Abstract：
INTRODUCTION:It is unclear which antibiotic regimen provides the best prophylaxis against surgical site infection (SSI) in patients undergoing hip and knee surgery. QUESTIONS/PURPOSES:Therefore, we determined whether dual antibiotic prophylaxis (1) reduced the rate of SSI compared to single antibiotic prophylaxis and (2) altered the microbiology of SSI. METHODS:We retrospectively reviewed 1828 primary THAs and TKAs performed between September 1, 2008 and December 31, 2010. We divided patients into two groups: (1) those who received a dual prophylactic antibiotic regimen of cefazolin and vancomycin (unless allergy), or (2) received cefazolin (unless allergy) as the sole prophylactic antibiotic. There were 701 males and 1127 females with an average age of 56 years (range, 15–97 years). We limited followup to 1 year, presuming subsequent infections were not related to the initial surgery. RESULTS:During this period, there were 22 SSIs (1.2%). The infection rates for dual antibiotic prophylaxis compared to a single antibiotic regimen were 1.1% and 1.4%, respectively. Of 1328 patients treated with dual antibiotic prophylaxis, only one (0.08%) SSI was culture positive for methicillin resistant Staphylococcus aureus (MRSA), while four of 500 patients (0.8%) receiving only cefazolin prophylaxis had culture positive MRSA infection at the time of reoperation. CONCLUSION:The addition of vancomycin as a prophylactic antibiotic agent apparently did not reduce the rate of SSI compared to cefazolin alone. Use of vancomycin in addition to cefazolin appeared to reduce the incidence of MRSA infections; however, the number needed to treat to prevent a single MRSA infection was very high. LEVEL OF EVIDENCE:Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Sewick A,Makani A,Wu C,O'Donnell J,Baldwin KD,Lee GCdoi
10.1007/s11999-012-2255-1subject
Has Abstractpub_date
2012-10-01 00:00:00pages
2702-7issue
10eissn
0009-921Xissn
1528-1132journal_volume
470pub_type
杂志文章abstract：:Intramedullary nailing after reaming of the medullary cavity according to Küntscher, provides a rigid fixation and makes early mobilization possible, and is even applicable to infected non-unions. Experience with 150 cases of fresh femoral fractures and more than 80 cases of non-union of the femur, the tibia, the hume...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1976-03-01 00:00:00
abstract：BACKGROUND:Exchangeable neck stems, defined as those with a dual taper (that is, a modular junction between the femoral head and the femoral neck and an additional junction between the neck and the stem body), were introduced in THA to improve restoration of joint biomechanics (restoring anteversion, offset, and limb l...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-017-5260-6
更新日期：2017-08-01 00:00:00
abstract：:The clinical and metallurgical performance of 12 retrieved Noiles total knee prostheses was investigated. Clinical histories and serial roentgenograms were used in conjunction with the American Society for Testing and Materials (ASTM) standard implant retrieval and analysis techniques to assess device performance. All...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-03-01 00:00:00
abstract：:A trigonometric evaluation of the amount of correction of metatarsus primus varus obtainable via lateral displacement of the first metatarsal head in a Chevron osteotomy technique revealed that approximately 1 degree of correction may be obtained for each millimeter of lateral shift. This calculated correction was cor...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1989-06-01 00:00:00
abstract：:The cells of cartilage are constantly remodeling the matrix in which they are suspended. The stimulus to initiate remodeling is probably the chondrocyte's response to physical and or chemical changes in the environment. Heat, pressure, friction, load, pH, and growth are examples of such factors, which, if altered, wou...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1986-12-01 00:00:00
abstract：:In 20 white leghorn chickens, the effect of proximity (proximal vs. distal) to the repair site and the effect of sheath excision versus sheath repair on biochemical matrix formation in the healing zone 2 flexor tendon were studied. In 14 animals, the profundus tendon of the long toe on both feet was lacerated and repa...
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：:This study investigated 11 patients with localized pigmented villonodular synovitis of the knee that was diagnosed and treated by arthroscopic technique. There were six male and five female patients between the ages of 15 and 59 years (mean, 34.6 years). Seven patients reported extension limitation without joint line ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200010000-00026
更新日期：2000-10-01 00:00:00
abstract：UNLABELLED:Results of total knee arthroplasty have demonstrated excellent pain relief and increased patient function, particularly in activities such as walking. This procedure has not always met the needs of certain ethnic and religious groups as well as younger patients who require greater magnitudes of knee flexion....
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/BLO.0b013e31812f785d
更新日期：2007-11-01 00:00:00
abstract：BACKGROUND:Large-head metal-on-metal (MoM) hip arthroplasties have demonstrated poor survival. Damage at the taper-trunnion junction is a contributing factor; however, the influence of junction design is not well understood. QUESTIONS/PURPOSES:(1) Does taper type affect fretting, corrosion, and volumetric wear at the ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-013-3115-3
更新日期：2014-02-01 00:00:00
abstract：UNLABELLED:Recently, medial patellofemoral ligament reconstruction has been emphasized for the treatment of patellar dislocation. This study compared the results of medial patellofemoral ligament reconstruction by adductor magnus tenodesis with distal patellar realignment in patients with recurrent patellar dislocation...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0207-6
更新日期：2008-06-01 00:00:00
abstract：:Certain deformities of the hip joint seem to predispose the hip to the development of osteoarthrosis. Successful surgical correction of these deformities before the onset of osteoarthrosis requires accurate characterization of the anatomic deviations from normal as the first step in planning corrective osteotomy. Thre...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-01-01 00:00:00
abstract：BACKGROUND:Many procedures have been developed to correct hallux valgus deformity using distal soft tissue realignment, metatarsal osteotomy, and periodically, a proximal phalanx osteotomy (Akin). The ideal metatarsal osteotomy allows for varying degrees of correction with reliable improvement in deformity and patient ...
journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章
doi：10.1007/s11999-010-1510-6
更新日期：2011-03-01 00:00:00
abstract：:Dissociation of the polyethylene liner from its metal shell has been reported as a rare occurrence. During a 4-year period, six hips in five patients who had the Harris-Galante II porous acetabular component implanted as part of a primary or revision total hip arthroplasty presented with acute onset of pain and diffic...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200105000-00021
更新日期：2001-05-01 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：BACKGROUND:Although patient-reported outcome measures (PROMs) are helpful to define whether an intervention has improved a patient's status in ways the patient feels are important, they may also serve an empowering educational role; specifically, sharing a patient's scores might help the patient understand his or her p...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999.0000000000000069
更新日期：2018-04-01 00:00:00
abstract：BACKGROUND:Revision TKA is a serious adverse event with substantial consequences for the patient. As the demand for TKA rises, reducing the risk of revision TKA is becoming increasingly important. Predictive tools based on machine-learning algorithms could reform clinical practice. Few attempts have been made to combin...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/CORR.0000000000001343
更新日期：2020-09-01 00:00:00
abstract：:The purpose of this study was to explore the relationship between the integrity of collagen and biomechanical properties of bone. In this study, age (range, 5-26 years old) and gender related changes in cortical bone samples from 33 baboon femurs (15 males and 18 females) were examined. The percentage of denatured col...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200002000-00027
更新日期：2000-02-01 00:00:00
abstract：:The purpose of this investigation was to determine the effects of continuous passive motion (CPM) on the chondrogenic potential of autogenous osteoperiosteal grafts to repair major osteochondral defects. A 3.5-mm-wide circular full-thickness defect was drilled in one medial femoral condyle of 55 adolescent New Zealand...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-07-01 00:00:00
abstract：:Radiocarpal fracture-dislocation was associated with fracture of the distal articular surface of the radius in five patients (six extremities). Closed manipulation resulted in satisfactory reduction of both the dorsal dislocation of the carpus on the distal radius and displaced articular fracture fragment(s) in two of...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1985-07-01 00:00:00
abstract：:Twenty patients with tuberculosis of the hip joint were treated by low-friction arthroplasty (LFA) and followed for eight to ten years. Five of the patients had reactivation of the infection and subsequent failure despite the use of chemotherapy. Successful revision arthroplasties have been performed on two of the fiv...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-10-01 00:00:00
abstract：:A prospective comparative study was conducted involving 62 patients to determine the effects and limits of accelerated rehabilitation on clinical outcome. The study focused on whether aggressive rehabilitation after anterior cruciate ligament reconstruction with the doubled semitendinosus and gracilis tendon autograft...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200204000-00043
更新日期：2002-04-01 00:00:00
abstract：:Sixty consecutive revision total hip arthroplasties were performed with bulk allograft bone supported by the Kerboull reinforcement acetabular device in 53 patients from 1980 to 1987. The average age of the patients at the time of hip revision was 57.7 years. Acetabular bone loss according to the American Academy of O...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200009000-00025
更新日期：2000-09-01 00:00:00
abstract：:Distal arthrogryposes are a group of syndromes with congenital contractures primarily involving the hands and feet, which often are associated with abnormal facies, and are transmitted by autosomal dominant inheritance. Many affected individuals present in an orthopaedic setting. The features of these syndromes are de...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：2005-06-01 00:00:00
abstract：:Anterior intervertebral fusion increasingly is used as a treatment for discogenic or intersegmental pathologic diseases of the lumbar spine. This is in part attributable to the evolution and refinement of laparoscopic and minimally invasive surgical techniques that now can be used to access the anterior spinal column....
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-200002000-00007
更新日期：2000-02-01 00:00:00
abstract：:Conductive, sensorineural and mixed hearing loss occur in osteogenesis imperfecta in autosomal dominant inheritance pattern. Hearing loss is generally due to the middle and inner ear pathology of osteogenesis imperfecta and only occasionally to the coincidental association of otosclerosis and osteogenesis imperfecta. ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1981-09-01 00:00:00
abstract：:Symptomatic (Stage II) impingement of the rotator cuff against the coracoacromial arch has been treated with anterior acromioplasty in 60 shoulders in 56 patients. Patient selection is crucial. Arthrography of the shoulder was routinely included in the preoperative diagnostic tools to rule out a tear of the rotator cu...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1990-03-01 00:00:00
abstract：:A 28-year-old woman with fascioscapulohumeral muscular dystrophy was treated with a one-stage bilateral scapulothoracic fusion. At operation, cortical allografts with screw fixation for anchorage were used, supplemented with autologous cancellous bone. A proper balance and symmetry of the shoulder girdle can be restor...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1991-12-01 00:00:00
abstract：:Total hip arthroplasty (THA) or total knee arthroplasty (TKA) is indicated for patients with juvenile rheumatoid arthritis (JRA) when marked joint destruction is present and pain or deformity compromises function despite optimal medical therapy. Relief of pain, reduction of the deformity, and dramatic improvement in f...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-01-01 00:00:00
abstract：:Recent technologic advances in bone mineral densitometry have resulted in increasingly precise and accurate methods of estimating bone mineral density. Dual-photon absorptiometry has been made obsolete by the introduction of dual-energy radiography, a development that is likely to result in more widespread use of dens...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1991-10-01 00:00:00
abstract：:To address the issue of nonunion with trochanteric osteotomy, surgeons have experimented with various modes of fixation, wire and cable being the two most popular. From a group of 643 primary cemented total hip arthroplasties performed by a single surgeon via the trans-trochanteric approach, minimum four-year roentgen...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-12-01 00:00:00
