Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Infection 118 articles

Articles

Antimicrobial Gauze as a Dressing Reduces Pin Site Infection: A Randomized Controlled Trial

C. K. Lee MBBS (U Malaya), Y. P. Chua MS Ortho (U Malaya), A. Saw FRCS (Edin)

Pin site infection is a common problem in external fixation. Plain gauze wetted with normal saline is commonly used for a pin site dressing owing to the simplicity and low cost. Evidence to support adding an antimicrobial agent in the dressing material is lacking.

Definition of Periprosthetic Joint Infection: Is There a Consensus?

Javad Parvizi MD, FRCS, Christina Jacovides BS, Benjamin Zmistowski BS, Kwang Am Jung MD

The diagnosis of periprosthetic joint infection (PJI) continues to pose a challenge. While many diagnostic criteria have been proposed, a gold standard for diagnosis is lacking. Use of multiple diagnostic criteria within the joint arthroplasty community raises concerns in patient treatment and comparison of research pertaining to PJI.

Sufficient Release of Antibiotic by a Spacer 6 Weeks after Implantation in Two-stage Revision of Infected Hip Prostheses

Bernd Fink MD, Sebastian Vogt PhD, Martin Reinsch PhD, Hubert Büchner PhD

Although antibiotic-loaded spacers are commonly used to treat periprosthetic infections, it is unclear whether spacers continue to release bactericidal levels of antibiotic 6 weeks after implantation.

Surfactant-stabilized Emulsion Increases Gentamicin Elution From Bone Cement

Ryan B. Miller MD, Alex C. McLaren MD, Christine M. Leon MS, Brent L. Vernon PhD, Ryan McLemore PhD

Liquid antimicrobial use for antimicrobial-loaded bone cement is limited because of decreased strength and small volume that can be loaded. Emulsifying the liquid antimicrobial into the monomer may address both issues.

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.