Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jul 2016
Multicenter Study Comparative StudyIs Vancomycin-only Prophylaxis for Patients With Penicillin Allergy Associated With Increased Risk of Infection After Arthroplasty?
Preoperative antibiotic prophylaxis remains one of the most important strategies for prevention of postoperative infection. In patients with penicillin allergy, alternative medications such as vancomycin are often used despite reduced antimicrobial coverage and recent literature questioning the efficacy of vancomycin monotherapy. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Jul 2016
Synovial Cytokines and the MSIS Criteria Are Not Useful for Determining Infection Resolution After Periprosthetic Joint Infection Explantation.
Diagnosing periprosthetic joint infection (PJI) requires a combination of clinical and laboratory parameters, which may be expensive and difficult to interpret. Synovial fluid cytokines have been shown to accurately differentiate septic from aseptic failed total knee (TKA) and hip (THA) arthroplasties. However, after first-stage explantation, there is still no reliable test to rule out PJI before a second-stage reimplantation procedure. ⋯ Level III, diagnostic study.
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Clin. Orthop. Relat. Res. · Jul 2016
Comparative StudyEarly Migration Predicts Aseptic Loosening of Cementless Femoral Stems: A Long-term Study.
Excessive early migration of cemented stems and cups after THA has been associated with poor long-term survival and allows predictable evaluation of implant performance. However, there are few data regarding the relationship between early migration and aseptic loosening of cementless femoral components, and whether early migration might predict late failure has not been evaluated, to our knowledge. Einzel-Bild-Röntgen-Analyse-femoral component analysis (EBRA-FCA) is a validated technique to accurately measure axial femoral stem migration without the need for tantalum markers, can be performed retrospectively, and may be a suitable tool to identify poor performing implants before their widespread use. ⋯ Level III, diagnostic study.
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Clin. Orthop. Relat. Res. · Jul 2016
The ACS NSQIP Risk Calculator Is a Fair Predictor of Acute Periprosthetic Joint Infection.
Periprosthetic joint infection (PJI) is a severe complication from the patient's perspective and an expensive one in a value-driven healthcare model. Risk stratification can help identify those patients who may have risk factors for complications that can be mitigated in advance of elective surgery. Although numerous surgical risk calculators have been created, their accuracy in predicting outcomes, specifically PJI, has not been tested. ⋯ Level III, diagnostic study.
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Clin. Orthop. Relat. Res. · Jul 2016
Comparative StudySupine and Standing AP Pelvis Radiographs in the Evaluation of Pincer Femoroacetabular Impingement.
Pelvic tilt can affect the presence of the ischial spine sign and crossover sign. Numerous studies of pelvic tilt on radiographic measurements of pincer impingement have shown that increasing anterior tilt is associated with more radiographic signs of pincer impingement. However, to our knowledge, no study has directly compared supine and standing plain radiographs in patients with respect to lateral center-edge (LCE) angle, acetabular inclination, crossover sign, and ischial spine sign. ⋯ Level III, diagnostic study.