Method

Commercially available knotted monofilament PPE mesh¹ was cut into 10mm circular shape, immersed in tryptic soy broth (TSB) with methicillin-sensitive staphylococcus aureus and cultured individually in 48-well plates for 10 days to elucidate the biofilm grown on mesh over time. At every 24 hours, a triplicate of samples was retrieved and biofilm on the mesh was dislodged by sonicating at 52 kHz for 15 minutes and quantified by counting colony-forming units (CFUs) after overnight growth. The biofilm growth was also verified using scanning electron microscopy.

The effect of saline and antiseptic solutions was verified by exposing 1) 0.05% chlorohexidine gluconate², 2) acetic acid-based mixture³, 3) diluted povidone-iodine (0.35%), 4) undiluted povidone-iodine (10%)⁴, and 5) 1:1 combination of 10% povidone-iodine & 3% hydrogen peroxide on immature and mature biofilms for 3 minutes, created by culturing with bacteria for 24 hours and 72 hours respectively. All experiments were performed in quintuples and repeated. Antiseptic treatments that produced a three-log reduction in CFU counts compared to controls were considered clinically significant.

Methods

Acellularized tibialis allograft tendons were used. Tendons were randomly reseeded with ACL-derived cells or ADMSCs. ACL-derived cells were harvested and isolated from remnants of ruptured ACLs during reconstruction surgery and cultured at passage three. Cell suspensions (200 µl) containing 2 × 10⁶ ACL-derived cells or ADMSCs were prepared for the purpose of reseeding. At days 1, 3, and 7 post-reseeding, graft composites were assessed for repopulation with histological and immunohistochemical analysis. Matrix protein contents and gene expression levels were analyzed.

Methods

Using a retrospective database of all primary TKA performed at a single institution between January, 1 2014 and July 1, 2018, we identified 18 cases of acute PJI after primary TKA, as defined by the Musculoskeletal Infection Society 2011 guidelines as less than 3 months from symptoms or index surgery to presentation. The use of antibiotic bone cement during the index procedure and time to surgical management of the infection were recorded. Fluid cultures and tissue cultures were obtained intraoperatively at the time of revision. The organisms from positive cultures underwent MIC testing to gentamicin, tobramycin and vancomycin using a gradient diffusion method (ETEST). MIC breakpoints for susceptibility were based on Clinical and Laboratory Standards Institute definitions.

Materials and methods

Five Titanium alloy (Ti-6Al-4V) ball mimicking femoral head was manufactured and was coted using plasma electrolytic oxidation. Wear rate was tested using validated wear tester with 10N compression force at 80rpm. The amount of wear was detected by measuring change of weight after wear test was completed. This was compared with femoral head manufactured with titanium alloy without PEO coating. Toxicity of the debris was also tested using MTT assay with human osteoblast cell line.

Material and method

Custom made cup model was developed which enables change in anteversion and inclination. Simple radiograph was taken with the cup in 10° to 70° degree of inclination at 10° increments and for each inclination angle, anteversion was corrected from 0° to 30° at 5° increments. The radiograph was taken with the beam directed at the center of the cup (mimicking hip centered anteroposterior radiograph) and at 9cm medial to the cup (mimicking pelvis anteroposterior radiograph). The measurements were done by two orthopaedic surgeons using methods described by 1) Pradhan et al, 2) Lewinak et al, 3) Widmer et al, and 4) Liaw et al. For each measurements, the anteversion were compared with the actual anteversion.