Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Aug 2020
A Low Percentage of Patients Satisfy Typical Indications for Single-stage Exchange Arthroplasty for Chronic Periprosthetic Joint Infection.
Periprosthetic joint infection (PJI) is a leading cause of revision arthroplasty. Considerable controversy still exists whether single- or two-stage exchange is the better approach for patients with chronic PJI. Historically, single-stage exchange arthroplasty was thought to have an unacceptably high risk of reinfection compared with two-stage exchange but recent studies have demonstrated that this may not be the case. To be considered for single-stage exchange, patients should meet certain criteria including a preoperatively identified nonvirulent pathogen in an immunocompetent host with an uncompromised soft tissue envelope. It is unclear what proportion of patients with chronic PJI actually meet these criteria. Additionally, patients who meet the criteria for single-stage exchange are selected because, in principle, they may be more likely to be able to overcome the infection, but it is unknown what the reinfection risk is in patients undergoing two-stage exchange who might have met selection criteria for single-stage exchange. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Aug 2020
Randomized Controlled TrialPlatelet-rich Plasma or Autologous Blood Do Not Reduce Pain or Improve Function in Patients with Lateral Epicondylitis: A Randomized Controlled Trial.
Platelet-rich plasma (PRP) and autologous blood are commonly used therapies for lateral epicondylitis, but the evidence from randomized, placebo-controlled trials is conflicting. Thus, it is still unclear if patients benefit from these treatments. ⋯ Level II, therapeutic study.
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Clin. Orthop. Relat. Res. · Aug 2020
Randomized Controlled TrialDoes Preoperative Decolonization Reduce Surgical Site Infections in Elective Orthopaedic Surgery? A Prospective Randomized Controlled Trial.
Surgical site infections (SSIs) after elective orthopaedic surgery are very stressful for patients due to frequent rehospitalizations with reoperations and poorer functional outcomes. Prevention of such events is therefore crucial. Although an evidence-based consensus is still lacking, preoperative decolonization could decrease SSI. Specifically, more information is needed about the effect of a preoperative decolonization procedure on SSI proportions in both Staphylococcus aureus carriers and non-S. aureus carriers after general orthopaedic surgery. ⋯ Level II, therapeutic study.