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.

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.

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).

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.