Laboratory of Tribology and System Dynamics, Ecole Centrale Lyon, France.
Laboratory of Bioengineering and Bioimagery for Bone and Articulation, Paris-Diderot University, France.
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osteoporosis is still to be elucidated. 2 A decrease of osteoblastic activity with age and with the menopause seems related. However, biotypes – female, fair-skinned and slim – and environmental conditions are also implicated. 3 Because of important
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of implant failure have been ruled out. 5 Despite the lack of an established standard for diagnosing metal hypersensitivity, investigations such as skin patch and lymphocyte transformation testing have been advocated. 5 Nickel is the fifth most
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Introduction The publication of Joseph Lister’s ‘Antiseptic principle in the practice of surgery’ in 1867 revolutionized surgical practice. 1 Despite his critics at the time, the routine use of antiseptic skin preparation for everything
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compromised through chronic vascular disease, prolonged steroid medication, and diminished skin turgor leading to open injuries even in low energy fractures. 3 Mobilisation of the patients after surgery will be complicated by sarcopaenia, decreased
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St George’s University of London, UK
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St George’s University of London, UK
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St George’s University of London, UK
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, blood vessels, nerves, and skin ( 2 , 12 , 13 , 14 , 15 ). Tourniquet use has also been associated with increased post-operative pain ( 16 , 17 , 18 ), longer length of hospital stay ( 16 , 19 ), increased risk of wound infection and wound
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confusion in the terminology used to refer to MIS (Minimal invasive surgery) or percutaneous surgery. The correct term to describe these procedures should be percutaneous (made through the skin) and MIS should be reserved for procedures situated in extent
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-type fractures, the so-called ‘S-deformity’ is usually present ( Fig. 1 ). However, light ecchymosis or swelling can be the only external manifestation of a minimally displaced extension fracture or a flexion-type fracture. Fig. 1 a) Skin puckering at the
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Purpose
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Surgical site infection (SSI) is a rare and serious complication of total knee arthroplasty (TKA), which causes a poor prognosis for patients. The purpose of this study was to explore the effect of intraosseous (IO) antibiotics in preventing infection and complications after TKA compared with intravenous (IV) antibiotics and to provide a certain theoretical basis for clinical treatment.
Methods
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The review process was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched the PubMed, Embase, Ovid, Web of Science, and the Cochrane Central Register of Controlled Trials databases about trials on IO antibiotics (into the proximal tibia before skin incision) to prevent infections in TKA from the respective inception dates to September 30, 2022. The infection occurred within 3 months after surgery. Both researchers individually screened the studies in accordance with the inclusion and exclusion criteria, performed the literature quality evaluation and data extraction, and used Stata 17 software for data analysis.
Results
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Five studies that enrolled 3801 patients were included in this meta-analysis. The results showed that IO antibiotics were effective in reducing the incidence of SSI (OR: 0.25, P = 0.001) and periprosthetic joint infections (OR: 0.16, P = 0.004) relative to IV. Moreover, the percentage of infection due to Gram-positive bacteria (OR: 0.18, P = 0.025) was reduced in the IO group compared with that in IV group, but Gram-negative bacteria levels were not significantly reduced (P = 0.14). There was no difference between the two groups for other systemic adverse effects of the drug.
Conclusions
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IO antibiotics in TKA are safe and effective alternatives to IV antibiotics. Large randomized clinical studies comparing infection rates and related complications with IO and IV antibiotics are required.
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needle fasciotomy and collagenase injections have a faster recovery, but incomplete correction and recurrence are markedly more frequent than open surgery ( 5 ). Fasciectomy can be augmented with skin grafting in cases of incomplete skin closure or to
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non-weight-bearing stump and the need for an ischial weight-bearing prosthesis. The TKA technique has been associated with frequent skin breakdown since the bulbous ends of the femur are only covered by a thin layer of cutaneous and subcutaneous
