Perioperative antibiotic prophylaxis use in modern orthopaedic procedures is well established. Studies have shown significant reduction in risk of post-operative infections. However, as effectiveness of these antibiotics is dependent on achieving high serum and tissue concentrations that exceed the minimum inhibitory concentrations of infective organisms for operation duration, the timing of prophylaxis is crucial. Although, optimal timing for administering prophylaxis varies in the literature, 30 to 60 minutes prior to skin incision or inflation of tourniquet is considered best standards. To audit our practice of timing of administration of perioperative prophylactic antibiotics in trauma and orthopaedic procedures.Introduction
Objectives
Computational models are the primary tools for efficient design-phase exploration of knee replacement concepts before in vitro testing. To improve design-phase efficiency, a subject-specific computational platform was developed that allows designers to assess devices in realistic conditions by directly integrating subject-specific experimental data in these models. Early in the design-phase of new implant design, numerous in vitro tests would be desirable to assess the influence of design parameters or component alignment on the performance of the device. However, cadaveric testing of knee replacement devices is a costly and time-consuming procedure, requiring manufacture of parts, preparation of cadaveric specimens, and personnel to carry of the experiments. Validated computational models are ideally suited for pre-clinical, high-volume design evaluation. Initial development of these models requires substantial time and expertise; once developed, however, computational simulations may be applied for comparative evaluation of devices in an extremely efficient manner [Baldwin et al. 2012]. Still, computational models are complementary of experimental testing and for this reason, computational models tuned with subject-specific experimental data, e.g. soft tissue parameters, could bring even more efficiency in the design phase. The objective of the current study was to develop a platform of tools that easily allows for subject-specific knee simulations. The system integrates with commercially available medical imaging and finite element software to allow for direct, efficient comparison of designs and surgical alignment under a host of different boundary conditions.Summary Statement
Introduction
