12630
2015
eng
505420
2015
article
1
2016-01-29
--
--
Calcinosis universalis - a rare case with classical presentation
Juvenile Dermatomyositis (JDM) is a rare autoimmune disease in children and adolescents. In these patients calcinosis might be the most characteristic symptom. However there are only few reported cases of intramuscular calcinosis in Dermatomyositis. We report a case of calcinosis universalis (CU) of the elbow in JDM successfully treated with broaching. The patient, a 24-year-old woman, suffered from a long history of JDM. On examination she presented with a fistula lateral to the olecranon and pain of the right elbow joint. Plain X-rays displayed a diffuse pattern of multiple periarticular, subcutaneous, and intramuscular calcifications. The patient underwent surgery for histological and microbiological sampling as well as broaching. Intraoperatively sinus formation and subfascial hard calcium deposition were found. Due to the risk of collateral tissue damage, incomplete broaching was performed. A local infection with Staphylococcus was diagnosed and treated with antibiotics. On six-week and 30-month follow-up the patient was free of pain and had very good function. Calcifications on standard radiographs had almost resolved entirely. This case report gives a summary on calcinosis in Dermatomyositis and adds a new case of recalcitrant CU to the literature. Broaching surgery proved to be a reliable treatment option in symptomatic calcinosis.
Case Reports in Orthopedics
10.1155/2015/505420
urn:nbn:de:bvb:20-opus-126300
Case Reports in Orthopedics Volume 2015, Article ID 505420, 6 pages DOI:10.1155/2015/505420
Sebastian Philipp Boelch
Thomas Barthel
Sascha Goebel
Maximilian Rudert
Piet Plumhoff
Chirurgie und verwandte medizinische Fachrichtungen
open_access
Lehrstuhl für Orthopädie
Förderzeitraum 2015
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/12630/Boelch_Case_Reports.pdf
25227
2021
eng
1
11
article
1
--
2021-12-23
--
Defining a synovial fluid white blood cell count threshold to predict periprosthetic infection after shoulder arthroplasty
Background: The diagnosis of periprosthetic shoulder infection (PSI) requires a thorough diagnostic workup. Synovial fluid aspiration has been proven to be a reliable tool in the diagnosis of joint infections of the lower extremity, but shoulder specific data is limited. This study defines a threshold for synovial fluid white blood cell count (WBC) and assesses the reliability of microbiological cultures. Methods: Retrospective study of preoperative and intraoperative fluid aspiration of 31 patients who underwent a revision of a shoulder arthroplasty (15 with PSI defined by IDSA criteria, 16 without infection). The threshold for WBC was calculated by ROC/AUC analysis. Results: WBC was significantly higher in patients with PSI than in other patients. A threshold of 2800 leucocytes/mm\(^3\) showed a sensitivity of 87% and a specificity of 88% (AUROC 0.92). Microbiological cultures showed a sensitivity of 76% and a specificity of 100%. Conclusions: A threshold of 2800 leucocytes/mm\(^3\) in synovial fluid can be recommended to predict PSI. Microbiological culture has an excellent specificity and allows for targeted antibiotic therapy. Joint aspiration presents an important pillar to diagnose PSI.
Journal of Clinical Medicine
2077-0383
10.3390/jcm11010050
urn:nbn:de:bvb:20-opus-252275
2022-01-03T15:38:38+00:00
sword
swordwue
attachment; filename=deposit.zip
624aa745abab9c2fc5a9053ea8ee42af
Journal of Clinical Medicine (2022) 11:1, 50. https://doi.org/10.3390/jcm11010050
false
true
CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International
Laura Elisa Streck
Chiara Gaal
Johannes Forster
Christian Konrads
Sebastian Philipp von Hertzberg-Boelch
Kilian Rueckl
eng
uncontrolled
upper extremity
eng
uncontrolled
joint infection
eng
uncontrolled
joint aspiration
eng
uncontrolled
leucocyte count
eng
uncontrolled
cutibacteria
eng
uncontrolled
ICM
eng
uncontrolled
MSIS
eng
uncontrolled
IDSA
eng
uncontrolled
WBC
Medizin und Gesundheit
open_access
Institut für Hygiene und Mikrobiologie
Lehrstuhl für Orthopädie
Import
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/25227/jcm-11-00050-v2.pdf
17557
2018
eng
7
13
article
1
2019-01-30
--
--
Insufficient sensitivity of joint aspiration during the two-stage exchange of the hip with spacers
Background:
Evaluation of infection persistence during the two-stage exchange of the hip is challenging. Joint aspiration before reconstruction is supposed to rule out infection persistence. Sensitivity and specificity of synovial fluid culture and synovial leucocyte count for detecting infection persistence during the two-stage exchange of the hip were evaluated.
Methods:
Ninety-two aspirations before planned joint reconstruction during the two-stage exchange with spacers of the hip were retrospectively analyzed.
Results:
The sensitivity and specificity of synovial fluid culture was 4.6 and 94.3%. The sensitivity and specificity of synovial leucocyte count at a cut-off value of 2000 cells/μl was 25.0 and 96.9%. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) values were significantly higher before prosthesis removal and reconstruction or spacer exchange (p = 0.00; p = 0.013 and p = 0.039; p = 0.002) in the infection persistence group. Receiver operating characteristic area under the curve values before prosthesis removal and reconstruction or spacer exchange for ESR were lower (0.516 and 0.635) than for CRP (0.720 and 0.671).
Conclusions:
Synovial fluid culture and leucocyte count cannot rule out infection persistence during the two-stage exchange of the hip.
Journal of Orthopedic Surgery and Research
10.1186/s13018-017-0703-z
urn:nbn:de:bvb:20-opus-175576
Journal of Orthopedic Surgery and Research (2018) 13:7. DOI: 10.1186/s13018-017-0703-z
false
true
CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International
Sebastian Philipp Boelch
Manuel Weissenberger
Frederik Spohn
Maximilian Rudert
Martin Luedemann
eng
uncontrolled
two-stage exchange
eng
uncontrolled
hip
eng
uncontrolled
periprosthetic infection
eng
uncontrolled
joint aspiration
eng
uncontrolled
spacer
Chirurgie und verwandte medizinische Fachrichtungen
open_access
Lehrstuhl für Orthopädie
Förderzeitraum 2018
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/17557/Boelch_Journal_of_Orthopaedic_Surgery_and_Research.pdf
24623
2021
eng
19
14
article
1
--
2021-09-28
--
Influence of Tranexamic Acid on Elution Characteristics and Compressive Strength of Antibiotic-Loaded PMMA-Bone Cement with Gentamicin
Purpose: The topical application of tranexamic acid (TXA) into the joint space during total joint arthroplasty (TJA) with no increase of complications, has been widely reported. We investigated the influence of TXA on antibiotic release, activity of the released antibiotic against a clinical isolate of S. aureus, and compressive strength of a widely used commercially prepared gentamicin-loaded cement brand (PALACOS R + G). Method: 12 bone cement cylinders (diameter and height = 6 and 12 mm, respectively) were molded. After curing in air for at least 1 h, six of the cylinders were completely immersed in 5 mL of fetal calf serum (FCS) and the other six were completely immersed in a solution consisting of 4.9 mL of FCS and 0.1 mL (10 mg) of TXA. Gentamicin elution tests were performed over 7 d. Four hundred µL of the gentamicin eluate were taken every 24 h for the first 7 d without renewing the immersion fluid. The gentamicin concentration was determined in a clinical analyzer using a homogeny enzyme immuno-assay. The antimicrobial activity of the eluate, obtained after day 7, was tested. An agar diffusion test regime was used with Staphylococcus aureus. Bacteria were grown in a LB medium and plated on LB agar plates to get a bacterial lawn. Fifty µL of each eluate were pipetted on 12-mm diameter filter discs, which were placed in the middle of the agar gel. After 24 h of cultivation at 37 °C, the zone of inhibition (ZOI) for each specimen was measured. The compressive strength of the cements was determined per ISO 5833. Results: At each time point in the gentamicin release test, the difference in gentamicin concentration, obtained from specimens immersed in the FCS solution only and those immersed in the FCS + TXA solution was not significant (p = 0.055–0.522). The same trend was seen in each of the following parameters, after 7 d of immersion: (1) Cumulative gentamicin concentration (p < 0.297); (2) gentamicin activity against S. aureus (strongly visible); (3) ZOI size (mostly > 20 mm) (p = 0.631); and (4) compressive strength (p = 0.262). Conclusions: For the PALACOS R + G specimens, the addition of TXA to FCS does not produce significant decreases in gentamicin concentration, in the activity of the gentamicin eluate against a clinical isolate of S. aureus, the zone of inhibition of S. aureus, and in the compressive strength of the cement, after 7 d of immersion in the test solution.
Materials
1996-1944
10.3390/ma14195639
urn:nbn:de:bvb:20-opus-246236
2021-10-01T16:50:56+00:00
sword
swordwue
attachment; filename=deposit.zip
2656e6eca38e4aaae964b98427e108a3
Materials 2021, 14(19), 5639; https://doi.org/10.3390/ma14195639
false
true
CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International
Martin Lüdemann
Axel Jakuscheit
Andrea Ewald
Leena Frühmann
Stefanie Hölscher-Doht
Maximilian Rudert
Sebastian Philipp von Hertzberg-Boelch
eng
uncontrolled
gentamicin-loaded poly (methyl methacrylate) bone cement
eng
uncontrolled
total joint arthroplasty
eng
uncontrolled
total knee arthroplasty
eng
uncontrolled
tranexamic acid
Medizin und Gesundheit
open_access
Lehrstuhl für Orthopädie
Klinik und Poliklinik für Unfall-, Hand-, Plastische und Wiederherstellungschirurgie (Chirurgische Klinik II)
Abteilung für Funktionswerkstoffe der Medizin und der Zahnheilkunde
Import
Förderzeitraum 2021
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/24623/materials-14-05639.pdf
25029
2021
eng
11
11
article
1
--
2021-11-18
--
Modifiable individual risks of perioperative blood transfusions and acute postoperative complications in total hip and knee arthroplasty
Background: The primary aim of this study was to identify modifiable patient-related predictors of blood transfusions and perioperative complications in total hip and knee arthroplasty. Individual predictor-adjusted risks can be used to define preoperative treatment thresholds. Methods: We performed this retrospective monocentric study in orthopaedic patients who underwent primary total knee or hip arthroplasty. Multivariate logistic regression models were used to assess the predictive value of patient-related characteristics. Predictor-adjusted individual risks of blood transfusions and the occurrence of any perioperative adverse event were calculated for potentially modifiable risk factors. Results: 3754 patients were included in this study. The overall blood transfusion and complication rates were 4.8% and 6.4%, respectively. Haemoglobin concentration (Hb, p < 0.001), low body mass index (BMI, p < 0.001) and estimated glomerular filtration rate (eGFR, p = 0.004) were the strongest potentially modifiable predictors of a blood transfusion. EGFR (p = 0.001) was the strongest potentially modifiable predictor of a complication. Predictor-adjusted risks of blood transfusions and acute postoperative complications were calculated for Hb and eGFR. Hb = 12.5 g/dL, BMI = 17.6 kg/m\(^2\), and eGFR = 54 min/mL were associated, respectively, with a 10% risk of a blood transfusion, eGFR = 59 mL/min was associated with a 10% risk of a complication. Conclusion: The individual risks for blood transfusions and acute postoperative complications are strongly increased in patients with a low preoperative Hb, low BMI or low eGFR. We recommend aiming at a preoperative Hb ≥ 13g/dL, an eGFR ≥ 60 mL/min and to avoid a low BMI. Future studies must show if a preoperative increase of eGFR and BMI is feasible and truly beneficial.
Journal of Personalized Medicine
2075-4426
10.3390/jpm11111223
urn:nbn:de:bvb:20-opus-250290
2021-12-02T02:05:51+00:00
sword
swordwue
attachment; filename=deposit.zip
68ff4f41f90aa966b9b0bd48c6ac38d6
Journal of Personalized Medicine (2021) 11:11, 1223. https://doi.org/10.3390/jpm11111223
false
true
CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International
Axel Jakuscheit
Nina Schaefer
Johannes Roedig
Martin Luedemann
Sebastian Philipp von Hertzberg-Boelch
Manuel Weissenberger
Karsten Schmidt
Boris Michael Holzapfel
Maximilian Rudert
eng
uncontrolled
patient blood management
eng
uncontrolled
total joint arthroplasty
eng
uncontrolled
haemoglobin
eng
uncontrolled
perioperative management
Medizin und Gesundheit
open_access
Lehrstuhl für Orthopädie
Klinik und Poliklinik für Unfall-, Hand-, Plastische und Wiederherstellungschirurgie (Chirurgische Klinik II)
Import
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/25029/jpm-11-01223.pdf
20053
2019
eng
636
20
article
1
2020-03-05
--
--
The posterior-anterior-flexed view is essential for the evaluation of valgus osteoarthritis. A prospective study on 134 valgus knees
Background
Radiographic imaging is an important tool to assess osteoarthritis (OA). Lateral compartment osteoarthritis (valgus OA) usually starts with cartilage degeneration along the posterior aspect of the lateral femoral condyle. There is evidence that the posterior-anterior (PA)-flexed view is more sensitive when diagnosing early stages of valgus OA compared to the anterior-posterior (AP) view. The current paper analyzes the value of the PA-flexed view for patients scheduled for total knee arthroplasty (TKA).
Methods
Radiographs of 134 valgus knees were assessed prior to TKA. The minimal joint space width (minJSW) was measured on AP and PA-flexed views. The extent of mechanical deformity was measured on hip to ankle standing films.
Results
49 (36.6%) AP views showed Kellgren and Lawrence (K/L)-grade 4 osteoarthritis in the lateral compartment, 82 (63.4%) showed grade 3 or less. The PA-flexed view resulted in an increased K/L-grading to grade 4 for 53 knees (62.4%) that were considered grade 3 or less on standard AP-radiographs. There was a significant differences between lateral minJSW on AP and PA-flexed view for patients with up to 10 degrees of mechanical valgus deformity (p < 0.001), as well as 11 to 15 degrees of mechanical deformity (p = 0.021). Only knees with severe deformity of more than 15 degrees did not show a difference in minJSW between PA-flexed view and AP view (p = 0.345).
Conclusions
The PA-flexed view is superior to the standard AP view in quantifying the extent of valgus OA in patients with zero to fifteen degrees of valgus deformity. It is recommended for the initial assessment of patients with valgus osteoarthritis and better documents the extent of osteoarthritis prior to TKA.
BMC Muscoskeletal Disorders
10.1186/s12891-019-3012-3
urn:nbn:de:bvb:20-opus-200536
BMC Musculoskeletal Disorders 20, 636 (2019). https://doi.org/10.1186/s12891-019-3012-3
CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International
Kilian Rueckl
Armin Runer
Ulrich Bechler
Martin Faschingbauer
Sebastian Philipp Boelch
Peter Keyes Sculco
Friedrich Boettner
eng
uncontrolled
Valgus osteoarthritis
eng
uncontrolled
Knee
eng
uncontrolled
PA-flexed view
eng
uncontrolled
View
eng
uncontrolled
Radiographs
Medizin und Gesundheit
open_access
Lehrstuhl für Orthopädie
Förderzeitraum 2019
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/20053/Rueckel_BMC_MuscoskeletalDiseases2019.pdf
23651
2021
eng
4
11
article
1
--
2021-04-08
--
Custom Made Monoflange Acetabular Components for the Treatment of Paprosky Type III Defects
Purpose: Patient-specific, flanged acetabular components are used for the treatment of Paprosky type III defects during revision total hip arthroplasty (THA). This monocentric retrospective cohort study analyzes the outcome of patients treated with custom made monoflanged acetabular components (CMACs) with intra- and extramedullary iliac fixation. Methods: 14 patients were included who underwent revision THA with CMACs for the treatment of Paprosky type III defects. Mechanism of THA failure was infection in 4 and aseptic loosening in 10 patients. Seven patients underwent no previous revision, the other seven patients underwent three or more previous revisions. Results: At a mean follow-up of 35.4 months (14–94), the revision rate of the implant was 28.3%. Additionally, one perioperative dislocation and one superficial wound infection occurred. At one year postoperatively, we found a significant improvement of the Western Ontario and McMaster Universities Arthritis Index (WOMAC) score (p = 0.015). Postoperative radiographic analysis revealed good hip joint reconstruction with a mean leg length discrepancy of 3 mm (−8–20), a mean lateralization of the horizontal hip center of rotation of 8 mm (−8–35), and a mean proximalization of the vertical hip center of rotation of 6 mm (13–26). Radiolucency lines were present in 30%. Conclusion: CMACs can be considered an option for the treatment of acetabular bone loss in revision THA. Iliac intra- and extramedullary fixation allows soft tissue-adjusted hip joint reconstruction and improves hip function. However, failure rates are high, with periprosthetic infection being the main threat to successful outcome.
Journal of Personalized Medicine
2075-4426
10.3390/jpm11040283
urn:nbn:de:bvb:20-opus-236513
2021-05-03T10:37:43+00:00
sword
swordwue
attachment; filename=deposit.zip
a0e964376d4f6cf198962274d41c5412
Journal of Personalized Medicine 2021, 11(4), 283; https://doi.org/10.3390/jpm11040283
false
true
CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International
Sebastian Philipp von Hertzberg-Boelch
Mike Wagenbrenner
Jörg Arnholdt
Stephan Frenzel
Boris Michael Holzapfel
Maximilian Rudert
eng
uncontrolled
patient specific implant
eng
uncontrolled
custom made implant
eng
uncontrolled
revision hip
eng
uncontrolled
Paprosky
eng
uncontrolled
pelvic discontinuity
Medizin und Gesundheit
open_access
Lehrstuhl für Orthopädie
Import
Förderzeitraum 2021
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/23651/jpm-11-00283.pdf
30079
2022
eng
23
article
1
--
--
--
The role of synovial fluid aspiration in shoulder joint infections
Background
Joint aspiration with analysis of synovial fluid white blood cell count (WBC) and microbiological culture is a widely established aspect in the diagnosis of shoulder joint infections (SJI). In case of a two stage revision for SJI, joint aspiration before re−/implantation of a total shoulder arthroplasty (TSA) was used to rule out persistent infection for years but its value is under debate. Shoulder specific data on all aspects is rare. The current study aims to answer the following research questions: Does joint aspiration have an insufficient predictive value in the diagnosis of SJI in (1) initial workup and (2) before definite arthroplasty with polymethylmethacrylate (PMMA)-Spacer in place?
Methods
This retrospective evaluation investigates 35 patients that were treated for SJI with a two staged implantation of a TSA after debridement and implantation of an PMMA-Spacer. Joint aspirations were performed preoperatively (PA) and before re−/implantation of the prosthesis while spacer was in place (interstage aspiration, IA). Samples were taken for microbiological culture and analysis of WBC. Sensitivity and specificity were calculated with reference to intraoperative microbiological samples. Receiver Operating Characteristic (ROC), Area-Under-Curve analysis (AUC) and calculation of the Youden index were performed to find optimum cut-off for WBC.
Results
The sensitivity of microbiological cultures from PA was 58.3% and the specificity was 88.9%. The mean WBC was 27,800 leucocytes/mm3 (range 400-96,300). The maximum Youden index (0.857) was a cut-off of 2600 leucocytes/mm3 with a sensitivity of 85.7% and a specificity of 100.0%. The sensitivity and specificity of IA were 0.0% and 88.5%, respectively.
Conclusions
Preoperative aspiration is likely to miss Cutibacteria spp. and CoNS and cannot rule out infection for sure. However, we recommend it for its advantages of targeted antibiotic therapy in case of germ identification. Empiric antibiotic therapy should cover Cutibacteria and CoNS even if aspiration showed negative microbiological cultures. In contrast, the diagnostic value of interstage aspiration does not qualify for its routine use.
BMC Musculoskeletal Disorders
10.1186/s12891-022-05285-x
urn:nbn:de:bvb:20-opus-300795
@articleStreck.2022, author = Streck, Laura Elisa and Forster, Johannes and von Hertzberg-Boelch, Sebastian Philipp and Reichel, Thomas and Rudert, Maximilian and Rueckl, Kilian, year = 2022, title = The role of synovial fluid aspiration in shoulder joint infections, pages = 390, volume = 23, number = 1, journal = BMC musculoskeletal disorders, doi = 10.1186/s12891-022-05285-x,
md5:b7e9e5d3d7aeaccab1c6ca8c339d6223
2023-01-23T07:16:37+00:00
/tmp/phpNw3NlL
bibtex
63ce3455546207.97235445
BMC Musculoskeletal Disorders (2022) 23:390. doi:10.1186/s12891-022-05285-x
false
true
CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International
Laura Elisa Streck
Johannes Forster
Sebastian Philipp von Hertzberg-Boelch
Thomas Reichel
Maximilian Rudert
Kilian Rueckl
eng
uncontrolled
revision arthroplasty
eng
uncontrolled
periprosthetic joint infection
eng
uncontrolled
white blood cell count
eng
uncontrolled
septic
eng
uncontrolled
microbiological culture
eng
uncontrolled
interstage aspiration
Medizin und Gesundheit
open_access
Institut für Hygiene und Mikrobiologie
Lehrstuhl für Orthopädie
Förderzeitraum 2022
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/30079/s12891-022-05285-x.pdf
23062
2020
eng
959-963
4
article
1
2021-03-11
--
--
Infection control and outcome of staged reverse shoulder arthroplasty for the management of shoulder infections
Background
The treatment of septic arthritis, caused by either hematogenous seeding, injections, or surgery, can be challenging. Staged reverse shoulder arthroplasty (RSA) with temporary implantation of an antibiotic-loaded spacer is widely accepted but still discussed controversially. This study investigated the shoulder-specific bacterial spectrum, infection control rate, functional outcome, and infection-free survival rate after staged RSA in the mid- to long-term follow-up. It was hypothesized that staged RSA would show a high infection-free survival rate.
Methods
A total of 39 patients treated with staged RSA for primary septic arthritis (n = 8), secondary infection (n = 8), or periprosthetic infection (n = 23) were retrospectively included. The infection control rate was calculated based on cultures taken intraoperatively at spacer removal and RSA implantation. Infection-free survival was defined as no revision due to infection. The minimum follow-up period for functional outcome assessment was 2 years (n = 14; mean, 76 months; range, 31-128 months).
Results
Cutibacterium (26%) and coagulase-negative staphylococci (23%) were the predominant pathogens. The infection control rate was 90%. The cumulative infection-free survival rate was 91% after 128 months. Follow-up examinations showed a mean Constant score of 48 (range, 7-85), a mean QuickDASH (short version of Disabilities of the Arm, Shoulder and Hand questionnaire) score of 40.0 (range, 11.4-93.3), and a mean pain score of 1.6 (range, 0-7).
Conclusion
Staged RSA implantation was confirmed to be a reliable treatment option for primary, secondary, and periprosthetic infections of the shoulder. The infection control rate and infection-free survival rate are satisfactory. However, patients and surgeons must be aware of functional impairment even after successful treatment of infections.
JSES International
10.1016/j.jseint.2020.08.012
urn:nbn:de:bvb:20-opus-230620
publish
JSES International 4 (2020) 959-963. https://doi.org/10.1016/j.jseint.2020.08.012
true
true
CC BY-NC-ND: Creative-Commons-Lizenz: Namensnennung, Nicht kommerziell, Keine Bearbeitungen 4.0 International
Sebastian Philipp Boelch
Laura Elisa Streck
Piet Plumhoff
Christian Konrads
Frank Gohlke
Kilian Rueckl
eng
uncontrolled
shoulder infection
eng
uncontrolled
periprosthetic infection
eng
uncontrolled
two stage
eng
uncontrolled
spacer
eng
uncontrolled
reerse shoulder arthoplasty
eng
uncontrolled
shoulder arthroplasty
eng
uncontrolled
outcome
Medizin und Gesundheit
open_access
Lehrstuhl für Orthopädie
Förderzeitraum 2020
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/23062/10.1016.j.jseint.2020.08.012.pdf
26576
2021
eng
2021
article
1
2022-04-05
--
--
Diagnosis of chronic infection at total hip arthroplasty revision is a question of definition
Purpose. Contradicting definitions of periprosthetic joint infection (PJI) are in use. Joint aspiration is performed before total hip arthroplasty (THA) revision. This study investigated the influence of PJI definition on PJI prevalence at THA revision. Test quality of prerevision aspiration was evaluated for the different PJI definitions. Methods. 256 THA revisions were retrospectively classified to be infected or not infected. Classification was performed according to the 4 different definitions proposed by the Musculoskeletal Infection Society (MSIS), the Infectious Diseases Society of America (IDSA), the International Consensus Meeting (ICM), and the European Bone and Joint Infection Society (EBJIS). Only chronic PJIs were included. Results. PJI prevalence at revision significantly correlated with the applied PJI definition (p=0.01, Cramer's V=0.093). PJI prevalence was 20.7% for the MSIS, 25.4% for the ICM, 28.1% for the IDSA, and 32.0% for the EBJIS definition. For synovial fluid white blood cell count, the best ROC-AUC for predicting PJI was 0.953 in combination with the MSIS definition. Conclusion. PJI definition significantly influences the rate of diagnosed PJIs at THA revision. Synovial fluid white blood cell count is a reliable means to rule out PJI. In cases with a borderline high synovial white blood cell count before THA revision as the only sign of chronic PJI, an extended diagnostic work-up should be considered.
Biomed Research International
10.1155/2021/8442435
urn:nbn:de:bvb:20-opus-265762
publish
Biomed Research International (2021) 2021:8442435. https://doi.org/10.1155/2021/8442435
false
true
CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International
Sebastian Philipp Boelch
Kilian Rüeckl
Laura Elisa Streck
Viktoria Szewczykowski
Manuel Weißenberger
Axel Jakuscheit
Maximilian Rudert
eng
uncontrolled
periprosthetic joint infection
eng
uncontrolled
algorithm
eng
uncontrolled
consensus
Chirurgie und verwandte medizinische Fachrichtungen
open_access
Lehrstuhl für Orthopädie
Förderzeitraum 2021
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/26576/8442435.pdf
28170
2022
eng
8
10
article
1
--
2022-07-29
--
PMMA bone cement: antibiotic elution and mechanical properties in the context of clinical use
This literature review discusses the use of antibiotic loaded polymethylmethacrylate bone cements in arthroplasty. The clinically relevant differences that have to be considered when antibiotic loaded bone cements (ALBC) are used either for long-term implant fixation or as spacers for the treatment of periprosthetic joint infections are outlined. In this context, in vitro findings for antibiotic elution and material properties are summarized and transferred to clinical use.
Biomedicines
2227-9059
10.3390/biomedicines10081830
urn:nbn:de:bvb:20-opus-281708
2022-08-03T11:34:38+00:00
sword
swordwue
attachment; filename=deposit.zip
e30c0b077a1bbe6ab146fa1ff6c697b4
Biomedicines (2022) 10:8, 1830. doi:10.3390/biomedicines10081830
CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International
Sebastian Philipp von Hertzberg-Boelch
Martin Luedemann
Maximilian Rudert
Andre F. Steinert
eng
uncontrolled
spacer
eng
uncontrolled
bone cement
eng
uncontrolled
PMMA
eng
uncontrolled
polymethylmethacrylate
eng
uncontrolled
periprosthetic infection
eng
uncontrolled
antibiotic elution
Chirurgie und verwandte medizinische Fachrichtungen
open_access
Lehrstuhl für Orthopädie
Import
Förderzeitraum 2022
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/28170/biomedicines-10-01830.pdf