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Cutibacterium acnes periprosthetic joint infections.
Bone Joint J
December 2024
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Article Synopsis
- - The study investigates demographics and treatment outcomes of patients with periprosthetic joint infections (PJIs) in the hip and knee, highlighting that these infections are often under-reported and can be confused with culture contamination.
- - A total of 35 PJIs were reviewed from January 2005 to December 2018, with findings indicating that about half were treated with chronic antibiotic suppression, while others underwent two-stage exchange arthroplasty; over two years, 94% remained free from revision.
- - The results showed that PJIs typically exhibited laboratory characteristics similar to traditional organisms, and infections cultured more rapidly than expected; both chronic antibiotic treatment and surgical options had low failure rates at mid-term follow-up.
Musculoskeletal manifestations of lower-extremity coccidioidomycosis: a case series.
J Bone Jt Infect
July 2024
Valley Fever Center for Excellence, College of Medicine - Tucson, University of Arizona, Tucson, AZ, United States of America.
: Coccidioidomycosis is a fungal infection endemic to the southwestern United States. Musculoskeletal manifestations are uncommon and seen in disseminated disease. While the involvement of the axial skeleton has been well described, the literature is limited on diseases involving the lower extremity.
View Article and Find Full Text PDFNext generation sequencing identifies an increased diversity of microbes in post lavage specimens in infected TKA using a biofilm disrupting irrigant.
Knee
December 2024
David Geffen School of Medicine, UCLA, Dept. of Orthopaedic Surgery, Los Angeles, USA.
Article Synopsis
- The study investigates chronic periprosthetic joint infection (PJI) after joint replacements, focusing on how a special irrigant can disrupt the biofilm covering the implant and enhance microbial detection.
- Researchers compared two methods (culture and Next Generation Sequencing) to identify microbes in samples from 38 Total Knee Arthroplasty patients before and after irrigation with the Bactisure Lavage.
- Results showed a decrease in detectable organisms with culture techniques post-lavage, while NGS identified many more microbes (177 vs. 126) afterward, including 135 organisms not detected before, indicating a hidden diversity of microbes in the biofilm.
Cementless, Cruciate-Retaining Primary Total Knee Arthroplasty Using Conventional Instrumentation: Technical Pearls and Intraoperative Considerations.
JBJS Essent Surg Tech
September 2024
Department of Orthopaedic Surgery, The Johns Hopkins Hospital, Baltimore, Maryland.
Article Synopsis
- Total knee arthroplasty (TKA) is a common surgical procedure for patients with severe knee osteoarthritis, especially when non-surgical treatments fail, leading to significant improvements in pain, function, and quality of life.
- The procedure can use various components (cemented, cementless, or a hybrid) and is generally performed with a focus on mechanical alignment, although newer alignment strategies like gap and kinematic balancing are showing promising results in early studies.
- The preferred surgical technique for cementless TKA involves a specific patient positioning and incision approach, starting with the application of a thigh tourniquet and a parapatellar incision, ensuring proper alignment and access during the surgery.*
Pyomyositis, accompanied by aseptic arthritis, has been previously documented in several publications. However, none of the authors in the mentioned case reports offered a pathophysiological explanation for this unusual phenomenon or proposed a treatment protocol. We present a case of a healthy, 70-year-old male who was presented to the emergency department 4 days after tripping over a pile of wooden planks and getting stabbed by a nail to his thigh.
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