Abstract：
:Infected arthroplasties reportedly have a lower eradication rate when caused by highly resistant and/or polymicrobial isolates and in these patients most authors recommend intravenous antibiotics. We asked whether two-stage revision with interim oral antibiotics could eradicate these infections. We prospectively followed 36 patients (mean age, 71.8 years) with late hip arthroplasty infections. Combinations of oral antibiotics were prescribed according to cultures, biofilm, and intracellular effectiveness. The minimum followup was 1 year (mean, 4.4 years; range, 1-12 years). We presumed eradication in the absence of clinical, serologic, and radiographic signs of infection. Infection was eradicated in all 13 patients with highly resistant bacteria who completed a two-stage protocol (10 with methicillin-resistant Staphylococci) and in eight of 11 patients treated with only the first stage (and six of nine with methicillin-resistant Staphylococci). Infection was eradicated in six of six patients with polymicrobial isolates (of sensitive and/or resistant bacteria) who completed a two-stage protocol and in five of seven with polymicrobial isolates treated with only the first surgery. The Harris hip score averaged 88.1 (range, 70-98) in patients who underwent reimplantation and 56.8 (range, 32-76) in patients who underwent resection arthroplasty. Long cycles of combined oral antibiotics plus a two-stage surgical exchange appear a promising alternative for infections by highly resistant bacteria, methicillin-resistant Staphylococci, and polymicrobial infections.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Cordero-Ampuero J,Esteban J,García-Cimbrelo Edoi
10.1007/s11999-009-0808-8subject
Has Abstractpub_date
2009-09-01 00:00:00pages
2335-42issue
9eissn
0009-921Xissn
1528-1132journal_volume
467pub_type
杂志文章abstract：BACKGROUND:Recent studies have shown successful midterm outcomes after total hip arthroplasty (THA) in patients with human immunodeficiency virus (HIV). However, little data exist on the epidemiology, risk of perioperative complications, and length of stay in patients with HIV receiving THA. QUESTIONS/PURPOSES:The pur...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-014-3855-8
更新日期：2015-02-01 00:00:00
abstract：:Contemporary management of Grade IIIB open tibial fractures has evolved to include intravenous antibiotics, thorough interval surgical debridement, rigid skeletal fixation, early local or free tissue myoplasty, and liberal use of autogenous bone graft beneath a clean, stable wound. External fixation has been the skele...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,meta分析
doi：10.1097/00003086-199611000-00003
更新日期：1996-11-01 00:00:00
abstract：:The dislocation rate of 3197 Charnley prostheses with 22 mm head in which the surgery was done between 1979 and 1991 in 2 orthopaedic centers was compared with that of 2875 Lubinus prostheses with 32 mm head in which the surgery was done between 1980 to 1991 in 3 other centers. A 1-year followup showed an equal rate o...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,多中心研究
doi：
更新日期：1996-12-01 00:00:00
abstract：:Delayed onset tuberculosis infection appeared in a total knee implant in a 61-year-old former coal miner. After a five-day interval the knee was salvaged by removal, aggressive debridement, suction-irrigation, and reinsertion. Antituberculosis drugs were administered immediately following surgery on the basis of the c...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1985-12-01 00:00:00
abstract：:A committee was appointed by the American Academy of Orthopaedic Surgeons in 1981 to continue the orthopaedic workforce studies begun by D. Kay Clawson a decade earlier. The committee found that the rapid increase in orthopaedists graduating from residency programs between 1970 and 1982 had resulted in a workforce in ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200104000-00013
更新日期：2001-04-01 00:00:00
abstract：:Plaster casts, custom-fabricated fracture braces, and prefabricated fracture braces were compared in the laboratory for the stability they provided to closed, experimental, diaphyseal fractures of the tibia and fibula on anatomic specimens. The stability was comparable for each type of device tested for the loading co...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-06-01 00:00:00
abstract：:The development of specific inhibitors of bone resorption has revolutionized the treatment of Paget's disease. The diphosphonates, the calcitonins, and mithramycin are capable of inducing marked suppression of disease activity for prolonged periods as judged by biochemical, kinetic, and histologic techniques. Whereas ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1987-04-01 00:00:00
abstract：:Discography as a diagnostic method is not a panacea and has distinct limitations. It should not replace myelography but is a useful adjunct, particularly in those cases in which myelography has not been helpful and in which conservative management has failed to produce improvement. It is particularly helpful in determ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-197503000-00016
更新日期：1975-01-01 00:00:00
abstract：:In a 37-year-old man, bilateral infraspinatus muscle weakness was associated with compression of the suprascapular nerve. The compression occurred at the spinoscapular angle by bilateral development of ganglia. The lesion was confirmed by electromyography. Surgical approaches to the area are described along with a rev...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1982-06-01 00:00:00
abstract：UNLABELLED:Residual deformity in resistant clubfoot is not uncommon. The "bean-shaped foot" exhibits forefoot adduction and midfoot supination and may interfere with function due to poor foot placement. For children less than 5 years of age we describe a corrective procedure combining a closing wedge cuboidal osteotomy...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-009-0755-4
更新日期：2009-05-01 00:00:00
abstract：:Shoulder motion has traditionally been described in reference to arbitrarily defined planes of motion (e.g., sagittal/flexion, coronal/abduction). This study examined shoulder muscle recruitment during conical arm movements, which include all planes of motion. Electromyographic (EMG) data was collected with intramuscu...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-11-01 00:00:00
abstract：:Hyperbaric oxygen has been shown to promote healing in bone and some soft tissues. This study was undertaken to determine its effect on ligamentous healing. Forty-eight Sprague-Dawley rats underwent a standardized surgical laceration of the right (divided) medial collateral ligament, whereas the left (undivided) media...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199903000-00028
更新日期：1999-03-01 00:00:00
abstract：:Patients with Perthes' disease develop a lesion comparable to osteochondritis dissecans (OCD). The frequency of this combination was about 6% of all Perthes' disease patients conservatively treated. In three out of 17 patients reported here, the lesion caused minor symptoms, but was associated with dislocation, loose ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1980-10-01 00:00:00
abstract：:Thirty revisions were performed on loose total hip replacements with a specific acetabular reconstruction technique combining the use of a bovine bone substitute and a support ring. One patient died of a cause unrelated to the procedure. No migration of the acetabular implant or bone lysis of the heterograft was seen ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199609000-00013
更新日期：1996-09-01 00:00:00
abstract：BACKGROUND:Bone cancer pain is very common, and patients with this type of pain may be difficult to treat. Development of an experimental model for studying this condition is critical to advancing an understanding of the mechanisms that cause pain in patients with malignant disease. METHODS:A murine model of bone canc...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/01.blo.0000093059.96273.56
更新日期：2003-10-01 00:00:00
abstract：:From 1972 to 1982, 455 patients had arthrodesis and other operations with screw-plate internal fixation of the lumbosacral spine. Of these 455 patients, 440-413 of whom had had spinal fusion and 27 of whom had undergone pars interarticularis reconstruction--were evaluated for a mean follow-up period of 31.6 months. Th...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-02-01 00:00:00
abstract：:Decisions made regarding resumption of driving after total hip arthroplasty may be determined by a combination of factors including driving reaction time and when postsurgical precautions need no longer be adhered to. Ninety patients, ranging in age from 34 to 85 years old were recruited after total hip arthroplasty t...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000072468.32680.ff
更新日期：2003-08-01 00:00:00
abstract：:Osteogenesis imperfecta (OI) Type II is a rare heritable disorder of bone matrix that results in catastrophic congenital skeletal dysplasia. Two cases of OI Type II had symmetric rhizomelic skeletal dysplasia apparent on ultrasound at 16 and 20 weeks' gestation. Histologic and histochemical studies performed on skelet...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-08-01 00:00:00
abstract：:An 18-month-old girl with a distal tibiofibular diastasis secondary to an osteochondroma was seen with a valgus deformity of the ankle. The patient underwent operative excision of the osteochondroma at the age of 2 years. At 13-year followup there was resolution of the diastasis, and the patient was free of symptoms. ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1997-12-01 00:00:00
abstract：BACKGROUND:Diffuse-type pigmented villonodular synovitis (PVNS) has a high local recurrence rate and as such can lead to erosive destruction of the involved joint. Multiple surgical modalities exist, but it is unknown which technique best minimizes local recurrence and surgical morbidity. QUESTIONS/PURPOSES:We compare...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2589-8
更新日期：2013-03-01 00:00:00
abstract：:Habitual dislocation of the hip occurred in a nine-year-old girl. The nomenclature of the literature on this disorder and other related conditions is confusing. The following simple classification is therefore proposed: (1) recurrent dislocation (posttraumatic, nonvoluntary); (2) voluntary dislocation (nonhabitual, as...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-05-01 00:00:00
abstract：:The role of local heat or cold therapy used in conjunction with exercise in the rehabilitation of total knee arthroplasty patients was investigated. Thirty-six osteoarthritic patients were analyzed. Parameters evaluated were range of motion, swelling about the knee, and pain. All patients received the total condylar k...
journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1983-09-01 00:00:00
abstract：BACKGROUND:Although aortic balloon occlusion has been shown to reduce blood loss during sacral tumor resections, it has not been validated in larger sacral tumors involving the lower lumbar spine. If such an approach were shown to be associated with less blood loss, it might aid the tumor surgeon in resecting these dif...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999.0000000000000053
更新日期：2018-03-01 00:00:00
abstract：:Reduction of the porosity of bone cement by centrifugation significantly improves the fatigue life of the cement when smooth, waisted specimens are tested. However, bone cement in vivo has surface irregularities at the interdigitation of the cement with the trabecular bone. The effect of centrifugation on the fatigue ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-04-01 00:00:00
abstract：:Two hundred cases of intracapsular femoral neck fractures have been treated with a multiple parallel pin technique similar to that originated by Austin Moore. The technique employs a personally designed guide which facilitates insertion of multiple parallel pins. The fixation obtained satisfactorily resists shear stre...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-11-01 00:00:00
abstract：:In the child born with sacral agenesis, the management of arthrogrypotic-like deformities, spinal and multisystem abnormalities poses several problems to the orthopedist. A clinical evaluation was undertaken on 17 patients and available parents in an effort to define better the heredity and proper management of this d...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1979-03-01 00:00:00
abstract：:Fingertip amputations are the most common type of amputation injury in the upper extremity. These injuries are either seen in the emergency room or in an office setting. These lesions are very frequent and require precise wound care for optimal results. The longer finger and the thumb, being the most distal and indepe...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-199808000-00008
更新日期：1998-08-01 00:00:00
abstract：:Temperature sensors were placed in 50 knees in 25 patients who had one or both joints replaced. Temperature recordings were made before walking, after walking, and after cycling. The heat generated in healthy, arthritic, and replaced knees was measured. The knee replacements were done using eight different prostheses....
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000183739.50869.bb
更新日期：2006-01-01 00:00:00
abstract：BACKGROUND:Alpha defensin was proposed as a new biomarker in synovial fluid for the diagnostic workup of failed joint prostheses. To our knowledge, no comparative study of the performance of the quantitative enzyme-linked immunosorbent assay (ELISA) and qualitative lateral flow alpha defensin test has been reported. Q...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/CORR.0000000000000336
更新日期：2018-08-01 00:00:00
abstract：BACKGROUND:The literature suggests lateral unicompartmental knee arthroplasties are associated with low revision rates. However, there are fewer reports describing techniques for lateral unicompartmental arthroplasty and whether technique influences ROM and function compared to reports for medial unicompartmental arthr...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-2005-9
更新日期：2012-01-01 00:00:00
