Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jul 2019
Is It Possible to Correct Congenital Spinal Deformity Associated With a Tethered Cord Without Prophylactic Intradural Detethering?
Patients who have a congenital spinal deformity with a tethered cord generally are treated with prophylactic intradural detethering before deformity correction. However, the detethering procedure carries substantial risk, and it is not clear whether deformity correction can be performed without detethering. ⋯ Level IV, therapeutic study.
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Clin. Orthop. Relat. Res. · Jul 2019
Multicenter StudyPatients with a History of Treated Septic Arthritis are at High Risk of Periprosthetic Joint Infection after Total Joint Arthroplasty.
In patients undergoing total joint arthroplasty (TJA), increasing attention has been directed recently toward identifying specific patient-related risk factors that may predispose patients to periprosthetic joint infection (PJI). Currently, it is unclear whether having a history of a treated native septic arthritis is a risk factor for PJI after TJA in the same joint. Previous studies have reported contradictory evidence and results varied between a substantially higher rates of PJIs to very low or no reported PJIs. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Jul 2019
Multicenter StudyPositive Alpha-defensin at Reimplantation of a Two-stage Revision Arthroplasty Is Not Associated with Infection at 1 Year.
Diagnosing periprosthetic joint infection (PJI) represents a challenge that relies on multiple clinical and laboratory criteria that may not be consistently present. The synovial alpha-defensin-1 (AD-1) test has been shown to correlate accurately with the Musculoskeletal Infection Society (MSIS) criteria for the diagnosis of PJI, however, its association with persistent PJI has not been elucidated in the setting of patients receiving antibiotic spacers during second-stage reimplantation. Applying a Delphi-based consensus to define successful eradication of PJI offers an opportunity to test the utility of AD-1 in this setting. ⋯ Level IV, diagnostic study.