Infection of orthopaedic implants is a significant problem, with increased
We report two cases of epicondylitis of the elbow occurring after treatment with fluoroquinolone
Two-stage revision surgery for infected total knee replacement offers the highest rate of success for the elimination of infection. The use of articulating antibiotic-laden cement spacers during the first stage to eradicate infection also allows protection of the soft tissues against excessive scarring and stiffness. We have investigated the effect of cyclical loading of cement spacers on the elution of
We have investigated the contaminating bacteria in primary hip arthroplasty and their sensitivity to the prophylactic
Cephamandole levels in serum and drain fluid were measured in 32 knee replacement operations to determine the benefit of an intravenous dose of
The diffusion of Fucidin, gentamicin, and clindamycin from acrylic cement was tested in an in vitro system. The activity of Fucidin was very short-lived and only against gram-positive organisms; gentamicin inhibited gram-positive and gram-negative organisms for twenty-two and eleven days respectively; clindamycin had significant action only against gram-positive organisms and retained some activity for fifty-six days. We suggest that the destruction of organisms in the tissues is more likely to be achieved by topical and intravenous administration of
Discitis after discography is due to bacterial penetration into the intervertebral disc by a contaminated needle and has an incidence of 1% to 4%. We have examined the prophylactic role of cephazolin administered at the time of discography. An experimental study in sheep using radiographic contrast containing Staphylococcus epidermidis showed that either adding the
We present a series of 48 patients with infected total knee replacements managed by the use of articulating cement spacers and short-term parenteral
Infection of a total hip replacement (THR) requires component removal and thorough local debridement. Usually, long-term
The current standard recommendation for
The outcome of primary management of acute osteomyelitis in 655 children treated in New Zealand between 1947 and 1976 is examined. Failure occurred in 20 per cent of children, in four-fifths of whom it was manifest by one year, and half of whom experienced one recurrence only. Lower failure rates were associated with use of bactericidal
Coloured bone cements have been introduced to
make the removal of cement debris easier at the time of primary and
revision joint replacement. We evaluated the physical, mechanical
and pharmacological effects of adding methylene blue to bone cement
with or without
We prepared a composite of D,L-lactic acid oligomer and dideoxykanamycin B for use as a biodegradable
The burden of revision total hip arthroplasty (rTHA) continues to grow. The surgery is complex and associated with significant costs. Regional rTHA networks have been proposed to improve outcomes and to reduce re-revisions, and therefore costs. The aim of this study was to accurately quantify the cost and reimbursement for a rTHA service, and to assess the financial impact of case complexity at a tertiary referral centre within the NHS. A retrospective analysis of all revision hip procedures was performed at this centre over two consecutive financial years (2018 to 2020). Cases were classified according to the Revision Hip Complexity Classification (RHCC) and whether they were infected or non-infected. Patients with an American Society of Anesthesiologists (ASA) grade ≥ III or BMI ≥ 40 kg/m2 are considered “high risk” by the RHCC. Costs were calculated using the Patient Level Information and Costing System (PLICS), and remuneration based on Healthcare Resource Groups (HRG) data. The primary outcome was the financial difference between tariff and cost per patient episode.Aims
Methods