Abstract：
BACKGROUND:Infections following hip and knee replacements can compromise the function and durability of arthroplasty. When these infections occur during the immediate postoperative period, irrigation and débridement can be attempted to salvage the implant. Prior studies have reported varying results likely due to lack of consistent inclusion criteria, variations in surgical technique, and lack of uniform treatment protocols. QUESTIONS/PURPOSES:To supplement this literature we determined the rate at which irrigation and débridement and prosthesis retention would control acute periprosthetic infections. METHODS:We retrospectively reviewed the medical records of 18 patients with acute periprosthetic infections occurring within 28 days after 13 THAs and 5 TKAs. The mean time to reoperation was 19 days (range, 6-28 days) after arthroplasty. Superficial débridements were performed in five cases, and a polyethylene or ball head exchange was performed in the remaining 13 cases when fascial defects were encountered at the time of surgery. RESULTS:We salvaged the prosthesis in four of five patients with superficial irrigation and débridement group and eight of 13 with deep infections. Intraoperative cultures were positive in 83% of cases (n = 15). Five patients (one superficial and four deep) eventually underwent resection arthroplasty. Three patients underwent repeat irrigation and débridement, and one of these three ultimately had resection arthroplasty. Polymicrobial infections were detected in four cases, all failures. The average time to resection was 62 days (range, 12-134 days). CONCLUSIONS:Consistent with the literature, success of prosthesis salvage for periprosthetic infections occurring within 28 days after arthroplasty depends on the location, extent, and microbiology of the infection. LEVEL OF EVIDENCE:Level IV, case series. See the Guidelines for Authors for a complete description of levels of evidence.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Van Kleunen JP,Knox D,Garino JP,Lee GCdoi
10.1007/s11999-010-1291-ysubject
Has Abstractpub_date
2010-08-01 00:00:00pages
2024-8issue
8eissn
0009-921Xissn
1528-1132journal_volume
468pub_type
杂志文章abstract：BACKGROUND:Metal-on-metal hip resurfacing arthroplasty (MOM HR) has become an established alternative to traditional metal-on-metal total hip arthroplasty (MOM THA) for younger, more active patients. Nevertheless, concerns remain regarding wear and corrosion of the bearing surfaces and the resulting systemic metal ion ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-013-2981-z
更新日期：2013-09-01 00:00:00
abstract：:The risk of litigation in the emergency room is not directly proportional to the severity of injury. In fact, the risk of initiation of legal action is greater in cases of relatively modest permanent and partial disability. In these cases, failure to obtain and document informed consent, failure to effectively communi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-200302000-00011
更新日期：2003-02-01 00:00:00
abstract：BACKGROUND:Health literacy is the ability to obtain, process, and understand health information needed to make appropriate health decisions. The proper comprehension by patients regarding a given disease, its treatment, and the physician's instructions plays an important role in shared decision-making. Studies have dis...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,收录出版
doi：10.1007/s11999.0000000000000075
更新日期：2018-04-01 00:00:00
abstract：:Insufficient posterior tibial tendons in 28 specimens from patients with clinical Stage II or III disease were examined to clarify the etiology of adult-acquired flatfoot deformity. Hematoxylin and eosin and Masson trichrome-stained sections of formalin-fixed tissue were viewed in plain and polarized light. We perform...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000218759.42805.43
更新日期：2006-09-01 00:00:00
abstract：:Popliteal artery injury during surgery of the knee is rare but can have devastating consequences. The position of knee flexion has been thought to be protective for the popliteal artery, allowing it to fall back from the knee joint. No prior study has provided in vivo cross sectional evidence of the behavior of the po...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1999-10-01 00:00:00
abstract：:External fixators commonly used in orthopaedic trauma and reconstruction may pose a potential safety hazard to patients exposed to magnetic resonance imaging. This interaction with the scanner depends on fixator composition, magnetism, and geometry. Image artifact produced by devices during scanning may diminish the d...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1995-08-01 00:00:00
abstract：:Ninety-two patients (103 hips) treated with total hip arthroplasty (THA) were assessed before and after operation to determine nutritional status and any correlation with delayed wound healing. Parameters indicative of nutritional status (serum albumin and serum transferrin) were assessed, along with immunologic and a...
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：:Static and fatigue tests of the small Orthofix unilateral external fixator frame and its main components were performed. The use of six pins increased torsional rigidity, but this configuration failed at lower bending loads when compared to the four-pin configuration, reflecting the uneven holding strength of the pin ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1990-04-01 00:00:00
abstract：:Tuberculosis was first described in 1756 by Acrel in a case report. Subsequent reports of musculoskeletal tuberculosis documented the uncommon occurrence of hand and wrist involvement. The two cases presented here demonstrate the difficulty in eradicating the organism even with modern regimens of chemotherapy. Intraop...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1991-01-01 00:00:00
abstract：BACKGROUND:For patients with failed surgical treatment of an infected TKA, salvage operations such as arthrodesis or above-knee amputation (AKA) may be considered. Clinical and institutional factors associated with AKA and arthrodesis after a failed TKA have not been investigated in a large-scale population, and the ut...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-017-5285-x
更新日期：2017-12-01 00:00:00
abstract：BACKGROUND:Several recently published population-based studies have highlighted the association between insurance status and survival in patients with various cancers such as breast, head and neck, testicular, and lymphoma [22, 24, 38, 41]. Generally, these studies demonstrate that uninsured patients or those with Medi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/CORR.0000000000000889
更新日期：2020-03-01 00:00:00
abstract：:The treatment program after anterior cruciate ligament (ACL) injury or reconstruction at the United States Military Academy embraces the four cornerstones of rehabilitation--strength, aerobic fitness, coordination, and confidence. It is divided into six phases--presurgery, to prepare the patient for postoperative reha...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-01-01 00:00:00
abstract：:The presence of a "pseudocapsule," composed of an inner compression zone and outer reactive zone, is a frequent finding in the periphery of osteosarcoma. Morphologic and immunohistochemical methods were used to determine the type of inflammatory cell most closely related to the formation of this pseudocapsule. Six and...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1994-03-01 00:00:00
abstract：:If hinged prostheses are revised with smaller and nonhinged prostheses, do these implants provide adequate fixation, do massive bone grafts in combination with smaller implants reinforce host bone stock, do less constrained prostheses restore ligament tension, and do they avoid problems of the extensor mechanism? To a...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000127586.10230.cc
更新日期：2004-06-01 00:00:00
abstract：BACKGROUND:Scapular notching is a unique complication of Grammont-style reverse total shoulder arthroplasty. While reverse total shoulder arthroplasty has revolutionized the treatment of pseudoparalysis secondary to cuff tear arthropathy, the implications of scapular notching with regard to patient function and implant...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1007/s11999-010-1720-y
更新日期：2011-09-01 00:00:00
abstract：:The effect of electromagnetic field stimulation was investigated in a group of 40 consecutive patients treated with valgus tibial osteotomy for degenerative arthrosis of the knee. All patients were operated on by the same author and followed the same postoperative program. After surgery, patients were randomly assigne...
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：1993-03-01 00:00:00
abstract：:The Short Form 36, The Toronto Extremity Salvage Score, and the 1987 and 1993 Musculoskeletal Tumor Society Rating Scales were compared as measures of functional status for patients with lower extremity sarcoma. The study included 97 patients with lower extremity sarcoma and evaluated each measure on the following mea...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1999-01-01 00:00:00
abstract：:Ninety-two patients with congenital pseudoarthrosis (infantile nonunion) were treated with pulsing electromagnetic fields (PEMF) in the United States and Europe in the past eight years. This represents the largest group of patients with infantile nonunions in which a common treatment modality has been used. Excluding ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1982-05-01 00:00:00
abstract：UNLABELLED:The use of extended offset femoral components and acetabular liners helps restore preoperative offset during hip arthroplasty. We report a relatively high acetabular component aseptic loosening rate with the use of offset polyethylene liners. We reviewed 1919 primary and 346 revision total hip arthroplasties...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0479-x
更新日期：2009-01-01 00:00:00
abstract：BACKGROUND:Compared with conventional polyethylene, first-generation highly cross-linked polyethylenes have low wear, but controversy exists regarding their reduced mechanical strength and/or retained free radicals. Second-generation highly cross-linked polyethylenes have been developed to reduce wear, maintain mechani...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,多中心研究
doi：10.1007/s11999-011-2177-3
更新日期：2012-06-01 00:00:00
abstract：:Measurements of uptake in vivo of 3H-proline into 3H-hydroxyproline demonstrate that cartilage surfaces in rabbit knees with surgically induced osteoarthrosis (up to 3 months after operation) incorporated 2 to 5 times more activity into collagen than cartilage of control knees. The high uptake indicates that collagen ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1980-03-01 00:00:00
abstract：:In spite of the increasing numbers of porous coated total hip femoral components implanted each year, little is known about the shear strength or fatigue performance of the interface between coating and implant substrate. The appearance of loose beads in clinical follow-up roentgenograms suggests that shear failure of...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1987-04-01 00:00:00
abstract：:For determination of the optimal position in examining the ankle joint for anterior drawer sign and talar tilting, 12 legs freshly amputated above the knee were radiographically examined after successive transection of the lateral ankle ligaments in three different sequences. Apparatuses secured the position of the an...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-03-01 00:00:00
abstract：:Patients who are young or active or both who require total joint replacement pose a unique challenge; their high activity demands wear-resistant bearings that will perform for decades, without suffering from the adverse effects of accumulated wear products. We discuss the tribologic and biologic properties of newly in...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-200401000-00017
更新日期：2004-01-01 00:00:00
abstract：BACKGROUND:Osteochondral allografting is an option for successful treatment of large articular cartilage defects. Use of osteochondral allografting is limited by graft availability, often because of loss of chondrocyte viability during storage. QUESTIONS/PURPOSES:The purpose of this study was to compare osteochondral ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-014-3773-9
更新日期：2014-11-01 00:00:00
abstract：:Fifty-six adults (average age, 38 years) with active tuberculosis of the lumbar and lumbosacral spine were treated conservatively with triple chemotherapy for 12 to 18 months. The minimum followup was 3 years. Three methods of assessments of the chronologic changes of sagittal spinal deformity were used on lateral rad...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200205000-00007
更新日期：2002-05-01 00:00:00
abstract：:To learn about the changes appearing in hip muscles after an above-knee amputation, 3-dimensional reconstructions of the hip and thigh region of 12 patients with above-knee amputations were made based on transverse magnetic resonance images. In all patients, the amputations were done at least 2 years before the study ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1995-10-01 00:00:00
abstract：:Comparable groups of patients with osteoarthritic knees who had either a St. Georg sledge unicompartmental arthroplasty or an upper tibial osteotomy were reviewed in 1985, five to ten years after operation. The results of unicompartmental arthroplasty were better, but it was uncertain whether the superior results woul...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1994-05-01 00:00:00
abstract：:To define radiographic criteria, the radiographs of all patients diagnosed with coxarthrosis during the year 1951 were reviewed. Structural or joint space changes, evident radiographically in one of every seven cases in 1951, persisted at the time of the review in 1962. In the remaining cases, the diagnosis had been b...
journal_title：Clinical orthopaedics and related research
pub_type： 传,古典文章,历史文章,杂志文章
doi：
更新日期：1993-02-01 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
