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.

Comparison of the Outcomes of Microendoscopic Cervical Foraminotomy versus Full-endoscopic Cervical Foraminotomy for the Treatment of Cervical Radiculopathy.

This study aimed to compare the outcomes of microendoscopic cervical foraminotomy (MECF) versus full-endoscopic cervical foraminotomy (FECF) for treating cervical radiculopathy (CR).A retrospective study was performed on patients with CR treated using MECF (n = 35) or FECF (n = 89). A 16-mm tubular retractor and endoscope was used for MECF, while a 4.

A Risk Calculator for the Prediction of C5 Nerve Root Palsy After Instrumented Cervical Fusion.

Background: C5 palsy is a common postoperative complication after cervical fusion and is associated with increased health care costs and diminished quality of life. Accurate prediction of C5 palsy may allow for appropriate preoperative counseling and risk stratification. We primarily aim to develop an algorithm for the prediction of C5 palsy after instrumented cervical fusion and identify novel features for risk prediction.

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.

Severity and location of lumbar spine stenosis affects the outcome of total knee arthroplasty.

Background: Recent studies have noted that patients with pre-existing lumbar spinal stenosis (LSS) have lower functional outcomes after total knee arthroplasty (TKA). Given that LSS manifests heterogeneously in location and severity, its influence on knee replacement merits a radiographically targeted analysis. We hypothesize that patients with more severe LSS will have diminished knee mobility before and after TKA.

Genicular Artery Embolization for the Treatment of Symptomatic Knee Osteoarthritis.

Unlabelled: Genicular artery embolization (GAE) is a novel therapy to treat patients with symptomatic knee osteoarthritis (OA) by reducing synovial arterial hypervascularity. This study evaluates the safety and efficacy of GAE for the treatment of symptomatic knee OA.

Methods: A prospective, single-center, open-label U.

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.

Randomized Trial of a Virtual Reality Tool to Teach Surgical Technique for Tibial Shaft Fracture Intramedullary Nailing.

Introduction: Active learning methods have accumulated popularity due to improved results in knowledge acquisition as opposed to passive learning methods. For surgical resident physicians with limited training opportunities outside of the operating room due to time constraints, virtual reality (VR) is a relatively inexpensive and time-efficient active training method for procurement of surgical skills. We conducted a simulated intramedullary nailing (IMN) of a tibia to demonstrate VR training programs as a more effective modality of learning orthopedic surgical techniques compared to passive learning tools such as a standard guide (SG) through trained novice medical students performing a SawBones simulation of intramedullary nail fixation.

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.

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.

Reconstructive Science in Orthopedic Oncology.

Limb salvage is widely practiced as standard of care in most cases of extremity bone sarcoma. Allograft and endoprosthesis reconstructions are the most widely utilized modalities for the reconstruction of large segment defects, however complication rates remain high. Aseptic loosening and infection remain the most common modes of failure.

Outpatient Posterior Lumbar Fusion: A Population-Based Analysis of Trends and Complication Rates.

Study Design: A retrospective case-control study.

Objective: The aim of this study was to determine the nationwide trends and complication rates associated with outpatient posterior lumbar fusion (PLF).

Summary Of Background Data: Outpatient lumbar spine fusion is now possible secondary to minimally invasive techniques that allow for reduced hospital stays and analgesic requirements.

Ambulatory anterior cervical discectomy and fusion is associated with a higher risk of revision surgery and perioperative complications: an analysis of a large nationwide database.

Background Context: With the changing landscape of health care, outpatient spine surgery is being more commonly performed to reduce cost and to improve efficiency. Anterior cervical discectomy and fusion (ACDF) is one of the most common spine surgeries performed and demand is expected to increase with an aging population.

Purpose: The objective of this study was to determine the nationwide trends and relative complication rates associated with outpatient ACDF.

Intraoperative Hypothermia is Common, but not Associated With Blood Loss or Transfusion in Pediatric Posterior Spinal Fusion.

Background: Intraoperative hypothermia may be associated with increased blood loss due to the effects of temperature on clotting but this has not been evaluated in the setting of pediatric posterior spinal fusion (PSF). The purpose of this study was to determine if a correlation exists between intraoperative hypothermia and estimated blood loss (EBL) or transfusion requirements in pediatric patients undergoing PSF.

Methods: A retrospective review of consecutive patients undergoing PSF for scoliosis at a single institution between 6/2004 and 3/2012 was performed.

Prevalence of specific gait abnormalities in children with cerebral palsy revisited: influence of age, prior surgery, and Gross Motor Function Classification System level.

Aim: To examine the impact of age, surgery, and Gross Motor Function Classification System (GMFCS) level on the prevalence of gait problems in children with cerebral palsy (CP).

Method: Gait analysis records were retrospectively reviewed for ambulatory patients with CP. Gait abnormalities were identified using physical exam and kinematic data.

Fever is common postoperatively following posterior spinal fusion: infection is an uncommon cause.

Objective: To determine the frequency and clinical significance of postoperative fever in pediatric patients undergoing posterior spinal fusion (PSF).

Study Design: A retrospective chart review was performed for consecutive patients undergoing PSF at a single institution between June 2005 and April 2011, with a minimum of 2-year follow up. Exclusion criteria were previous spine surgery, a combined anterior-posterior approach, and delayed wound closure at the time of surgery.

Effect of Delta-9-tetrahydrocannabinol on mouse resistance to systemic Candida albicans infection.

Delta-9-tetrahydrocannabinol (Δ9-THC), the psychoactive component of marijuana, is known to suppress the immune responses to bacterial, viral and protozoan infections, but its effects on fungal infections have not been studied. Therefore, we investigated the effects of chronic Δ9-THC treatment on mouse resistance to systemic Candida albicans (C. albicans) infection.

Primary response against cytomegalovirus during antiviral prophylaxis with valganciclovir, in solid organ transplant recipients.

Antiviral prophylaxis has proved successful for prevention of cytomegalovirus (CMV) disease in solid organ transplant (SOT) patients; though emerging data suggest that antiviral agents interfere with immunity, and may inhibit immune priming. In this context, we investigated levels and phenotype of primary CMV-specific immune responses that developed during antiviral prophylaxis in a cohort of CMV seronegative recipients (R(-) ) of a SOT from a seropositive donor (D(+) ). We longitudinally monitored CMV viral load, antibodies and levels of the negative immuno-modulator IL-10.