The widespread legalization of cannabis has increased its use.

Mechanical complications and revision following total joint arthroplasty in acromegalic patients: A nationwide US-based study.

Background: Acromegaly is associated with significant osteoarthritis (OA) and increased risk of vertebral and hip fractures. There is limited data on total joint arthroplasty (TJA) outcomes in patients with acromegaly.

Methods: In this retrospective study, we identified patients with acromegaly who underwent total hip arthroplasty (THA), total knee arthroplasty (TKA), and total shoulder arthroplasty (TSA) between 2010 and 2022 using the PearlDiver national database.

Poor Outcomes of Girdlestone Resection Arthroplasty in Injection Drug Users: A Retrospective Study.

This retrospective cohort study aims to investigate the clinical outcomes of Girdlestone resection arthroplasty (GRA) in injection drug users with septic hip arthritis. Patients who underwent primary GRA for septic hip arthritis secondary to injection drug use at two academic trauma centers from 2015 to 2023 were retrospectively reviewed. Patient demographics, surgical details, and follow-up outcomes, including patient-reported outcome measures, were collected and analyzed.

Preoperative SSRI use increases perioperative transfusion need in patients undergoing surgical procedures on the hip joint.

Purpose: Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for psychiatric conditions. Previous studies have shown that SSRIs can increase bleeding risk by affecting platelet aggregation. However, their impact on perioperative outcomes in hip surgery remains uncertain.

Knee fusion versus above knee amputation as two options to deal with knee periprosthetic joint infection.

Background: Periprosthetic joint infection (PJI) poses a significant challenge in total knee arthroplasty (TKA), with recurrence rates as high as 14-28%, leading to substantial morbidity and treatment costs. When conventional treatments fail, knee fusion and above-the-knee amputation (AKA) emerge as alternative options. Existing literature offers conflicting views on the efficacy and impact of knee fusion versus AKA with varied outcomes and limitations.

Effectiveness of synthetic versus autologous bone grafts in foot and ankle surgery: a systematic review and meta-analysis.

Background: All orthopaedic procedures, comprising foot and ankle surgeries, seemed to show a positive trend, recently. Bone grafts are commonly employed to fix bone abnormalities resulting from trauma, disease, or other medical conditions. This study specifically focuses on reviewing the safety and efficacy of various bone substitutes used exclusively in foot and ankle surgeries, comparing them to autologous bone grafts.

Local delivery of linezolid in the treatment of complex orthopedic bone and joint infections in patients with vancomycin allergy: a case series.

: Osteomyelitis is a challenging bone infection associated with ischemia, trauma, or various surgical procedures (e.g., joint reconstruction).

Initiating chemotherapy in joint arthroplasty patients increases the risk of periprosthetic joint infections.

Background: Total Joint Arthroplasties (TJAs) are becoming more popular, resulting in a growing economic burden due to potential postoperative complications, with periprosthetic joint infections (PJIs) playing a significant role. The effect of immunosuppression on PJI risk, particularly in cancer patients following chemotherapy, is unknown. The hypothesis of this study investigated whether chemotherapy increases PJI rates in patients who received post-arthroplasty chemotherapy within one year of surgery.

Limb Lengthening and Reconstruction Society orthopedic surgeons in the United States: An analysis of geographical distribution, academic, leadership, and demographic characteristics.

Background: The Limb Lengthening and Reconstruction Society (LLRS) is a premier orthopedic specialty organization that promotes limb reconstruction for all ages. LLRS membership characteristics, however, are poorly reported. This study delineates orthopedic surgeon LLRS members' demographic traits, academic achievement, leadership attainment, and geographical distribution across the United States.

Antibiotic-Coated Intramedullary Nailing Managing Long Bone Infected Non-Unions: A Meta-Analysis of Comparative Studies.

Long bone infected non-unions are such an orthopedic challenge that antibiotic-coated intramedullary nailing (ACIN) has become a viable therapeutic option for their management. This study aims to provide a comprehensive assessment of the available data about the use of antibiotic-coated nailing in the treatment of long bone infected non-unions. Following the PRISMA guideline in this meta-analysis, a systematic literature search was conducted across major databases for studies evaluating ACIN in long bone infected non-unions.

Intravenous Drug Abuser Treated for Chronic Infected Open Forearm Fracture with Shortening and Primary Wound Closure.

Neglected and open forearm fracture wounds accompanied by shortening are complex injuries that are seldom reported in the known literature. We describe a patient with a history of chronic intravenous drug abuse (IVDA) and a neglected forearm wound with radius and ulna fractures with chronic osteomyelitis managed by limb salvage. The patient had a history of IVDA and a neglected forearm wound with fractures in both the radius and ulna, along with chronic osteomyelitis.

Nano-hydroxyapatite structures for bone regenerative medicine: Cell-material interaction.

Bone tissue engineering holds great promise for the regeneration of damaged or severe bone defects. However, several challenges hinder its translation into clinical practice. To address these challenges, interdisciplinary efforts and advances in biomaterials, cell biology, and bioengineering are required.

Functional Outcomes of Knee Arthrodesis for Infected Total Knee Arthroplasty.

Introduction: As the occurrence of total knee arthroplasties (TKAs) is forecasted to continue rising, so too will the frequency of prosthetic joint infections (PJIs) and revision TKAs. Multiple revisions can result in an unreconstructible knee. In such instances, the knee may be salvaged through arthrodesis.

Functional Outcome of Above-Knee Amputation After Infected Total Knee Arthroplasty.

Background: Periprosthetic joint infection is a serious complication of total knee arthroplasty (TKA). Management usually involves irrigation and debridement, polyethylene liner exchange, one-stage revision, two-stage revision, knee arthrodesis, or ultimately above-knee amputation (AKA). We present our experience with 21 patients who underwent AKA as a sequela of unresolved infected TKA, highlighting their etiology and functional outcomes.

The Trans-Achilles Approach for Plate Supplementation of Ankle Arthrodesis With an Existing Hindfoot Fusion Nail: A Case Report.

Tibiotalar arthrodesis revision surgeries are not uncommon. Several approaches have been described in the literature for ankle arthrodesis nonunions. In this article, we describe the posterior trans-Achilles approach, which ensures adequate surgical exposure while minimizing damage to the surrounding soft tissues.

Motorized Intramedullary Nail Lengthening in the Older Population.

Limb lengthening has not been widely employed in the elderly population due to concerns that outcomes will be inferior. The purpose of this multicenter, retrospective case-control series was to report the bone healing outcomes and complications of lower limb lengthening in older patients (≥60 years) using magnetic intramedullary lengthening nail (MILN). Our hypothesis was that healing parameters including consolidation days, the consolidation index, maturation days, and the maturation index, as well as the number of adverse events reported in the older population, would be no different to those of the general adult population.

Intramedullary Canal Injection of Vancomycin- and Tobramycin-loaded Calcium Sulfate: A Novel Technique for the Treatment of Chronic Intramedullary Osteomyelitis.

Aim: In this study, we present a detailed surgical technique for treating chronic osteomyelitis (COM) of the intramedullary canal with injectable tobramycin and vancomycin-loaded calcium sulfate (CS).

Background: Chronic osteomyelitis of the long bones has been treated using antibiotic-impregnated polymethyl methacrylate (PMMA), which typically requires a second procedure for removal.

Technique: Removal of the infected intramedullary nail (if any), copious irrigation, canal reaming, and intramedullary canal injection of vancomycin- and tobramycin-loaded calcium sulfate as a single-stage procedure for the treatment of COM of long bones.

Fusion Revision Surgery With Reamer-Irrigator-Aspirator to Harvest Autograft After Spinal Pseudarthrosis.

Background and purpose Spinal pseudarthrosis (SPA) is a common complication after attempted cervical or lumbosacral spinal fusion surgery. Revision surgeries usually necessitate bone graft implementation as an adjunct to hardware revision. Iliac crest bone graft is the gold standard but availability can be limited and usage often leads to persistent postoperative pain at the donor site.

Efficacy of Infection Eradication in Antibiotic Cement-Coated Intramedullary Nails for Fracture-Related Infections, Nonunions, and Fusions.

Antibiotic cement-coated intramedullary nails (ACCINs) are increasing in popularity as a viable solution for the treatment of fracture-related infections (FRIs), infected long bone nonunions, and arthrodeses without an external fixator. ACCINs effectively manage to fulfill three of the basic principles for eradicating osteomyelitis: dead space management, antibiotic delivery, and bone stability. We performed a retrospective review of 111 patients who were treated with ACCINs between January 2014 and December 2020.

Tobramycin Blood Levels after Local Antibiotic Treatment of Bone and Soft Tissue Infection.

Local antibiotic delivery using different carriers plays an important role in both infection prophylaxis and treatment. Besides dead space management, these carriers have the advantage of providing a high concentration of local antibiotics with a lower risk of systemic toxicity. Few studies have reported on systemic toxicity associated with antibiotic-impregnated carriers.

Outcomes of Total Knee Arthroplasty in Patients With a Prior Contralateral Above-Knee Amputation: A Retrospective Review of a Nationwide Database.

Background: Total knee arthroplasty (TKA) in patients with a prior contralateral above-knee amputation (AKA) is uncommon, with limited literature describing the outcomes. We used a national database to compare the outcomes of primary TKA in above-knee amputees and nonamputees.

Methods: A retrospective review of TKA recipients with prior contralateral AKA was performed using the PearlDiver database from 2010 to Q2 of 2019.

Survival and Outcomes of 1.5-Stage vs 2-Stage Exchange Total Knee Arthroplasty Following Prosthetic Joint Infection.

Background: Traditional management of prosthetic joint infection following total knee arthroplasty (TKA) consists of a 2-stage approach. However, 1.5-stage exchange has seen preliminary success, whereby metal femoral and all-polyethylene tibia components are placed without intention for subsequent second stage.

Fracture-Associated Microbiome and Persistent Nonunion: Next-Generation Sequencing Reveals New Findings.

Introduction: Fracture nonunion remains a devastating complication and may occur for several reasons, though the microbial contribution remains poorly estimated. Next-generation sequencing (NGS) techniques, including 16S rRNA gene profiling, are capable of rapid bacterial detection within clinical specimens. Nonunion cases may harbor microbes that escape detection by conventional culture methods that contribute to persistence.

Immunological evaluation of patients with orthopedic infections: taking the Cierny-Mader classification to the next level.

: Cierny-Mader osteomyelitis classification is used to label A, B, or C hosts based on comorbidities. This study's purpose was to define the "true" host status of patients with orthopedic infection using serologic markers to quantify the competence of their immune system while actively infected. : Retrospective chart review identified patients at a single-surgeon practice who were diagnosed with orthopedic infection between September 2013 and March 2020 and had immunological laboratory results.