High-dose antibiotic-loaded acrylic cement (ALAC) is used for managing periprosthetic joint infections (PJIs). The marked increase in resistant high-virulence bacteria is drawing the attention of physicians towards alternative antimicrobial formulations to the routinely used antibiotics. To date, few studies simultaneously investigated the elution properties of a broad range of antibiotics. The aim of thepresent All the ALAC samples showed a burst release of antibiotics in the first hour, progressively decreasing overtime, and elution curves strictly adhered to a non-linear regression analysis formula. Among aminoglycosides, commonly addressed as the most appropriate antibiotics to be loaded into the bone cement, the highest elution rate was that of tobramycin. Among the glycopeptides, commonly used to treat PJIs because of the prevalence of aminoglycoside resistance, vancomycin showed better elution in comparison with teicoplanin. Clindamycin, that can be associated with aminoglycosides to prepare ALACsshowed the highest absolute and relative elutions among all the tested formulations. A noticeable elution was also detected for colistin, an antibiotic of last resort for treating multi-drug resistant bacteria. The current study demonstrates theoretical advantages in the preparation of ALAC for some antibiotics notroutinely used in the clinical setting for PJIs. The use of these antibiotics based on the infecting bacteria sensitivity may represent an useful option for physicians to eradicate PJIs.
The technique we described consists in the identification and reconstruction of the medial part of calcar that becomes “the thread conductor” for restoration of the height and the retrotorsion of the humeral head.
We propose this technique with it of a biological support, the fractured humeral head, adequately modeled, in order to give again the just tension to the cuff
There were six proximal, seven bifocal interesting the third proximal and shaft and eleven diaphyseal humeral fractures fracture.
All fractures but one healed; in one case, 80 days after the operation, we had a deep infection treated with a self-customed cement spacer.
The authors describe a surgical technique with a modular prosthesis that permits an anatomical reconstruction of the proximal humerus from the calcar-side, that becomes the point reference of reconstruction with the “Puzzle-Pieces” technique.
The technique we described consists in the identification and reconstruction of the medial part of calcar that becomes “the thread conductor” for restoration of the height and the retrotorsion of the humeral head.
The goal of this technique is to restore normal anatomy of proximal humerus around a bone bridge inside the head and the metaphysis.
The Authors report the goal of this technique is to restore normal anatomy of proximal humerus around a triangle-shaped bone block positioned inside between the head and the metaphyseal. The fragments are then stabilized with a minimal osteosynthesis by K- wires, screws or bone sutures. The results of our study show that the technique we propose has good clinical and functional outcomes, with a low percentage of complications.
Arthroscopic capsulolabral stabilization for the treatment of recurrent anterior shoulder instability repair using absorbable Knotless offers reliable results with respect to failure rate, range of motion, and shoulder function also at 4 years follow-up. The percentage of rate for instability is 6,7% and is in accord with the International Literature on non resorbable anchors.