Comparing the in Vitro Efficacy of Commonly Used Surgical Irrigants for the Treatment of Implant-Associated Infections.

Background: Implant-associated infections (IAIs) require aggressive debridement to eliminate microbial bioburden. The use of irrigants may improve microbial killing during debridement. This study compared the efficacy of surgical irrigants in vitro against Staphylococcus aureus alone and in combination with Candida albicans, in both planktonic and biofilm states.

Characterizing Socioeconomic Factors That Influence Treatment Selection in Myxoid Liposarcoma: A Population-Based Study From the Surveillance, Epidemiology, and End Results Database.

Introduction: Myxoid liposarcoma (MLS) is the second most common liposarcoma, representing 6% of adult soft-tissue sarcomas. This study examines differences in treatment types and survival outcomes by income and rurality in MLS patients.

Methods: A retrospective cohort study was conducted using the Surveillance, Epidemiology, and End Results database for MLS patients from 2000 to 2021.

The utilization of a novel Outpatient Appropriateness Fragility Score to predict inpatient stay following biportal lumbar endoscopic decompression.

Background: Biportal endoscopic spine surgery offers advantages such as reduced postoperative pain and faster recovery, often enabling same-day discharge. However, the patient-specific factors influencing the need for inpatient admission remain unclear. This study evaluates variables contributing to overnight stays following biportal lumbar endoscopic decompression and proposes a predictive fragility score.

Novel Mechanism for Preserving Stump Length During Revision of Endoprosthetic Limb Salvage: A Case Report.

Case: An 18-year-old woman with osteosarcoma of the left distal femur underwent resection and limb-salvage surgery with compressive osseointegration endoprosthetic reconstruction and experienced tumor recurrence 1 year after index surgery. A transfemoral amputation was performed preserving the existing compressive osseointegration device, and limb lengthening was achieved using intercalary and distal femoral segments. 3.

Income and Rurality Impact Overall Survival but not Cause-Specific Survival in Patients With Chondrosarcoma: A Population-Based Study From the SEER Database.

Background And Objectives: Previous studies evaluating socioeconomic status (SES) in bone malignancies such as chondrosarcoma used the Cox Proportional Hazards model, which might overestimate risk compared to cause-specific models like the Fine-Gray model. This study aims to evaluate the prognostic significance of income status in chondrosarcoma using both models.

Methods: We performed a retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER) database for patients diagnosed with chondrosarcoma.

Identifying Predictors of Successful Conversion from OREF Grants to Extramural Federal Funding Among Orthopaedic Surgeons.

Background: Musculoskeletal diseases are a major contributor to global human disability, but research in this area of medicine contends with chronic underfunding in the United States, receiving <2% of the National Institutes of Health (NIH) budget. The Orthopaedic Research and Education Foundation (OREF) serves as a vital nongovernmental organization, providing essential support for orthopaedic research. This study investigated the translation of various OREF grants into successful extramural federal funding discerning the clinician demographics and OREF award characteristics associated with increased chances of securing federal grants.

Acromioclavicular joint cyst presenting with findings concerning for a soft tissue tumor - a case report.

Case: We present the case of a 73-year-old female with an acromioclavicular joint cyst associated with atypical, exquisite, progressive pain, and imaging findings concerning for neoplastic etiology. She underwent en bloc resection of the trapezium containing this cystic mass and distal clavicle. Surgical pathology demonstrated findings consistent with a large ganglion cyst without evidence of malignancy.

Monoclonal Antibody Disrupts Biofilm Structure and Restores Antibiotic Susceptibility in an Orthopedic Implant Infection Model.

Bacterial biofilms on orthopedic implants are resistant to the host immune response and to traditional systemic antibiotics. Novel therapies are needed to improve patient outcomes. TRL1068 is a human monoclonal antibody (mAb) against a biofilm anchoring protein.

Clinical outcomes and complications after biportal endoscopic spine surgery: a comprehensive systematic review and meta-analysis of 3673 cases.

Purpose: Current literature suggests that biportal spinal endoscopy is safe and effective in treating lumbar spine pathology such as lumbar disc herniation, lumbar stenosis, and degenerative spondylolisthesis. No prior study has investigated the postoperative outcomes or complication profile of the technique as a whole. This study serves as the first comprehensive systematic review and meta-analysis of biportal spinal endoscopy in the lumbar spine.

What are the indications and survivorship of tumor endoprosthetic reconstructions for patients with extremity metastatic bone disease?

Background And Objectives: Given advances in therapies, endoprosthetic reconstruction (EPR) in metastatic bone disease (MBD) may be increasingly indicated. The objectives were to review the indications, and implant and patient survivorship in patients undergoing EPR for MBD.

Methods: A review of patients undergoing EPR for extremity MBD between 1992 and 2022 at two centers was performed.

Adaptive antimicrobial resistance, a description of microbial variants, and their relevance to periprosthetic joint infection.

Periprosthetic joint infection (PJI) is a difficult complication requiring a comprehensive eradication protocol. Cure rates have essentially stalled in the last two decades, using methods of antimicrobial cement joint spacers and parenteral antimicrobial agents. Functional spacers with higher-dose antimicrobial-loaded cement and antimicrobial-loaded calcium sulphate beads have emphasized local antimicrobial delivery on the premise that high-dose local antimicrobial delivery will enhance eradication.

In vitro and in vivo methods to study bacterial colonization of hydrogel dermal fillers.

Preclinical in vitro and in vivo methods to study bacterial interactions with dermal fillers and infection pathogenesis are lacking. In this work, first in vitro methods to assess protein biofouling and effective pore size of commercial dermal fillers, including degradable hyaluronic acid (HA)-based fillers and other semi-degradable or permanent fillers (non-HA), were developed. The results were then related to Staphylococcus aureus (S.

Influenza-induced thrombotic microangiopathy in a patient with cancer on proteasome inhibitor: a diagnostic dilemma.

Thrombotic microangiopathy (TMA) in a cancer patient is a common complication of either cancer itself or anticancer therapy. Incidence of TMA from anticancer therapy was found to be > 15%, since the introduction of anti-angiogenic drugs like anti-vascular endothelial growth factor agents. It is, however, important to not ignore other causes of TMA such as bacteria, viruses, antiplatelet drugs, hereditary complement mutations, and autoimmune disorders.

Point-of-care antimicrobial coating protects orthopaedic implants from bacterial challenge.

Implant related infections are the most common cause of joint arthroplasty failure, requiring revision surgeries and a new implant, resulting in a cost of $8.6 billion annually. To address this problem, we created a class of coating technology that is applied in the operating room, in a procedure that takes less than 10 min, and can incorporate any desired antibiotic.

Predictors of Medical Malpractice Outcomes After Spine Surgery: A Comprehensive Analysis From 2010 to 2019.

Study Design: Retrospective review of spine surgery malpractice cases.

Objectives: The aim was to compare medical malpractice outcomes among different types of spine surgery and identify predictors of litigation outcomes.

Summary Of Background Data: Spine surgery is highly litigious in the United States with data suggesting favorable outcomes for defendant surgeons.

Sirtuin-3 mediates sex differences in kidney ischemia-reperfusion injury.

Studies suggest that biological sex influences susceptibility to kidney diseases with males demonstrating greater risk for developing ischemic acute kidney injury (AKI). Sex-related differences in mitochondrial function and homeostasis exist, likely contributing to sexual dimorphism in kidney injury, but the mechanisms are not well characterized. Our observations reveal lower baseline expression of Sirtuin-3 (Sirt3, a major mitochondrial acetyltransferase) in the kidneys of male mice versus females.

In vivo Mouse Model of Spinal Implant Infection.

Spine implant infections portend poor outcomes as diagnosis is challenging and surgical eradication is at odds with mechanical spinal stability. The purpose of this method is to describe a novel mouse model of spinal implant infection (SII) that was created to provide an inexpensive, rapid, and accurate in vivo tool to test potential therapeutics and treatment strategies for spinal implant infections. In this method, we present a model of posterior-approach spinal surgery in which a stainless-steel k-wire is transfixed into the L4 spinous process of 12-week old C57BL/6J wild-type mice and inoculated with 1 x 10 CFU of a bioluminescent strain of Staphylococcus aureus Xen36 bacteria.

Novel in vivo mouse model of shoulder implant infection.

Background: Animal models are used to guide management of periprosthetic implant infections. No adequate model exists for periprosthetic shoulder infections, and clinicians thus have no preclinical tools to assess potential therapeutics. We hypothesize that it is possible to establish a mouse model of shoulder implant infection (SII) that allows noninvasive, longitudinal tracking of biofilm and host response through in vivo optical imaging.

Progress not panacea: vancomycin powder efficacy and dose evaluated in an in vivo mouse model of spine implant infection.

Background: Intrawound vancomycin powder (VP) has been rapidly adopted in spine surgery with apparent benefit demonstrated in limited, retrospective studies. Randomized trials, basic science, and dose response studies are scarce.

Purpose: This study aims to test the efficacy and dose effect of VP over an extended time course within a randomized, controlled in vivo animal experiment.

The Use of a Novel Antimicrobial Implant Coating In Vivo to Prevent Spinal Implant Infection.

Study Design: A controlled, interventional animal study.

Objective: Spinal implant infection (SII) is a devastating complication. The objective of this study was to evaluate the efficacy of a novel implant coating that has both a passive antibiotic elution and an active-release mechanism triggered in the presence of bacteria, using an in vivo mouse model of SII.

Multimodal imaging guides surgical management in a preclinical spinal implant infection model.

Spine implant infections portend disastrous outcomes, as diagnosis is challenging and surgical eradication is at odds with mechanical spinal stability. Current imaging modalities can detect anatomical alterations and anomalies but cannot differentiate between infection and aseptic loosening, diagnose specific pathogens, or delineate the extent of an infection. Herein, a fully human monoclonal antibody 1D9, recognizing the immunodominant staphylococcal antigen A on the surface of Staphylococcus aureus, was assessed as a nuclear and fluorescent imaging probe in a preclinical model of S.

Single-Dose, Preoperative Vitamin-D Supplementation Decreases Infection in a Mouse Model of Periprosthetic Joint Infection.

Background: Despite recent advances, infection remains the most common etiology of arthroplasty failure. Recent work suggests that 25-hydroxyvitamin D (25D) deficiency correlates with the frequency of periprosthetic joint infection (PJI). We endeavored to examine whether 25D3 deficiency leads to increased bacterial burden in vivo in an established mouse model of PJI and, if so, whether this effect can be reversed by preoperative 25D3 supplementation.