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Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_12 | Pages 59 - 59
1 Oct 2019
BACTERIOPHAGE-DERIVED LYSIN COMBINATION WITH VANCOMYCIN DEMONSTRATES SUPERIOR ANTIMICROBIAL POTENTIAL IN MURINE DAIR MODEL OF PERIPROSTHETIC JOINT INFECTION (PJI)
Sosa B Niu Y Turajane K Staats K Suhardi V Carli A Fischetti V Bostrom MPG Yang X
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Introduction

PJI is a devastating complication following total joint arthroplasty. In this study, we explore the efficacy of a bacteriophage-derived lysin, PlySs2, against in-vitro biofilm on titanium implant surfaces and in an acute in-vivo murine debridement antibiotic implant retention (DAIR) model of PJI.

Methods

In-vitro: Xen 36 S. aureus biofilm was grown on Ti-6Al-4V mouse tibial implants for 1 day or 5 days and subsequently exposed to growth media, 1000× minimal inhibitory concentration (MIC) Vancomycin, or 5× MIC PlySs2. Implants were sonicated and analyzed for Colony Forming Units (CFU).

In-vivo: A Ti-6Al-4V implant was inserted into the proximal tibia of C57BL/6J mice (n=21). All mice received 104 CFU inoculation of Xen 36 S. aureus to the knee joint capsule and the infection was permitted 5 days to progress. On day 5 the mice were separated into three groups (n=7/group): (1) no further surgical intervention (control group), (2) irrigation and debridement (I&D) with saline, (3) I&D with 2mg/mL PlySs2. No implant-exchange was performed to mimic a debridement, antibiotic, and implant retention (DAIR) therapeutic strategy. All mice were sacrificed at day 10.

Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_9 | Pages 20 - 20
1 May 2018
PELVIC POSITIONING IS MORE RELIABLE IN THE SUPINE POSITION, LEADING TO MORE CONSISTENT CUP ORIENTATION AFTER TOTAL HIP ARTHROPLASTY
Grammatopoulos G Gofton W Cochran M Dobransky J Carli A Abdelbary H Gill H Beaulé P
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Introduction

The resultant cup orientation depends upon the orientation of the pelvis at impaction. No studies to date have assessed whether patient-position during total hip arthroplasty (THA) has an effect on cup orientation. This study aims to 1) Determine the difference in pelvic position that occurs between surgery and radiographic, supine, post-operative assessment; 2) Examine how the difference in pelvic position influences subsequent cup orientation and 3) Establish whether pelvic orientation, and thereafter cup orientation, differences exist between THAs performed in the supine versus the lateral decubitus positions.

Patients/Materials & Methods

This is a retrospective, multi-surgeon, single-centre, consecutive series. 321 THAs who had intra-operative, post-cup impaction, AP pelvic radiograph, in the operative position were included; 167 were performed with the patient supine (anterior approach), whilst 154 were performed in the lateral decubitus (posterior approach). Cup inclination/anteversion was measured from intra- and post-operative radiographs and the difference (Δ) was determined. Change in pelvic position (tilt, rotation, obliquity) between surgery and post-operatively was calculated from Δinclination/anteversion using the Levenberg-Marquardt algorithm.