Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jun 2018
Vitamin E Phosphate Coating Stimulates Bone Deposition in Implant-related Infections in a Rat Model.
Implant-related infections are associated with impaired bone healing and osseointegration. In vitro antiadhesive and antibacterial properties and in vivo antiinflammatory effects protecting against bone loss of various formulations of vitamin E have been demonstrated in animal models. However, to the best of our knowledge, no in vivo studies have demonstrated the synergistic activity of vitamin E in preventing bacterial adhesion to orthopaedic implants, thus supporting the bone-implant integration. ⋯ The use of vitamin E coatings may open new perspectives for developing coatings that can limit septic loosening of infected implants with bacterial contamination. However, a deeper insight into the mechanism of action and the local release of vitamin E as a coating for orthopaedic implants is required to be used in clinics in the near future. Although this study cannot support the antimicrobial properties of vitamin E, promising results were obtained for bone-implant osseointegration. These preliminary results will require further in vivo investigations to optimize the host response in the presence of antibiotic prophylaxis.
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Clin. Orthop. Relat. Res. · Jun 2018
CSA-90 Promotes Bone Formation and Mitigates Methicillin-resistant Staphylococcus aureus Infection in a Rat Open Fracture Model.
Infection of open fractures remains a significant cause of morbidity and mortality to patients worldwide. Early administration of prophylactic antibiotics is known to improve outcomes; however, increasing concern regarding antimicrobial resistance makes finding new compounds for use in such cases a pressing area for further research. CSA-90, a synthetic peptidomimetic compound, has previously demonstrated promising antimicrobial action against Staphylococcus aureus in rat open fractures. However, its efficacy against antibiotic-resistant microorganisms, its potential as a therapeutic agent in addition to its prophylactic effects, and its proosteogenic properties all require further investigation. ⋯ The antimicrobial properties of CSA-90 combined with further evidence of its proosteogenic potential make it a promising compound to develop further for orthopaedic applications.
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Clin. Orthop. Relat. Res. · Jun 2018
Is Anesthesia Technique Associated With a Higher Risk of Mortality or Complications Within 90 Days of Surgery for Geriatric Patients With Hip Fractures?
Postoperative mortality and complications after geriatric hip fracture surgery remain high despite efforts to improve perioperative care for these patients. One factor of particular interest is anesthetic technique, but prior studies on this are limited by sample selection, competing risks, and incomplete followup. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Jun 2018
Multicenter Study Comparative StudyAre Age and Patient Gender Associated With Different Rates and Magnitudes of Clinical Improvement After Reverse Shoulder Arthroplasty?
An improved understanding of how gender differences and the natural aging process are associated with differences in clinical improvement in outcome metric scores and ROM measurements after reverse total shoulder arthroplasty (rTSA) may help physicians establish more accurate patient expectations for reducing postoperative pain and improving function. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Jun 2018
Moderate to Severe Renal Insufficiency Is Associated With High Mortality After Hip and Knee Replacement.
In patients having elective hip or knee replacements, many comorbid conditions, including diabetes, cardiovascular disease, and congestive heart failure, are associated with postoperative mortality. Renal failure and a history of renal transplantation also increase mortality. However, the effect of different stages of chronic kidney disease on patients' prognoses is unclear. ⋯ Level III, therapeutic study.