Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Infection 113 articles

Articles

Amphotericin B Delivery From Bone Cement Increases With Porosity but Strength Decreases

Chris Kweon MD, Alex C. McLaren MD, Christine Leon MS, Ryan McLemore PhD

Amphotericin B is a highly hydrophobic antifungal used for orthopaedic infections. There is disagreement about whether amphotericin B is released when it is loaded in polymethylmethacrylate (PMMA). It is unknown how much a poragen will increase amphotericin B release or decrease the compressive strength of the PMMA.

Infection Control Rate of Irrigation and Débridement for Periprosthetic Joint Infection

Loukas Koyonos MD, Benjamin Zmistowski BS, Craig J. Della Valle MD, Javad Parvizi MD, FRCS

Irrigation and débridement with retention of prosthesis is commonly performed for periprosthetic joint infection. Infection control is reportedly dependent on timing of irrigation and débridement relative to the index procedure.

An Articulating Antibiotic Spacer Controls Infection and Improves Pain and Function in a Degenerative Septic Hip

Erin E. Fleck MD, Mark J. Spangehl MD, Venkat R. Rapuri MD, FRCS, Christopher P. Beauchamp MD

Treating septic arthritis of the hip with coexisting advanced degenerative disease is challenging. The use of primary total hip arthroplasty (THA) has led to postoperative infection rates as high as 22%. Insertion of antibiotic spacers with subsequent reimplantation of a THA controls infection and improves pain and function in patients with periprosthetic infections.

Case Report: Lower Extremity Sparganosis in a Bursa

Kee-Yong Ha MD, In-Soo Oh MD

Sparganosis is a rare parasitic infection caused by the plerocercoid tapeworm larva of the genus Spirometra.

Amphotericin B Is Cytotoxic at Locally Delivered Concentrations

Samuel Harmsen MD, Alex C. McLaren MD, Christine Pauken PhD, Ryan McLemore PhD

Orthopaedic fungal infections are commonly treated with systemic amphotericin, which has a narrow therapeutic index and is associated with systemic toxicities. Local delivery of amphotericin has been described yet is poorly understood. As with bacterial infections, fungal infections are associated with biofilm. However, it is unclear whether experience with local delivery of antibacterials can be applied to local antifungal delivery.

Molecular Techniques to Detect Biofilm Bacteria in Long Bone Nonunion: A Case Report

Michael Palmer MD, William Costerton PhD, Jeffrey Sewecke DO, Daniel Altman MD

Biofilms cause chronic infections including those associated with orthopaedic hardware. The only methods that are Food and Drug Administration-approved for detecting and identifying bacterial infections are cultures and selected DNA-based polymerase chain reaction methods that detect only specific pathogens (eg, methicillin-resistant Staphylococcus aureus). New DNA-based technologies enable the detection and identification of all bacteria present in a sample and to determine the antibiotic sensitivities of the organisms.

Propionobacter acnes Infection as an Occult Cause of Postoperative Shoulder Pain: A Case Series

Peter J. Millett MD, MSc, Yi-Meng Yen MD, PhD, Connie S. Price MD, Marilee P. Horan MPH, Olivier A. Meijden MD, Florian Elser MD

Infections after shoulder surgery are potentially devastating complications. Propionibacterium acnes is recognized as a causal agent in shoulder infections. The clinical presentation is usually insidious and nonspecific, but a P. acnes infection could be an occult cause of postoperative shoulder pain.

Infirmity and Injury Complexity are Risk Factors for Surgical-site Infection after Operative Fracture Care

Abdo Bachoura MD, Thierry G. Guitton MSc, R. Malcolm Smith MD, Mark S. Vrahas MD, David Zurakowski PhD, David Ring MD, PhD

Orthopaedic surgical-site infections prolong hospital stays, double rehospitalization rates, and increase healthcare costs. Additionally, patients with orthopaedic surgical-site infections (SSI) have substantially greater physical limitations and reductions in their health-related quality of life. However, the risk factors for SSI after operative fracture care are unclear.

Current Concepts for Clean Air and Total Joint Arthroplasty: Laminar Airflow and Ultraviolet Radiation: A Systematic Review

Richard P. Evans MD

With the trend toward pay-for-performance standards plus the increasing incidence and prevalence of periprosthetic joint infection (PJI), orthopaedic surgeons must reconsider all potential infection control measures. Both airborne and nonairborne bacterial contamination must be reduced in the operating room.