Articles | Volume 6, issue 9
https://doi.org/10.5194/jbji-6-393-2021
© Author(s) 2021. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
https://doi.org/10.5194/jbji-6-393-2021
© Author(s) 2021. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
Value of ultrasound-guided aspiration of hip arthroplasties performed in an orthopedic clinic by orthopedic surgeons
Holly Duck
CORRESPONDING AUTHOR
Department of Orthopedic Surgery, Mayo Clinic, Rochester MN, USA
Suzanne Tanner
Department of Orthopedic Surgery, Mayo Clinic, Rochester MN, USA
Debra Zillmer
Department of Orthopedic Surgery, Mayo Clinic, Rochester MN, USA
Douglas Osmon
Department of Infectious Diseases, Mayo Clinic, Rochester MN, USA
Kevin Perry
Department of Orthopedic Surgery, Mayo Clinic, Rochester MN, USA
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Patients with bone and joint infections are often sent home before all test results are final. We created a new team-based process to review these results after discharge and take action if needed. In over one-third of cases, changes to treatment were made, some of which prevented serious harm. This approach improves patient safety and shows how teamwork and follow-up after hospital stays can make a meaningful difference in care.
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In a multicenter retrospective study of musculoskeletal Nocardia infections (2011–2022), nine cases were identified. Disseminated disease occurred in 33 %, all in solid organ transplant recipients. Surgical intervention was common (89 %), with varied treatment duration (21–467 d). The 1-year mortality was 22%; all fatal cases involved disseminated disease. Localized infection generally had favorable outcomes compared to disseminated disease and requires a collaborative approach for management.
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This retrospective case-matched study evaluated males and females with staphylococcal PJI (periprosthetic joint infection) treated with two-stage exchange arthroplasty. We matched 156 males and females for age, type of staphylococcal infection, and joint involved. We compared clinical parameters related to presentation, treatment, and outcome. We did not find a statistically significant difference in outcome between males and females treated with the same surgical approach at our institution.
Christin A. Tiegs-Heiden, Tanner C. Anderson, Mark S. Collins, Matthew P. Johnson, Douglas R. Osmon, and Doris E. Wenger
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Magnetic resonance imaging (MRI) is an imaging test that is often used in patients with a suspected bone infection in their foot. MRI findings may impact how these patients are treated; thus, it is important to understand the significance of various MRI findings. This study compared different patterns of MRI findings in these patients to their clinical outcomes. Patients with classic features of bone infection on MRI had the worst outcomes, whereas patients without them sometimes healed.
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Tenosynovitis due to Histoplasma capsulatum in an immunocompromised host warrants special attention. Following surgical debridement, the patient initially improved on antifungal therapy, but as immunosuppression was decreased, she presented with a flare, requiring further debridement. With negative fungal cultures and declining antigenemia, it was felt that her interim worsening was as a consequence of immune reconstitution inflammatory syndrome (IRIS).
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Antibiotics are frequently used in bone cement during joint replacements or treatment of bone and joint infections. Amikacin is rarely used in bone cement, particularly the liquid formulation. We describe a series of patients in which liquid amikacin was incorporated into bone cement. We did not observe the occurrence of adverse drug reactions definitively attributed to its use. All patients had favorable outcomes.
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Short summary
This paper describes an ultrasound guided technique for aspiration of hip arthroplasties that has not been published. We believe this technique is important because it yields useful fluid 99 % of the time with low contamination rate (2 %). Ultrasound, although common in Europe, is gaining popularity in the United States. Besides teaching a useful technique, this paper also discusses findings of lavage-obtained samples which are rarely discussed in other aspiration papers.
This paper describes an ultrasound guided technique for aspiration of hip arthroplasties that...