Bacterial infection activates neutrophils to release neutrophil extracellular traps (NETs) in bacterial biofilms of periprosthetic joint infections (PJIs). The aim of this study was to evaluate the increase in NET activation and release (NETosis) and haemostasis markers in the plasma of patients with PJI, to evaluate whether such plasma induces the activation of neutrophils, to ascertain whether increased NETosis is also mediated by reduced DNaseI activity, to explore novel therapeutic interventions for NETosis in PJI in vitro, and to evaluate the potential diagnostic use of these markers. We prospectively recruited 107 patients in the preoperative period of prosthetic surgery, 71 with a suspicion of PJI and 36 who underwent arthroplasty for non-septic indications as controls, and obtained citrated plasma. PJI was confirmed in 50 patients. We measured NET markers, inflammation markers, DNaseI activity, haemostatic markers, and the thrombin generation test (TGT). We analyzed the ability of plasma from confirmed PJI and controls to induce NETosis and to degrade in vitro-generated NETs, and explored the therapeutic restoration of the impairment to degrade NETs of PJI plasma with recombinant human DNaseI. Finally, we assessed the contribution of these markers to the diagnosis of PJI.Aims
Methods
This study aimed to assess the performance of an automated multiplex polymerase chain reaction (mPCR) technique for rapid diagnosis of native joint septic arthritis Consecutive patients with suspected septic arthritis undergoing aseptic diagnostic joint aspiration were included. The aspirate was used for analysis by mPCR and conventional microbiological analysis. A joint was classed as septic according to modified Newman criteria. Based on receiver operating characteristic (ROC) analysis, the area under the ROC curve (AUC) values of the mPCR and the synovial fluid culture were compared using the z-test. A total of 72 out of 76 consecutive patients (33 women, 39 men; mean age 64 years (22 to 92)) with suspected septic arthritis were included in this study.Aims
Patients and Methods
Tuberculosis (TB) infection of bones and joints accounts for
6.7% of TB cases in England, and is associated with significant
morbidity and disability. Public Health England reports that patients
with TB experience delays in diagnosis and treatment. Our aims were
to determine the demographics, presentation and investigation of
patients with a TB infection of bones and joints, to help doctors
assessing potential cases and to identify avoidable delays. This was a retrospective observational study of all adults with
positive TB cultures on specimens taken at a tertiary orthopaedic
centre between June 2012 and May 2014. A laboratory information
system search identified the patients. The demographics, clinical presentation,
radiology, histopathology and key clinical dates were obtained from
medical records.Aims
Patients and Methods
Implant-associated infection is a major source
of morbidity in orthopaedic surgery. There has been extensive research
into the development of materials that prevent biofilm formation,
and hence, reduce the risk of infection. Silver nanoparticle technology
is receiving much interest in the field of orthopaedics for its
antimicrobial properties, and the results of studies to date are
encouraging. Antimicrobial effects have been seen when silver nanoparticles are
used in trauma implants, tumour prostheses, bone cement, and also
when combined with hydroxyapatite coatings. Although there are promising
results with Cite this article:
The number of arthroplasties being undertaken
is expected to grow year on year, and periprosthetic joint infections will
be an increasing socioeconomic burden. The challenge to prevent
and eradicate these infections has resulted in the emergence of
several new strategies, which are discussed in this review. Cite this article:
Non-tuberculous mycobacterial (NTM) infection
of the musculoskeletal tissue is a rare disease. An early and accurate diagnosis
is often difficult because of the indolent clinical course and difficulty
of isolating pathogens. Our goal was to determine the clinical features
of musculoskeletal NTM infection and to present the treatment outcomes.
A total of 29 patients (nine females, 20 males between 34 and 85
years old, mean age 61.7 years; 34 to 85) with NTM infection of the
musculoskeletal system between 1998 to 2011 were identified and
their treatment retrospectively analysed. Microbiological studies
demonstrated NTM in 29 patients: the isolates were Cite this article:
Periosteum is important for bone homoeostasis
through the release of bone morphogenetic proteins (BMPs) and their
effect on osteoprogenitor cells. Smoking has an adverse effect on
fracture healing and bone regeneration. The aim of this study was
to evaluate the effect of smoking on the expression of the BMPs
of human periosteum. Real-time polymerase chain reaction was performed
for BMP-2,-4,-6,-7 gene expression in periosteal samples obtained from
45 fractured bones (19 smokers, 26 non-smokers) and 60 non-fractured
bones (21 smokers, 39 non-smokers). A hierarchical model of BMP
gene expression (BMP-2 >
BMP-6 >
BMP-4 >
BMP-7) was demonstrated
in all samples. When smokers and non-smokers were compared, a remarkable
reduction in the gene expression of BMP-2, -4 and -6 was noticed
in smokers. The comparison of fracture and non-fracture groups demonstrated
a higher gene expression of BMP-2, -4 and -7 in the non-fracture
samples. Within the subgroups (fracture and non-fracture), BMP gene
expression in smokers was either lower but without statistical significance
in the majority of BMPs, or similar to that in non-smokers with
regard to BMP-4 in fracture and BMP-7 in non-fracture samples. In
smokers, BMP gene expression of human periosteum was reduced, demonstrating
the effect of smoking at the molecular level by reduction of mRNA
transcription of periosteal BMPs. Among the BMPs studied, BMP-2
gene expression was significantly
