National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK.
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National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK.
North Bristol NHS Trust, Southmead Hospital, Bristol, UK.
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National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK.
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, including the epidemiology, impact, assessment, risk factors, aetiology and treatment. Personal and economic impact Chronic pain after TKA can affect all dimensions of health-related quality of life, and has been found to be associated with
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assessment of the tibiofemoral knee compartments states, including the joint space. For evaluation of the patellofemoral joint, skyline or Merchant views are used. However, computerized tomography (CT) and magnetic resonance imaging (MRI) can give more subtle
Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
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Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
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, nerve root irritation, and certain inflammation ( 5 ). Due to the different characteristics of the two spinal deformities, this paper mainly discusses the postural assessment of non-structural spinal deformities. Body posture is mainly described as the
Department of Orthopaedics, Golden Jubilee National Hospital, Clydebank, UK
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Department of Orthopaedics, Golden Jubilee National Hospital, Clydebank, UK
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increased limitation of activities. 5 Currently ‘patient-reported instability’ is the benchmark used in clinical studies as well as in clinical assessment. Patients usually describe the sensation of ‘giving way’, ‘slipping’, ‘buckling’ or a lack of
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assessment of the injury and failure to restore pelvic circumferential stability due to inadequate synthesis of the anterior frame. Apart from being post-traumatic, this type of instability can also be observed after childbirth with a large foetus which
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° indicating mild scoliosis, and angles above 30° or 40° indicating severe scoliosis ( 4 , 5 , 6 ). With technological advancements, stereo-radiography (EOS) is increasingly used for the diagnosis of scoliosis because it enables the assessment of spinal
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Why it is important for an orthopaedic surgeon to know about imaging modalities in peri-prosthetic assessment Imaging is one essential part in the work-up of patients with total joint replacements. Although the actual scans are not done by the
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included in the data analysis. Quality assessment The methodological quality of all patient series found (non-comparative studies with more than three patients) was assessed using the first eight items of the Methodological Index for Non
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Department of Orthopaedics & Trauma, Royal Adelaide Hospital, Adelaide, South Australia, Australia
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the studies passing the initial eligibility screening and assessed for eligibility using the same approach with disagreements discussed to reach a consensus. Quality assessment Quality assessment of the studies was conducted using the Cochrane
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Because of the risk of bacterial biofilm infections, prophylactic use of antibiotics in orthopaedic procedures involving the implantation of large prosthesis systems is considered mandatory.
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A strategy based on the rationale that local antibiotics released from bone cement or other carriers establish a second antibacterial frontline in and around the prosthesis is considered complementary to the administration of systemic antibiotics.
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Although less common as a consequence of the initially very high drug concentrations of local antibiotics in the tissues, a selection process of previous high resistance bacteria may occur, leading to antibiotic resistance.
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The use of antibiotic combinations in bone cement is generally accepted to improve antibiotic efficacy and minimizes the treatment failure risk due to antibiotic resistance. This is important in septic revisions and/or in patients at particularly high risk of infection.
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On an individual basis, the benefit of a lower infection probability with combined systemic and local antibiotic application should outweigh the risk of the selection of more resistant bacteria. Each prevented infection means that a complex and extended antibiotic therapy with risk of resistance development over time has been avoided.
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On an epidemiological level there is no clinical evidence that the routine use of bone cement impregnated with appropriate bactericidal antibiotics promotes the widespread development of antibiotic resistance and thereby puts the successful treatment of a prosthetic joint infection at higher risk.
Cite this article: EFORT Open Rev 2019;4:576-584. DOI: 10.1302/2058-5241.4.180104