Consensus statement on problematic knee replacement and revision knee replacement: A collaboration between EKS and BASK.

Background: Up to 20% of primary total knee arthroplasty (TKA) patients are not satisfied with their outcome. Both the analysis of these patients and revision surgery can be complex, expensive and outcomes can vary widely.

Aim: The aim of this study was to deliver consensus recommendations regarding outpatient analysis, surgical treatment and arrangement of clinical services concerning patients with a problematic TKA or revision knee replacement (RTKA).

Debridement, Antibiotics and Implant Retention: A Systematic Review of Strategies for Treatment of Early Infections after Revision Total Knee Arthroplasty.

Goal: The purpose of this review is to provide a systematic and comprehensive overview of the available literature on the treatment of an early prosthetic joint infection (PJI) after revision total knee arthroplasty (TKA) and provide treatment guidelines.

Methods: This systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The search was conducted using the electronic databases of PubMed, Trip, Cochrane, Embase, LILACS and SciElo.

Dislocation of modern design rotating hinge total knee arthroplasty : case series and narrative review.

Knee dislocation is an infrequent complication after rotating hinge total knee arthroplasty (RHTKA). The aim of the present study was to describe our experience with dislocating RHTKA in a consecutive prospective large series, its occurrence rate, causative mechanisms and to perform a review of available literature. In total, six dislocations were observed in 303 RHTKA procedures (NexGen RHK, ZimmerBiomet, Warsaw, Indiana, US) at a mean of 10 (range, 2 - 24) months after surgery.

The diagnostic potential of low-field MRI in problematic total knee arthroplasties - a feasibility study.

Purpose: Low-field MRI, allowing imaging in supine and weight-bearing position, may be utilized as a non-invasive and affordable tool to differentiate between causes of dissatisfaction after TKA ('problematic TKA'). However, it remains unclear whether low-field MRI results in sufficient image quality with limited metal artefacts. Therefore, this feasibility study explored the diagnostic value of low-field MRI concerning pathologies associated with problematic TKA's' by comparing low-field MRI findings with CT and surgical findings.

MRI as Diagnostic Modality for Analyzing the Problematic Knee Arthroplasty: A Systematic Review.

Background: Various diagnostic modalities are available to assess the problematic knee arthroplasty. Visualization of soft-tissue structures in relation to the arthroplasty and bone remains difficult. Recent developments in MRI sequences could make MRI a viable addition to the diagnostic arsenal.

Persistent Wound Drainage After Total Joint Arthroplasty: A Narrative Review.

Background: Persistent wound drainage after total joint arthroplasty (TJA) is an important complication with potential substantial adverse consequences, in particular periprosthetic joint infection.

Methods: This review evaluated the available literature regarding several issues in the field of persistent wound drainage after TJA and offers a classification of persistent wound drainage and an algorithmic approach to the decision-making process.

Results: Available literature addressing the diagnosis and treatment of persistent wound drainage after TJA is scarce and an evidence-based clinical guideline is lacking.

LEAK study: design of a nationwide randomised controlled trial to find the best way to treat wound leakage after primary hip and knee arthroplasty.

Introduction: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are highly successful treatment modalities for advanced osteoarthritis. However, prolonged wound leakage after arthroplasty is linked to prosthetic joint infection (PJI), which is a potentially devastating complication. On the one hand, wound leakage is reported as a risk factor for PJI with a leaking wound acting as a for micro-organisms.

Managing persistent wound leakage after total knee and hip arthroplasty. Results of a nationwide survey among Dutch orthopaedic surgeons.

Persistent wound leakage after joint arthroplasty is a scantily investigated topic, despite the claimed relation with a higher risk of periprosthetic joint infection. This results in a lack of evidence-based clinical guidelines for the diagnosis and treatment of persistent wound leakage after joint arthroplasty. Without such guideline, clinical practice in orthopaedic hospitals varies widely.

Treatment outcome in the most severely affected Legg-Perthes patients, comparing prolonged traction in abduction with femoral varus derotation treatment.

Purpose: Compare conservative and operative treatment in the most severely affected Legg-Perthes disease patients.

Methods: 29 patients (14 conservative and 15 operative) with 32 affected hips (16 conservative and 16 operative) were evaluated, all Catterall 3 or 4. The conservative group, with a median age-at-onset of 4.

[Diagnostic image. A woman with a growth at a toe nail].

A 34-year-old woman presented with a progressive subungual swelling of the hallux caused by subungual exostosis.

Purification of high-throughput organic synthesis libraries by counter-current chromatography.

Experiments were performed to evaluate whether counter-current chromatography (CCC) could function as an alternative purification method to reversed-phase high-performance liquid chromatography (RP-HPLC) and normal-phase supercritical fluid chromatography (SFC). RP-HPLC and SFC are the routine methods currently used in our high-throughput purification (HTP) facility for the purification of high-throughput organic synthesis (HTOS) libraries and medicinal chemistry reaction mixtures. Pre-equilibration of the solvent mixture layers was not mandatory for effective chromatography when hexanes-ethyl acetate-methanol-water (HEMW) solvent mixtures were used.

Posterior tibial tendon transfer: results of fixation to the dorsiflexors proximal to the ankle joint.

Background: Most techniques for posterior tibial tendon transfer attach the posterior tibial tendon somewhere at the dorsum of the foot. Inadequate tendon length and difficulties in securing the tendon to bone or tendon can complicate these procedures. Performing the tenodesis proximal to the ankle joint can prevent these problems.

From bacterial genomes to novel antibacterial agents: discovery, characterization, and antibacterial activity of compounds that bind to HI0065 (YjeE) from Haemophilus influenzae.

As part of a fully integrated and comprehensive strategy to discover novel antibacterial agents, NMR- and mass spectrometry-based affinity selection screens were performed to identify compounds that bind to protein targets uniquely found in bacteria and encoded by genes essential for microbial viability. A biphenyl acid lead series emerged from an NMR-based screen with the Haemophilus influenzae protein HI0065, a member of a family of probable ATP-binding proteins found exclusively in eubacteria. The structure-activity relationships developed around the NMR-derived biphenyl acid lead were consistent with on-target antibacterial activity as the Staphylococcus aureus antibacterial activity of the series correlated extremely well with binding affinity to HI0065, while the correlation of binding affinity with B-cell cytotoxicity was relatively poor.

Rapid hit to lead evaluation of pyrazolo[3,4-d]pyrimidin-4-one as selective and orally bioavailable mGluR1 antagonists.

Our HTS effort yielded a preferential mGluR1 pyrimidinone antagonist 1 with lead-like characteristics. Rapid hit to lead (HTL) study identified compounds with improved functional activity and selectivity such as 1b with little improvements in ADME properties. Addition of an aminosulfonyl group on the N-1 aromatic ring led to 2f, a compound with similar in vitro biochemical profiles as those of 1b but drastically improved in vitro ADME properties.

A new CT scan method for measuring the tibial tubercle trochlear groove distance in patellar instability.

Patellar malalignment leading to objective or potential patella instability can be caused by tibial tuberosity lateralisation. This can be treated with a tuberosity medialisation. CT scan measurements are needed to assess the tibial tubercle trochlear groove distance.

Conventional radiography cannot replace CT scanning in detecting tibial tubercle lateralisation.

Patellar instability can be caused by an excessive lateral distance between the anterior tibial tubercle and the trochlear groove (TT-TG). This study was designed to compare the TT-TG in reformatted computed tomography to the TT-TG on a 30 degrees axial conventional radiograph (CR) using lead markers to visualize the tibial tubercle and epicondyles. This is the first report on the use of lead markers for determining the TT-TG.

Novel antibacterial class: a series of tetracyclic derivatives.

We describe the synthesis and antibacterial activity of a series of tetracyclic naphthyridones. The members of this series act primarily via inhibition of bacterial translation and belong to the class of novel ribosome inhibitors (NRIs). In this paper we explore the structure-activity relationships (SAR) of these compounds to measure their ability both to inhibit bacterial translation and also to inhibit the growth of bacterial cells in culture.

A strategy for discovery of novel broad-spectrum antibacterials using a high-throughput Streptococcus pneumoniae transcription/translation screen.

The authors report the development of a high-throughput screen for inhibitors of Streptococcus pneumoniae transcription and translation (TT) using a luciferase reporter, and the secondary assays used to determine the biochemical spectrum of activity and bacterial specificity. More than 220,000 compounds were screened in mixtures of 10 compounds per well, with 10,000 picks selected for further study. False-positive hits from inhibition of luciferase activity were an extremely common artifact.

Deletion of the UL21 gene in Pseudorabies virus results in the formation of DNA-deprived capsids: an electron microscopy study.

We studied the morphogenesis of three pseudorabies virus mutants lacking parts of the gene homologous to the UL21 gene of the herpes simplex virus type 1. The mutants were examined in an SK-6 cell-line, in an SK-6 cell-line expressing the UL21 gene product, in porcine lung alveolar macrophages (PLAM) and in porcine nasal mucosa explants. Although on SK-6 cells and PLAM, the virus-assembly and egress of mutant virus M155, lacking almost the entire UL21 gene, was similar to that of the rescued PRV mutant, M155 producing virions containing little or no DNA (A-type particles).

A comparative study of the pathogenesis of malabsorption syndrome in broilers.

Five malabsorption syndrome (MAS) homogenates from The Netherlands and Germany were used to reproduce MAS in broilers. We studied the histopathology after inoculation of 1-day-old broiler chicks and the agents that might be involved. Generally, the MAS homogenates induced signs that differed in severity and pathobiology.