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The Bone & Joint Journal
Vol. 102-B, Issue 7 Supple B | Pages 3 - 10
1 Jul 2020
Sosa BR Niu Y Turajane K Staats K Suhardi V Carli A Fischetti V Bostrom M Yang X

Aims

Current treatments of prosthetic joint infection (PJI) are minimally effective against Staphylococcus aureus biofilm. A murine PJI model of debridement, antibiotics, and implant retention (DAIR) was used to test the hypothesis that PlySs2, a bacteriophage-derived lysin, can target S. aureus biofilm and address the unique challenges presented in this periprosthetic environment.

Methods

The ability of PlySs2 and vancomycin to kill biofilm and colony-forming units (CFUs) on orthopaedic implants were compared using in vitro models. An in vivo murine PJI model of DAIR was used to assess the efficacy of a combination of PlySs2 and vancomycin on periprosthetic bacterial load.


Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_12 | Pages 59 - 59
1 Oct 2019
Sosa B Niu Y Turajane K Staats K Suhardi V Carli A Fischetti V Bostrom MPG Yang X
Full Access

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.


The Bone & Joint Journal
Vol. 100-B, Issue 10 | Pages 1280 - 1288
1 Oct 2018
Grammatopoulos G Gofton W Cochran M Dobransky J Carli A Abdelbary H Gill HS Beaulé PE

Aims

This study aims to: determine the difference in pelvic position that occurs between surgery and radiographic, supine, postoperative assessment; examine how the difference in pelvic position influences subsequent component orientation; and establish whether differences in pelvic position, and thereafter component orientation, exist between total hip arthroplasties (THAs) performed in the supine versus the lateral decubitus positions.

Patients and Methods

The intra- and postoperative anteroposterior pelvic radiographs of 321 THAs were included; 167 were performed with the patient supine using the anterior approach and 154 were performed with the patient in the lateral decubitus using the posterior approach. The inclination and anteversion of the acetabular component was measured and the difference (Δ) between the intra- and postoperative radiographs was determined. The target zone was inclination/anteversion of 40°/20° (± 10°). Changes in the tilt, rotation, and obliquity of the pelvis on the intra- and postoperative radiographs were calculated from Δinclination/anteversion using the Levenberg–Marquardt algorithm.


Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_9 | Pages 20 - 20
1 May 2018
Grammatopoulos G Gofton W Cochran M Dobransky J Carli A Abdelbary H Gill H Beaulé P
Full Access

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.