Abstract:
BACKGROUND:Debridement and irrigation with prosthetic retention followed by antibiotic therapy (DAIR) is one of the treatments of choice in acute infections after a total knee arthroplasty. However, the success rate varies widely in the literature, depending on several factors such as comorbidities of the patient, duration of infection, and microorganisms involved. The goal of this study was to assess the outcomes of this therapeutic option and to identify possible predictors of the result. METHODS:We retrospectively reviewed cases of acute postoperative (≤ 3 months from index procedure) and acute hematogenous periprosthetic knee infections treated with DAIR at our hospital between 2004 and 2016. Overall, 26 knees were included, with a mean age of 73.4 years. Several variables related to patient characteristics, infection type, and surgery were examined to evaluate their influence on outcome, and functional and radiographic outcome were assessed. The mean follow-up was 41 months. A descriptive analysis was carried out on the collected data, and a univariate analysis was performed with the objective of searching for influential factors in the resolution of the infection using the chi-square nonparametric test in the case of the categorical variables and the Wilcoxon test for the continuous ones. Moreover, univariate cox regression analysis was performed. RESULTS:The overall success rate was 77% at the last follow-up, recording a significantly greater cure in acute infections (93% acute vs 58% acute hematogenous, p = 0.03). The infections in which the Staphylococcus aureus was isolated had a significantly lower cure rate, with only 33% of success, compared to 82% of the non-aureus microorganisms (p < 0.05). CONCLUSIONS:The present study shows a considerable cure rate in the treatment of acute knee infections through DAIR, although patient comorbidities, type of infection, and causative microorganism should be considered for decision-making.
journal_name
J Orthop Surg Resjournal_title
Journal of orthopaedic surgery and researchauthors
Iza K,Foruria X,Moreta J,Uriarte I,Loroño A,Aguirre U,de Los Mozos JLMdoi
10.1186/s13018-019-1324-5subject
Has Abstractpub_date
2019-08-28 00:00:00pages
278issue
1issn
1749-799Xpii
10.1186/s13018-019-1324-5journal_volume
14pub_type
杂志文章abstract:BACKGROUND:The incidence of intertrochanteric hip fracture is expected to increase as the global population ages. It is one of the most important causes of mortality and morbidities in the geriatric population. The incidence of reverse oblique and transverse intertrochanteric (AO/OTA 31-A3) fractures is relatively low;...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-019-1414-4
更新日期:2019-11-08 00:00:00
abstract:BACKGROUND:Mesenchymal stem cells (MSCs) have great potential for the repair and regeneration of bone fracture, but their optimal origins remain controversial. METHODS:Bone marrow-MSCs (BM-MSCs) and bone-bone marrow-MSCs (B-BM-MSCs) were isolated from 12 SD rats, and the morphology, MSC-associated markers, and prolife...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-019-1346-z
更新日期:2019-09-03 00:00:00
abstract:BACKGROUND:The shape of the patella has been considered to be a predisposing factor resulting in patellar instability, but the effects of abnormal patella position during its development are unclear. The present study evaluated patellar morphological changes after patella instability and evaluated the influence of pate...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-017-0615-y
更新日期:2017-07-11 00:00:00
abstract:INTRODUCTION:The OTA/AO type 31 A3 intertrochanteric fracture has a transverse or reverse oblique fracture at the lesser trochanteric level, which accentuates the varus compressive stress in the region of the fracture and the implant. Intramedullary fixation using different types of nails is commonly preferred. The pur...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-019-1431-3
更新日期:2019-11-12 00:00:00
abstract:BACKGROUND:The use of cephalo-medullary nails (CMN) is a widely accepted management option for the treatment of unstable per-trochanteric hip fractures. A growing body of literature has reported good functional and radiological outcomes in patients managed with a dynamic hip screw supplemented with a trochanteric stabi...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章,评审
doi:10.1186/s13018-020-02193-5
更新日期:2021-01-11 00:00:00
abstract:SUMMARY:Proximal humerus fractures (PHF) are common injuries, but previous studies have documented poor inter-observer reliability in fracture classification. This disparity has been attributed to multiple variables including poor imaging studies and inadequate surgeon experience. The purpose of this study is to evalua...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/1749-799X-6-38
更新日期:2011-07-29 00:00:00
abstract:BACKGROUND:Achilles sleeve avulsion usually occurs from pre-existing insertional Achilles tendinopathy, leaving a calcific spur at the insertional site. The purpose of this study was to introduce a new technique using the spur base on the insertional site to drill the suture tunnel to repair Achilles sleeve avulsion. ...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-020-01699-2
更新日期:2020-06-17 00:00:00
abstract:BACKGROUND:Transpedicular screws may cause damage to the cartilage in the neural arch of the vertebra, and give continuous pressure to the skeleton besides the vertebral body. The aim of this study is to examine the morphological change of the vertebral body at fixation sites and development of the vertebral body after...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-015-0302-9
更新日期:2016-01-13 00:00:00
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journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-015-0232-6
更新日期:2015-06-03 00:00:00
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journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-018-0857-3
更新日期:2018-06-18 00:00:00
abstract:BACKGROUND:Dynamic spine implants were developed to prevent adjacent segment degeneration (ASD) and adjacent segment disease (ASDi). Purpose of this study was to investigate the clinical and radiological outcomes of "topping off" devices following lumbar spinal fusion procedure using a PEEK-based dynamic rod system. Mo...
journal_title:Journal of orthopaedic surgery and research
pub_type: 临床试验,杂志文章
doi:10.1186/s13018-018-0905-z
更新日期:2018-08-09 00:00:00
abstract:: The treatment of an above knee amputee who has sustained a fracture of femoral neck is a challenge for both the orthopaedic surgeon and the rehabilitation team. We present a case of such a patient and discuss different difficulties in his treatment. ...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/1749-799X-4-30
更新日期:2009-07-31 00:00:00
abstract:BACKGROUND:A high percentage of closed femur fractures have slight comminution. Using micro-CT (μCT), multiple fragment segmentation is much more difficult than segmentation of unfractured or osteotomied bone. Manual or semi-automated segmentation has been performed to date. However, such segmentation is extremely labo...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-017-0609-9
更新日期:2017-07-11 00:00:00
abstract:BACKGROUND:The scarf osteotomy is a well-established surgical method for correcting a hallux valgus deformity. It is often combined with an Akin osteotomy. However, clear guidelines defining indication criteria are missing. The purpose of this study was to analyze the radiological outcome after scarf osteotomy in depen...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-019-1241-7
更新日期:2019-06-26 00:00:00
abstract:BACKGROUND:The study aims to compare the long-term functional and radiographic outcomes of two devices for the treatment of primary intertrochanteric fractures (IFs, OTA 3.1A2.1-A2.3) in elderly patients with osteoporosis. METHODS:Between December 2010 and August 2014, 332 elderly osteoporosis patients with IFs (OTA 3...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-017-0648-2
更新日期:2017-10-10 00:00:00
abstract:BACKGROUND:Scoliosis causes thoracic deformities, and it is necessary to assess these changes in pulmonary function test (PFT). To determine how measurements of spinal and thoracic cage deformities are related to pulmonary function. METHODS:Seventy-two patients with main right thoracic curvature in adolescent idiopath...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-019-1451-z
更新日期:2019-12-16 00:00:00
abstract:INTRODUCTION:The clinical outcome of hemiarthroplasty for proximal humeral fractures is not satisfactory. Secondary fragment dislocation may prevent bone integration; the primary stability by a fixation technique is therefore needed to accomplish tuberosity healing. Present technical comparison of surgical fixation tec...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章,评审
doi:10.1186/1749-799X-6-36
更新日期:2011-07-18 00:00:00
abstract:PURPOSE:To compare the time return to work and long-term results of tendoscopic versus open technique for de Quervain's disease. METHODS:From 2005 to 2013, either tendoscopic or open decompression was performed on 56 consecutive patients (56 wrists) with symptomatic de Quervain's disease despite a minimum of 3 months ...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-019-1393-5
更新日期:2019-11-12 00:00:00
abstract:BACKGROUND:High tibial osteotomy (HTO) is a common treatment for moderate osteoarthritis of the medial compartment in the knee joint by the translation of the force center toward the lateral compartment. However, the stability of a short plate such as Puddu used in this procedure was not as effective as other long plat...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-019-1269-8
更新日期:2019-07-16 00:00:00
abstract:BACKGROUND:Using a larger, more comprehensive sample, and inclusion of the reverse shoulder arthroplasty as a primary surgical approach for proximal humerus fracture, we report on geographic variation in the treatment of proximal humerus fracture in 2011 and comment on whether treatment consensus is being reached. MET...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-018-1052-2
更新日期:2019-01-21 00:00:00
abstract:BACKGROUND:The medial collateral ligament (MCL) is the main static stabilizer of the medial knee. The surgical treatment was recommended in cases with serious medial collateral ligament insufficiency combined with multi-ligament injuries and chronic symptomatic medial instability. Several surgical techniques have been ...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-016-0416-8
更新日期:2016-07-22 00:00:00
abstract:BACKGROUND:The zero-profile anchored cage (ZP) has been widely used for its lower occurrence of dysphagia. However, it is still controversial whether it has the same stability as the cage-plate construct (CP) and increases the incidence of postoperative subsidence. We compared the rate of subsidence after anterior cerv...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-020-01711-9
更新日期:2020-05-24 00:00:00
abstract:BACKGROUND:Intertrochanteric fracture (ITF) is increasing with the rapid increase in the aging population, often causes a high mortality rate in old patients and increases the economic burden of the family and society. ERAS (Enhanced Recovery after Surgery) is a powerful guarantee for patients to accelerate their recov...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章,随机对照试验
doi:10.1186/s13018-020-01586-w
更新日期:2020-03-05 00:00:00
abstract:BACKGROUND:Numerous quantitatively based studies measuring the association between gout and the risk of fractures remain inconclusive. In order to determine whether gout could increase the risk of fractures, a meta-analysis was performed systematically. METHODS:Electronic databases, MEDLINE/PubMed, Embase, and Cochran...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章,meta分析,评审
doi:10.1186/s13018-019-1317-4
更新日期:2019-08-27 00:00:00
abstract:OBJECTIVES:The aim of this study was to evaluate the efficacy of local infiltration anaesthesia (LIA) during primary total hip arthroplasty (THA) via a posterolateral approach under general anaesthesia and to compare the efficacy of LIA in all layers with LIA in the deep and superficial fascia. PATIENTS AND METHODS:On...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-020-02182-8
更新日期:2021-01-22 00:00:00
abstract:BACKGROUND:A lateral approach with open reduction and internal fixation with a plate is a very effective technique for the majority of distal fibular fractures. However, this open approach for ankle fixation may be complicated by wound dehiscence and infection, especially in high-risk patients. An alternative to platin...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-016-0435-5
更新日期:2016-09-15 00:00:00
abstract:BACKGROUND:Microfracture and scaffold application in the treatment of osteochondral defects is still one of the most frequently used methods in the clinic. The most important step in this treatment method is the stabilization of fibrin clot. Tranexamic acid (TA) is an antifibrinolytic agent commonly used in orthopedic ...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-019-1144-7
更新日期:2019-04-15 00:00:00
abstract:BACKGROUND:The aim of this study was to analyze and compare the surgical data, clinical outcomes, and complications between three-column osteotomy (3-COS) and standard surgical management (SSM) for the treatment of adult spine deformity (ASD). METHODS:A total of 112 patients who underwent consecutive 3-COS (n = 48) an...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-015-0154-3
更新日期:2015-02-03 00:00:00
abstract:BACKGROUND:The aim of this research is to analyze the influence of Modic types on the clinical results of cervical spondylotic myelopathy treated by anterior cervical diskectomy and fusion. METHODS:A total of 106 patients with a mean age of 55.8 ± 6.5 years were included in this study. Patients with Modic changes were...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-014-0146-8
更新日期:2015-01-28 00:00:00
abstract:BACKGROUND:We evaluated the effects on arteriovenous fistula (AVF) function and clinical outcomes in patients given cast fixation, external skeletal fixation [ESF], or volar locking plate fixation [VLPF] for an ipsilateral distal radial fracture (DRF). METHODS:Thirteen patients were assigned to the surgery group or th...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-019-1171-4
更新日期:2019-05-22 00:00:00