Developing an antibiogram for empiric antibiotic prescribing for adult non-spinal orthopaedic infections in a developing world setting.

Purpose: Empiric antibiotic strategies in the treatment of fracture-related infections, chronic osteomyelitis, prosthetic joint infection, and septic arthritis should be based on local microbiological antibiograms. This study aims to describe the microbiology and review the antibiogram profiles of bacterial isolates from patients undergoing surgical treatment for non-spinal orthopaedic infections, to identify the most appropriate empiric antibiotic strategy.

Methods: A retrospective review was performed of all cases of non-spinal orthopaedic infections treated surgically from 1 January 2018 to 31 December 2018.

Bilateral hip dysplasia in a South African male: A case study from the 17-18th century.

Objective: To identify, critically analyse and describe severe bilateral skeletal pathology involving the ossa coxae of an individual from historic era Cape Town.

Materials: A single individual from the University of Cape Town's Human Skeletal Repository was analysed under research approval (HREC# 035/2021).

Methods: An osteobiography was constructed, radiocarbon dating and isotopic analyses were conducted.

How resources affect management of periprosthetic fractures of the distal femur: perspectives from Israel, South Sudan, and South Africa.

Periprosthetic fractures of the distal femur have significant morbidity in both total hip and total knee arthroplasty (THA and TKA, respectively). The incidence of these fractures is growing, with the predominant mechanism of injury being a fall from a standing height and therefore considered fragility fractures. In many countries, improved public funding and a flourishing private health care sector, when coupled with increased life expectancy, translates to more older patients receiving both TKA and THA and therefore an increased prevalence of periprosthetic fractures and their associated complications.

Primary hip and knee arthroplasty at district level is safe and may reduce the burden on tertiary care in a low-income setting.

Background: Arthroplasty procedures in low-income countries are mostly performed at tertiary centers, with waiting lists exceeding 12 to 24 months. Recently, this is further exacerbated by the impact of the Covid Pandemic on elective surgeries. Providing arthroplasty services at other levels of healthcare aims to offset this burden, however there is a marked paucity of literature regarding surgical outcomes.

Efficacy and Safety of Masitinib in Corticosteroid-Dependent Severe Asthma: A Randomized Placebo-Controlled Trial.

Background: Masitinib is an oral tyrosine kinase inhibitor that selectively targets mast cell activity and platelet-derived growth factor receptor (PDGFR) signaling, both of which are implicated in various mechanisms of asthma pathogenesis.

Objective: Assessment of masitinib as an add-on to standard maintenance therapy as compared with placebo in the treatment of oral corticosteroid-dependent severe asthma.

Methods: We conducted a randomized (2:1), placebo-controlled study of masitinib (6 mg/kg/d) in adults with severe asthma uncontrolled by high dose inhaled corticosteroids and long-acting beta-adrenoreceptor agonists plus oral corticosteroids (OCS) (≥7.

Low 30-day mortality in South African orthopaedic patients undergoing surgery at an academic hospital during the first wave of the COVID-19 pandemic: It was safe to perform orthopaedic procedures at our hospital during the first COVID-19 peak.

Background:  Initial local and global evidence suggests that SARS-CoV-2-infected patients who undergo surgery, and those who become infected perioperatively, have an increased mortality risk post surgery.

Objectives: To analyse and describe the 30-day mortality, presurgical COVID-19 status and hospital-acquired SARS-CoV-2 infection rates of patients, both SARS-CoV-2-positive and negative, undergoing orthopaedic surgery at a tertiary academic hospital in South Africa (SA) during the first COVID-19 peak.

Methods: This single-centre, observational, prospective study included patients who underwent orthopaedic procedures from 1 April 2020 (beginning of the COVID-19 case increase in SA) to 31 July 2020 (first COVID-19 peak in SA).

Enhancing the sense of self of a mid-career woman through career construction counselling.

This article reports on career construction counselling with a purposefully selected, mid-career, midlife woman. A single-case study research design was implemented. Data were gathered using an integrative qualitative and quantitative approach.

Drastic reduction of orthopaedic services at an urban tertiary hospital in South Africa during COVID-19: Lessons for the future response to the pandemic.

Background: The COVID-19 pandemic has impacted on the global surgery landscape.

Objectives: To analyse and describe the initial impact of the COVID-19 pandemic on orthopaedic surgery at Groote Schuur Hospital, a tertiary academic hospital in South Africa.

Methods: The number of orthopaedic surgical cases, emergency theatre patient waiting times, and numbers of outpatient clinic visits, ward admissions, bed occupancies and total inpatient days for January - April 2019 (pre-COVID-19) were compared with the same time frame in 2020 (COVID-19).

Quality of recovery after total hip and knee arthroplasty in South Africa: a national prospective observational cohort study.

Background: Encouraged by the widespread adoption of enhanced recovery protocols (ERPs) for elective total hip and knee arthroplasty (THA/TKA) in high-income countries, our nationwide multidisciplinary research group first performed a Delphi study to establish the framework for a unified ERP for THA/TKA in South Africa. The objectives of this second phase of changing practice were to document quality of patient recovery, record patient characteristics and audit standard perioperative practice.

Methods: From May to December 2018, nine South African public hospitals conducted a 10-week prospective observational study of patients undergoing THA/TKA.

A Vertical Measurement System to Predict the Change in Leg Length in Total Hip Arthroplasty.

The management of leg lengths in total hip arthroplasty continues to challenge orthopaedic surgeons. The aim of this study is to test the reliability of a measuring device used to measure the resected femoral head and how the resulting intra operatively calculated change in leg length compares to the radiographically measured change in leg length. Four orthopaedic surgeons measured 20 femoral heads and the intra class coefficients of the raters were between 0.

What Is the Clinical Presentation of Adverse Local Tissue Reaction in Metal-on-metal Hip Arthroplasty? An MRI Study.

Background: Adverse local tissue reaction (ALTR) is not only a prominent cause of metal-on-metal (MoM) implant revision, but may also compromise the result of revision surgery. Patients treated with MoM arthroplasty and subsequently revised as a result of ALTR have been shown to experience worse patient-reported outcomes, inferior survivorship, and more complications when compared with patients receiving MoM implants who were revised for reasons other than ALTR. There is conflicting evidence as to whether the presence of symptoms is associated with ALTR in patients with MoM implants.

Optimising perioperative care for hip and knee arthroplasty in South Africa: a Delphi consensus study.

Background: A structured approach to perioperative patient management based on an enhanced recovery pathway protocol facilitates early recovery and reduces morbidity in high income countries. However, in low- and middle-income countries (LMICs), the feasibility of implementing enhanced recovery pathways and its influence on patient outcomes is scarcely investigated. To inform similar practice in LMICs for total hip and knee arthroplasty, it is necessary to identify potential factors for inclusion in such a programme, appropriate for LMICs.

Hip and knee arthroplasty waiting list - how accurate and fair?

Background: Resource-intensive procedures require the use of patient waiting lists in an attempt to increase fairness of access to surgery and improve surgical efficiency. Total hip and knee arthroplasty has waiting lists in excess of years.

Objectives: To analyse our tertiary state institution's hip and knee arthroplasty waiting list to assess its accuracy.

The Ububele Baby Mat intervention: facilitating meaning in a multi-cultural context.

This paper expands on the continuing understanding of the Ububele Baby Mat Project - a community-based parent-infant mental health intervention now offered at six primary healthcare clinics in Alexandra, Johannesburg. This paper describes the influence of cultural diversity and the complex layers of meaning-making involved in the Baby Mat intervention. Meaning-making is a collaborative process between the caregiver-infant dyad's cultural beliefs and experiences, the Baby Mat couple's relationship, knowledge and skills, and the additional minds of the multicultural supervision group.

CEPHEUS SA: a South African survey on the undertreatment of hypercholesterolaemia.

Aim: The aim of the CEntralised Pan-South African survey on tHE Under-treatment of hypercholeSterolaemia (CEPHEUS SA) was to evaluate the current use and efficacy of lipidlowering drugs (LLDs), and to identify possible patient and physician characteristics associated with failure, if any, to achieve low-density lipoprotein cholesterol (LDL-C) targets.

Methods: The survey was conducted in 69 study centres in South Africa and recruited consecutive consenting patients who had been prescribed LLDs for at least three months. One visit was scheduled for data collection, including fasting plasma lipid and glucose levels.