Abstract:
BACKGROUND:Surgical site infections (SSIs), particularly periprosthetic joint infections (PJI), following a primary total joint arthroplasty (TJA) impose a major burden by increasing morbidity, mortality, disability rate, and health expenditure. Surgeons are increasingly using topical vancomycin powder as a preventative measure, but the effectiveness of this method has been debated in TJA. Thus, we designed a meta-analysis to compare the outcomes after primary TJA between a group treated with topical vancomycin powder and an untreated control group aiming to answer: (1) whether the application of topical vancomycin powder can reduce the infection rate after primary total joint replacement; (2) are the main types of pathogens causing SSIs after the application of topical vancomycin powder different from those of patients not using topical vancomycin? MATERIALS AND METHODS:A meta-analysis was conducted in accordance with the PRISMA guidelines. We included retrospective cohort studies and prospective randomized controlled trials of patients who underwent primary total joint arthroplasty with and without vancomycin powder application before wound closure and reported the SSI rates. The English literature in the PubMed (MEDLINE), EMBASE, Web of Science, and the Cochrane Library databases was comprehensively searched. Literature search, data extraction, and quality assessment were conducted by 2 authors. The main outcomes were SSI and PJI rates, and the secondary outcome was the bacterial spectrum. Statistical analyses were performed with the Review Manager (RevMan) Version 5.3. RESULTS:Six retrospective cohort studies and 3 prospective cohort studies with 4512 participants were included (2354 in vancomycin group and 2158 in the control group). In the TJA group, the vancomycin powder-treatment resulted in a significantly lower proportion of patients with SSIs (relative risk [RR]=0.40, 95% confidence interval [CI]=0.27-0.61 [p<0.001]) or PJI (RR=0.37, 95% CI=0.23-0.60 (p<0.001)). In the total hip arthroplasty group, the vancomycin powder treatment decreased the rate of SSIs and PJI by 66% (RR=0.34, 95% CI=0.15-0.78 [p=0.01]) and 74% (RR=0.26, 95% CI=0.10-0.67 (p=0.005)), respectively. In the total knee arthroplasty group, the vancomycin powder decreased the rate of SSIs and PJI by 67% (RR=0.43, 95% CI=0.26-0.70 [p<0.001]) and 66% (RR=0.44, 95% CI=0.25-0.77 [p=0.004]) respectively. Staphylococcus aureus (or methicillin-sensitiveStaphylococcus aureus) (6 in vancomycin group versus 11 in control group) was the most common pathogenic bacteria, followed by Staphylococcus epidermidis (1 in vancomycin group versus 2 in control group) and methicillin-resistant Staphylococcus aureus (2 in vancomycin group versus 4 in control group). Pseudomonas aeruginosa was the main gram-negative pathogen, with 3 cases in the control group and 1 case in the vancomycin powder-treatment group. DISCUSSION:The local application of vancomycin powder could significantly decrease the rate of SSIs and PJI in primary TJA without modifying the spectrum of bacteria involved. We recommend topical administration of the vancomycin powder before wound closure after a full evaluation of the patients. LEVEL OF EVIDENCE:III; meta-analysis.
journal_name
Orthop Traumatol Surg Resjournal_title
Orthopaedics & traumatology, surgery & research : OTSRauthors
Peng Z,Lin X,Kuang X,Teng Z,Lu Sdoi
10.1016/j.otsr.2020.09.006subject
Has Abstractpub_date
2020-11-27 00:00:00pages
102741issn
1877-0568pii
S1877-0568(20)30310-8pub_type
杂志文章,评审abstract::Varus deviation as defined by Thomine is the basis for understanding load distribution between the medial and lateral tibial plateau; it was originally defined in the frontal plane. Analysis in the sagittal and horizontal planes leads to a concept of varizing area. Varizing area sheds light on how, during gait, load p...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,多中心研究
doi:10.1016/j.otsr.2011.03.009
更新日期:2011-06-01 00:00:00
abstract:INTRODUCTION:There is increasing interest in using hip arthroscopy for the treatment of femoroacetabular impingement (FAI). However, the distraction is typically done with a traction table, which can lead to complications. Our working hypothesis was that a hip-specific distractor could be used to perform arthroscopic t...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2011.02.007
更新日期:2011-06-01 00:00:00
abstract:INTRODUCTION:The potential value of proximal femoral locking compression plate (PFLCP) for extracapsular femoral fractures has been discussed in several case reports; however, clinical control studies are lacking. Therefore, we performed a case control study to assess: (1) If PFLCP offers better functional results and ...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2014.06.012
更新日期:2014-10-01 00:00:00
abstract:PURPOSE:The purpose of this work was to report the main characteristics and results of all active anterior cruciate ligament (ACL) reconstruction registers along with the differences between them. METHODS:We systematically searched on Google and Medline via PubMed to identify ACL registers. National or regional regist...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2014.07.020
更新日期:2014-12-01 00:00:00
abstract::Burnout corresponds to a state of exhaustion (emotional, physical, mental) that can result in complete psychological and/or physical breakdown. Burnout is a result of how our society has evolved. A recent phenomenon, it affects all strata of society, all corporations, and all countries. Physicians are not immune to it...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
doi:10.1016/j.otsr.2019.04.029
更新日期:2020-02-01 00:00:00
abstract:INTRODUCTION:Assessment of soft-tissue balance by the gap technique in Total Knee Arthroplasty (TKA) impacts femoral component rotation positioning. Proper femoral component rotation is a critical factor in TKA, both for adequate patellar tracking and in achieving a symmetrical flexion gap. Soft tissue balance assessme...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2011.01.004
更新日期:2011-05-01 00:00:00
abstract:INTRODUCTION:Unusual locations of osteoarticular tuberculosis (OA-TB) raise diagnostic issues due to their untypical and non-suggestive clinical and radiological presentation. OBJECTIVES:The present retrospective study analyzed the various clinical, radiological and therapeutic aspects. PATIENTS AND METHODS:A retrosp...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2012.10.012
更新日期:2013-05-01 00:00:00
abstract::Chronic patellar tendon ruptures are somewhat rare, thus little work has been done in this area and their true incidence is not known. The management of a neglected, chronic patellar tendon rupture must address three difficulties: the proximally retracted patella, the reconstruction of the patellar tendon, finally, th...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2011.01.015
更新日期:2011-06-01 00:00:00
abstract:INTRODUCTION:There is concern regarding potential non-union of the fibula following distraction osteogenesis and if non-union of the fibula leads to poor outcome. HYPOTHESIS:Assess the incidence of fibula non-union in patients undergoing distraction osteogenesis of the tibia and to report the effects on patient outcom...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2018.09.012
更新日期:2018-12-01 00:00:00
abstract:INTRODUCTION:Chronic scapholunate instability can lead to functional deficits and radiocarpal osteoarthritis. A number of procedures, namely scapho-trapezio-trapezoid (STT) fusion, scaphocapitate (SC) fusion or soft tissue reconstruction procedures, aim to improve function while protecting the wrist from osteoarthritis...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2010.11.006
更新日期:2011-04-01 00:00:00
abstract:INTRODUCTION:The incidence of periprosthetic fractures after total knee arthroplasty (TKA) is increasing, and treatment is becoming more necessary. In periprosthetic tibial fractures, the stem of the tibial component largely occupies the medullary canal of the proximal tibia, which limits the selection of implants. The...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2016.10.007
更新日期:2017-04-01 00:00:00
abstract:PURPOSE OF THE STUDY:Desmoid-type fibromatosis is a fibroblastic proliferation that develops in the deep soft tissues and is characterized by infiltrative growth and a tendency towards local recurrence but does not metastasize. Fibromatosis of the chest wall is rare, representing only 10 to 20% of all deep fibromatoses...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2010.09.017
更新日期:2011-02-01 00:00:00
abstract:INTRODUCTION:The optimal treatment of isolated fractures of the greater tuberosity is an important topic of current surgical research. While non-displaced fractures are amenable to conservative treatment, displacement of the fragment can result in rotator cuff malfunction and impingement. For the present study, risk fa...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2018.06.017
更新日期:2019-04-01 00:00:00
abstract::Although total hip arthroplasty is now a classic procedure that is well controlled by orthopedic surgeons, some cases remain complex. Difficulties may be due to co-morbidities: obesity, skin problems, muscular problems, a history of neurological disease or associated morphological bone deformities. Obese patients must...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
doi:10.1016/j.otsr.2012.11.008
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:The main disadvantage of the surgical management of early onset scoliosis (EOS) using conventional growing rods is the need for iterative surgical procedures during childhood. The emergence of an innovative device using distraction-based magnetically controlled growing rods (MCGR) provides the opportunity to...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2014.05.006
更新日期:2014-09-01 00:00:00
abstract:PURPOSE:To clarify the relationship between whole body sagittal radiographic parameters and health related quality of life (HRQOL) in patients with spinal disease, and further analyse such relationship based on the pelvic incidence (PI) value. METHODS:100 patients (mean age: 64.4 years, M/F=50/50) with lumbar degenera...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2018.07.009
更新日期:2018-11-01 00:00:00
abstract:INTRODUCTION:Distal radius fractures are common injuries treated in a multitude of ways. One treatment paradigm not extensively studied is initial treatment by external fixation (EF) followed by conversion to open reduction internal fixation (ORIF). Such a paradigm may be beneficial in damage control situations, when t...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2016.01.013
更新日期:2016-05-01 00:00:00
abstract:INTRODUCTION:Patient information is the requisite first step in securing informed consent ahead of surgery, and is legally mandatory. The study hypothesis was that this information is deficient in a significant proportion of cases. This was tested on a clinical audit. The principal objective was to quantify the rate of...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2012.03.007
更新日期:2012-09-01 00:00:00
abstract:PURPOSE:Patient-reported outcome measures (PROMs) have been gaining in popularity over the last decade. The Oxford Shoulder Score (OSS) is a well-established self-administered questionnaire for shoulder evaluation adapted for the English-speaking population. The aim of the present study was to develop a translation and...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2016.05.010
更新日期:2016-09-01 00:00:00
abstract::Management of lower limb fractures in children involves many approaches, spanning from conservative treatment to open reduction and internal fixation. A number of intermediate treatments have also been shown to be effective, notably skeletal traction. However, each of these techniques has its own advantages and disadv...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2011.05.016
更新日期:2011-12-01 00:00:00
abstract:INTRODUCTION:Total disc replacement (TDR) has existed since 1984 but is not covered by the French national healthcare system (Sécurité Sociale). The present study assessed clinical outcomes, and also pre-, peri- and postoperative treatment costs. HYPOTHESIS:Surgical management of low back pain (LBP) provides medical a...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2011.04.004
更新日期:2011-09-01 00:00:00
abstract:PURPOSE:The morphological and biomechanical features of the thoracic spine, together with its close proximity to the spinal cord, set it apart from other spinal segments. Management of thoracic spine injuries consists of achieving a reduction and an immediate and long-lasting stabilization of the spine while constantly...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2014.05.007
更新日期:2014-09-01 00:00:00
abstract:INTRODUCTION:In traumatic proximal brachial plexus lesions (i.e., C5/C6), reconstruction of the musculocutaneous, axillary and suprascapular nerves yields satisfactory short- and medium-term functional outcomes. HYPOTHESIS:Early functional outcomes after nerve surgery will be maintained in the long-term. METHODS:A re...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2020.03.033
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Acute Achilles tendon rupture can be treated conservatively or surgically. Open surgery restores tendon continuity but carries a risk of skin complications. Tenolig(®) is a device designed for the percutaneous biological treatment of acute Achilles tendon rupture. Earlier studies found high rates of recurren...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2014.09.018
更新日期:2014-12-01 00:00:00
abstract:INTRODUCTION:There is some debate over the best treatment for anterior-superior iliac spine (ASIS) avulsion fractures, although non-surgical treatment can achieve the same results as open surgery. HYPOTHESIS:Absorbable screws can be safely used for ASIS avulsion fractures in children and adolescents. AIM OF THE STUDY...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2020.02.014
更新日期:2020-11-01 00:00:00
abstract:INTRODUCTION:The purpose of this study was to determine if there is a difference in knee function between patients with quadriceps tendon rupture and patellar tendon rupture after acute surgical repair. Our hypothesis was that knee function would be similar between the two groups. METHODS:The study population included...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2018.09.019
更新日期:2019-02-01 00:00:00
abstract:INTRODUCTION:The aim of this study was to identify points on the scapula that can be used to predict the anatomy of the native premorbid glenoid. MATERIAL AND METHODS:Forty-three normal scapulas reconstructed in 3D and positioned in a common coordinate system were used. Twenty points distributed over the blade of the ...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2018.10.024
更新日期:2019-04-01 00:00:00
abstract:INTRODUCTION:Patellar tendon ruptures make up about 5% of all extensor mechanism injuries. They mainly occur in young, athletic men who have contributing risk factors such as chronic tendinopathy. The aim of this study was to evaluate the return to sport after repair of an acute patellar tendon rupture. We hypothesized...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2020.01.010
更新日期:2020-05-01 00:00:00
abstract:INTRODUCTION:Management of septic non-union of the tibia requires debridement and excision of all infected bone and soft tissues. Various surgical techniques have been described to fill the bone defect. The "Induced Membrane" technique, described by A. C. Masquelet in 1986, is a two-step procedure using a PMMA cement s...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2018.04.013
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Trochanteric fractures are a major source of mortality, morbidity and functional impairment in the elderly. Morbidity is closely related to the degree of instability and comminution and is substantially influenced by the quality of reduction and internal fixation. Advanced age and associated co-morbidities a...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2009.08.001
更新日期:2009-11-01 00:00:00