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A rare case report of chronic osteomyelitis of ulna with global involvement in an infant: A management perspective using Modified Masquelet technique with “Atmanirbhar” Gentamycin beads

July 10, 2020/in For New site, Vol 5 | Issue 2 | July-Dec 2020 /by editor.jcorth

Author: Rajesh Lalchandani [1], Gaurav Garg [1], Rakesh Parmar [1], Rajesh kumar Yadav [1]

[1] Department of Orthopedics, P.D. Hinduja National Hospital & MRC, Veer Savarkar Marg, Mahim West, Mumbai – 400016

Address of Correspondence
Dr. Vivek Shetty,
Department of Orthopedics, P.D. Hinduja National Hospital & MRC, Veer Savarkar Marg, Mahim West, Mumbai – 400016
E-mail: vivshetty7777@gmail.com

Abstract

Chronic osteomyelitis treatment has always been a serious challenge for an orthopaedic surgeon to treat and it needs dedication, perseverance and multiple operations for its complete cure. We hereby report a case of a one year female who presented to us with chronic osteomyelitis ulna with global involvement. The case was successful managed by debridement, excision of sequestered ulna and insertion of locally made gentamycin beads mounted on kirschner wire as a cement spacer in the first stage. After 4 weeks, removal of gentamycin beads was done followed by visualization of membrane formation and fibular grafting mounted on a k wire for stabilization. During follow-up, we observed good uptake of the graft at both the ends and regeneration of the fibula at donor site with no signs of recurrence of osteomyelitis. We are reporting this case because of its unique global involvement of ulna and use of modified Masquelet technique using gentamycin beads(rather than a blob of cement) on a wire as cement spacer and also as a tool for local delivery of antibiotics.
Keywords: Chronic Osteomyelitis, Modified Masquelet technique, gentamycin beads, diaphyseal osteomyelitis

References

1. Chadayammuri, Vivek et al. “Innovative strategies for the management of long bone infection: a review of the Masquelet technique.” Patient safety in surgery vol. 9 32. 14 Oct. 2015, doi:10.1186/s13037-015-0079-0
2. Careri, S. & Vitiello, Raffaele & Oliva, M.S. & Ziranu, A. & Maccauro, G. & Perisano, Carlo. (2019). Masquelet technique and osteomyelitis: innovations and literature review. European review for medical and pharmacological sciences. 23. 210-216. 10.26355/eurrev_201904_17495
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4. D. Bettin, H. Böhm, M. Clatworthy, D. Zurakowski, T.M. LinkRegeneration of the donor side after autogenous fibula transplantation in 53 patients: evaluation by dual x-ray absorptiometry Acta Orthop Scand, 74 (2003), pp. 332-336
5. A.H. Krieg, F. HeftiReconstruction with non-vascularised fibular grafts after resection of bone tumours J Bone Joint Surg Br, 89 (2007), pp. 215-221
6. C.W. Steinlechner, N.C. MkandawireNon-vascularised fibular transfer in the management of defects of long bones after sequestrectomy in children J Bone Joint Surg Br, 87 (2005), pp. 1259-1263.

How to Cite this article: Shekhar S, Shetty V, Wagh Y. Challenges and Difficulties faced by Orthopedic Surgeons during the COVID-19 Pandemic: A Review of Modified Surgical Protocols. Journal of Clinical Orthopaedics July-Dec 2020;5(2):45-48.

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Pre fixation compression screw as a cutting-edge technique for varus correction during proximal femoral nailing for intertrochanteric fractures: a study on 46 cases

July 10, 2020/in For New site, Vol 5 | Issue 2 | July-Dec 2020 /by editor.jcorth

Author: Mithun Shetty [1], Shashi Kumar M.S [1], Shree Krishnananda Sagar [1]

[1] Department of Orthopaedics AJ Institute of Medical Sciences, Mangalore 575004

Address of Correspondence
Dr. Shashi Kumar,
room no #707, resident hostel aj institute of medical sciences, kuntikana, mangalore 575004
E-mail: shashikumar859@gmail.com

Abstract

Background: Achieving reduction prior to fixation is a key aspect in successfully managing intertrochanteric fractures. In this study of proximal femoral nailing for intertrochanteric fractures, a novel technique of utilizing prefixation compression screw was introduced to achieve and maintain reduction of femoral neck shaft angle.
Materials and Methods: The current prospective study was conducted over a period of six months between July 2018 and January 2019 among patients who underwent surgical fixation by PFN for intertrochanteric fractures of femur. Prefixation compression screw was used in all the cases to achieve and maintain correction of varus. Pre-operative, intra-operative and post- operative neck shaft angles were documented. Data was analysed by using Statistical Package for Social Sciences (SPSS). The results were expressed as percentages and graphs.
Results: There is significant improvement in correction of varus (average increase of neck shaft angle =14.04 degrees) with the use of prefixation screw technique. This procedure did neither increase the blood loss (average blood loss = 34.67 ml) during the procedure nor the duration (average duration = 19.46 mins) of the procedure.
Conclusion: Prefixation compression screw can be used as an effective alternative for varus correction in cases of simple intertrochanteric fractures undergoing PFN fixation with added intra-op and post-op advantages compared to other methods of reduction.
Keywords: Intertrochanteric fractures,Proximal Femoral nailing, Prefixation screw, Varus correction

References

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How to Cite this article: Shetty M, Kumar M.S.S, Sagar SK.Pre fixation compression screw as a cutting-edge technique for varus correction during proximal femoral nailing for intertrochanteric fractures: a study on 46 cases. Journal of Clinical Orthopaedics July-Dec 2020;5(2): 6-12.

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Mature Spinal Cord Teratoma In Adults: Report Of Two Unusual Cases And Literature Review

July 10, 2020/in For New site, Vol 5 | Issue 2 | July-Dec 2020 /by editor.jcorth

Author: Sapan Kumar [1], Sanjeev kumar [1], Mohit Kumar Patralekh [1], Ramesh Kumar [1]

[1] Department of Orthopaedics, VMMC & Safdarjung Hospital, Delhi-110029, India

Address of Correspondence
Dr. Sapan Kumar,
Department of Orthopaedics, VMMC & Safdarjung Hospital, Delhi-110029, India
E-mail:- sapan2576@gmail.com

Abstract

Background: Teratoma is a germ cell tumour that is composed of a variety of parenchymal cell types derived from all three germinal layers (ectoderm, mesoderm, and endoderm). Spinal teratomas are very rare. Only 0.15-0.18% of spinal tumours have been classified as teratomas. We report two cases of spinal cord teratoma managed surgically, with good outcome.
Case reports: A 23 year old female presented with back pain and right lower limb weakness. She was evaluated by blood and radiological investigation. T12 through L2-3 flip laminoplasty with fixation was performed and the tumour was totally removed. The postoperative course was excellent, and histopathologically, numerous fatty cysts consisting of neuroepithelial and epithelial tissues were observed. The final diagnosis was that of a mature cystic teratoma.
Another 22 year old male, was presented with back pain for six months. He was evaluated by blood and radiological investigation. Total resection of the tumour by means of L2 – L3 laminectomy was done. Ectodermal, mesodermal and endodermal
elements were revealed. The final histopathological diagnosis was that of a mature cystic teratoma.
Conclusion: Although intramedullary teratomas are very rare in adults, they need to be considered in differential diagnosis. The present study also compares the literature
concerning adult intradural mature teratoma, summarises the basic clinical characteristics and theory of origin of adult intradural mature teratoma and reviews the available treatment options for this disease.
Key words: Intradural; Intramedullary; Spinal Cord; Teratoma; Adult.

References

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How to Cite this article: Kumar S, kumar S, Patralekh MK, Kumar R. Mature Spinal Cord Teratoma In Adults: Report Of Two Unusual Cases And Literature Review. Journal of Clinical Orthopaedics July-Dec 2020;5(2):49-52.

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Clinical outcomes of patients undergoing Minimally Invasive Plate Osteosynthesis (MIPO) for distal tibia fractures

July 10, 2020/in For New site, Vol 5 | Issue 2 | July-Dec 2020 /by editor.jcorth

Author: Shikhar D Singh [1], Sachin Y Kale [1], Adnan Asif [2], Jay Parsania [1], Atul Jain [3], Prasad Chaudhari [1]

[1] Department of Orthopedics, DY Patil University School of Medical, Nerul, Navi Mumbai
[2] Department of Orthopedics, Christian Medical College, Vellore
[3] Department of Orthopedics, Deep Chand Bhandu Hospital, New Delhi

Address of Correspondence
Dr. Sachin Y Kale,
Department of Orthopaedics, DY Patil University School of Medical
Sector 7, Nerul, Navi Mumbai – 400706
E-mail: drsinghshikhar@gmail.com

Abstract

Introduction: Distal tibial fracture being subcutaneous poses a surgical challenge and can be complicated with delayed union, non-union, wound infection and wound dehiscence. Minimally Invasive Plate Osteosynthesis (MIPO) of distal fractures is indicted for displaced or unstable fractures due to its technical advantages and satisfactory clinical outcomes.
Methodology: We prospectively studied consecutive adult patients with closed distal tibia fracture treated with locking plates with MIPO technique. We included consecutive patients with Gustillo type 1 closed fracture with or without articular extension. Clinical outcome was assessed using Olerud and Molander Score (OAMS). Radiographic assessment was done to assess for radiological union.
Results: Among the 30 patients, right side was involved in 53% of the patients and the most common type of fracture was 43.A1 type (47%). OAMS done post-operatively found that 67% had excellent outcome, 27% had good outcome, 6% and fair and none of the patients had poor clinical outcome. Radiological union was achieved in 12 weeks in 20%, 12 to 16 weeks in 23%, 16 to 20 weeks in 50% and 20 to 24 weeks and 24 to 28 weeks in one patient each. Superficial wound infections was observed in five patients, ankle stiffness in four patients and delayed union in two patients.
Conclusions: Results of our study show that locking compression plate using MIPO technique does not compromise the periosteal blood supply and does not rely on the compression between the plate and the bone. Thus MIPO is an effective treatment for tibial diaphysis and distal tibia fractures.
Keywords: Distal tibial fractures, locking plate, Minimally invasive percutaneous plate osteosynthesis

References

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12. Collinge CA, Sanders RW. Percutaneous plating in the lower extremity. J Am Acad Orthop Surg. 2000;8(4):211–16.

How to Cite this article: Singh SD, Kale SY, Asif A,Parsania J, Jain A, Chaudhari P. Clinical outcomes of patients undergoing Minimally Invasive Plate Osteosynthesis (MIPO) for distal tibia fractures. Journal of Clinical Orthopaedics July-Dec 2020;5(2):2-5.

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Partial Rotator Cuff Tears: a review of the literature

July 10, 2020/in For New site, Vol 5 | Issue 2 | July-Dec 2020 /by editor.jcorth

Author: Stefania Kokkineli [1], Emmanouil Brilakis [1], Emmanouil Antonogiannakis [1]

[1] Department of Orthopaedic, HYGEIA Hospital. MD. Erythrou Stavrou 4, Marousi 15123

Address of Correspondence
Dr. Stefania Kokkineli,
Department of Orthopaedic, HYGEIA Hospital. Athens, Greece
Address: Erythrou Stavrou 4, Marousi 15123. Greece
E-mail: stephaniekokkineli@gmail.com

Abstract

Partial- thickness rotator cuff tears are the most common cause of shoulder pain in adults and have been classified into subtypes according to location and depth. The frequency rate and tear size progression increase with age, tobacco use and medical comorbidities. Partial tears are divided into tears of acute, chronic or acute-on-chronic onset. Surgical treatment is indicated in symptomatic patients with persistent pain after failed conservative treatment of at least 3 months, mainly with tears that exceed 50% of the tendon thickness. Arthroscopic repair techniques include in situ and tear completion repair. Authors’ preferred technique for in situ repair is described followed by the postoperative rehabilitation protocol. The surgical techniques described have various advantages and disadvantages with regard to intra- operative complications, clinical outcomes, recovery time and re-tear rates which make it difficult to decide on which technique to use. The option is a matter of surgical indications, philosophy and skills.
Keywords: Partial-thickness rotator cuff tears, transtendon repair, in-situ repair, shoulder, arthroscopy

References

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3. Salem, H., Carter, A., Tjoumakaris, F., Freedman, K., B. Double-Row Repair Technique for Bursal-Sided Partial-Thickness Rotator Cuff Tears. Arthrosc Tech. 2018;7(3):e199–e203. doi:10.1016/j.eats.2017.08.068.
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19. Camurcu, Y., Ucpunar, H., Ari, H., Duman, S., Cobden, A., Sofu, H. Predictors of allocation to surgery in patients older than 50 years with partial-thickness rotator cuff tear. JSES. 2019;28(5):828-832. doi:10.1016/j.jse.2018.12.014.
20. Gereli, A., Kocaoglu, B., Ulku, T. K., Silay, S., Kilinc, E., Uslu, S., Nalbantoglu, U. Completion repair exhibits increased healing characteristics compared with in situ repair of partial thickness bursal rotator cuff tears. Knee Surg Sports Traumatol Arthrosc. 2018;26(8):2498–2504. doi:10.1007/s00167-018-4870-1.
21. Hahn, S., Lee, Y., H., Chun, Y., M., Park, E., H., Suh, J., S. Magnetic resonance arthrography results that indicate surgical treatment for partial articular-sided supraspinatus tendon avulsion: a retrospective study in a tertiary center. Acta Radiologica. 2017;58(9), 1115–1124. doi:10.1177/0284185116684673.
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23. Kim, Y., S., Lee, H., J., Bae, S., H., Jin, H., Song, H. S. Outcome Comparison Between in Situ Repair Versus Tear Completion Repair for Partial Thickness Rotator Cuff Tears. Arthroscopy. 2015;31(11):2191–2198. doi:10.1016/j.arthro.2015.05.016.
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How to Cite this article: Kokkineli S, Brilakis E, Antonogiannakis E. Partial Rotator Cuff Tears: a review of the literature. Journal of Clinical Orthopaedics July-Dec 2020;5(2):30-34.

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Understanding Osteotomy: A narrative review

January 10, 2020/in For New site, Vol 5 | Issue 1 | Jan-June 2020 /by editor.jcorth

Author: Domenico Alesi [1], Vito Gaetano Rinaldi [1], Amit Meena [2], Giulio Maria Marcheggiani Muccioli [1,3], Stefano Zaffagnini [1,3]

[1] 2nd Orthopaedic and Traumatology Clinic – IRCCS – Istituto Ortopedico Rizzoli – Via G.B. Pupilli 1, 40136, Bologna, Italy.
[2] Central Institute of Orthopaedics, VMMC and Safdarjung Hospital, New Delhi, 110029, India.
[3] DIBINEM, University of Bologna, Bologna, Italy.

Address of Correspondence
Dr. Domenico Alesi,
Resident in Orthopedics and Traumatology, IRCCS – Istituto Ortopedico Rizzoli Via di Barbiano, 1/13, Bologna
E-mail: domenico.alesi@ior.it

Abstract

Osteotomy around the knee is an effective surgical procedure for active, physiologically young patients with symptomatic unicompartmental osteoarthritis (OA) and malalignment. It restores the correct lower limb mechanical alignment, redistributing weight-bearing from a damaged joint surface area to an undamaged one. Hence, it consistently provides relief in knee pain, improves knee function, and delay the need for TKA. Despite all these advantages its popularity was decreasing in the past but improved meniscal and cartilage restoration techniques renewed interest in knee osteotomies in young patients with knee pain and joint surface defects. Hence, in the last decade, the majority of osteotomies have been performed in combined with cartilage repair, meniscal transplantation, and ligament reconstruction. Understanding the rationale of an osteotomy and the possibility to combine it with other procedures allows us to obtain the most clinical benefit for the patient. This review article provides an overview of the basic osteotomy planning for knee axes malalignment, describing the different techniques based on the location of the deformity and the presence of associated lesions, thus presenting the main results of isolated and combined procedures, to provide useful updates to guide the surgeon in the choice of possible variants or associated gestures.
Keywords: Deformities around the knee, High tibial osteotomy, Clinical outcome.

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How to Cite this article: Alesi D, Rinaldi VG, Meena A, Muccioli GMM, Zaffagnini S | Understanding osteotomy: a narrative review | Journal of Clinical Orthopaedics | January-June 2020; 5(1):21-30.

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Beliefs regarding knee pain in Indian adults: A knowledge, attitude and practice (KAP) survey

January 10, 2020/in For New site, Vol 5 | Issue 1 | Jan-June 2020 /by editor.jcorth

Author: Keyur B. Desai [1], Shruti A. Mondkar [2]

[1] Department of Orthopaedics, King Edward VII Memorial Hospital, Parel, Mumbai, India.
[2] Department of Pediatrics, King Edward VII Memorial Hospital, Parel, Mumbai, India.

Address of Correspondence
Dr. Keyur B. Desai,
401, Dadarkar arcade, N.L parelkar marg, opp trimurti building, Parel village. Parel, Mumbai. Maharashtra, India.
E-mail: doctorkbd@gmail.com

Abstract

Background: Belief along with habits and personality acts as important force guiding human behaviour. Health education can modify irrational beliefs and help people adopt healthy behaviour. The aim of this study is to know the existing beliefs among individuals regarding knee pain, its aetiology, and their most effective treatment modality. The study also explores the sources of healthcare information across different age groups that can be utilized for education and creating public awareness. This study also explores the different reasons why individuals do not prefer to attend a health care facility for their knee pain.
Methods: A questionnaire based cross sectional study was designed to assess individuals beliefs and modes of treatment of knee pain, the accessibility to healthcare and the factors responsible for non attendance of healthcare facility. The likely source of health information and use of internet and smart-phones for acquiring health related information was enquired.
Results: ‘Ageing’, ‘Obesity’, ‘Overactivity’, ‘Sports and recreation’, ‘Hereditary’, were among the most commonly believed causes of knee pain. Some irrational beliefs like association with food items, fate etc were also known. Internet and smart phones remain the most accessible and used source of health information among the age group of <20 years and 20-40 years. Health professionals were more trusted for information in the age group of 40-60 and above 60 years.
Conclusions: Regulated health information through widely available medium like internet and smartphones can effectively tweak the false beliefs in the community and help to develop healthy behaviour.
Keywords: Beliefs, Traditions, Education, Aarogya Setu, Physiotherapy, Health information, Internet and health care, Smart phones and health care, Osteoarthritis, Knee pain, Indian beliefs.

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How to Cite this article: Desai KB, Mondkar SA | Beliefs regarding knee pain in Indian adults: A knowledge, attitude and practice (KAP) survey | Journal of Clinical Orthopaedics | January-June 2020; 5(1):47- 54.

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Understanding Osteotomy: A narrative review

January 10, 2020/in For New site, Vol 5 | Issue 1 | Jan-June 2020 /by editor.jcorth

Author: Domenico Alesi [1], Vito Gaetano Rinaldi [1], Amit Meena [2], Giulio Maria Marcheggiani Muccioli [1,3], Stefano Zaffagnini [1,3]

[1] 2nd Orthopaedic and Traumatology Clinic – IRCCS – Istituto Ortopedico Rizzoli – Via G.B. Pupilli 1, 40136, Bologna, Italy.
[2] Central Institute of Orthopaedics, VMMC and Safdarjung Hospital, New Delhi, 110029, India.
[3] DIBINEM, University of Bologna, Bologna, Italy.

Address of Correspondence
Dr. Domenico Alesi,
Resident in Orthopedics and Traumatology, IRCCS – Istituto Ortopedico Rizzoli Via di Barbiano, 1/13, Bologna
E-mail: domenico.alesi@ior.it

Abstract

Osteotomy around the knee is an effective surgical procedure for active, physiologically young patients with symptomatic unicompartmental osteoarthritis (OA) and malalignment. It restores the correct lower limb mechanical alignment, redistributing weight-bearing from a damaged joint surface area to an undamaged one. Hence, it consistently provides relief in knee pain, improves knee function, and delay the need for TKA. Despite all these advantages its popularity was decreasing in the past but improved meniscal and cartilage restoration techniques renewed interest in knee osteotomies in young patients with knee pain and joint surface defects. Hence, in the last decade, the majority of osteotomies have been performed in combined with cartilage repair, meniscal transplantation, and ligament reconstruction. Understanding the rationale of an osteotomy and the possibility to combine it with other procedures allows us to obtain the most clinical benefit for the patient. This review article provides an overview of the basic osteotomy planning for knee axes malalignment, describing the different techniques based on the location of the deformity and the presence of associated lesions, thus presenting the main results of isolated and combined procedures, to provide useful updates to guide the surgeon in the choice of possible variants or associated gestures.
Keywords: Deformities around the knee, High tibial osteotomy, Clinical outcome.

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How to Cite this article: Alesi D, Rinaldi VG, Meena A, Muccioli GMM, Zaffagnini S | Understanding osteotomy: a narrative review | Journal of Clinical Orthopaedics | January-June 2020; 5(1):21-30.

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Micro-core Decompression combined with Intralesional Zoledronic Acid as a treatment of Osteonecrosis of femoral Head: A Novel Technique

January 10, 2020/in For New site, Vol 5 | Issue 1 | Jan-June 2020 /by editor.jcorth

Author: Muhammed Ashraf [1], Jyothis George [1], Ibad Sha I [1]

[1] Department of Orthopedics, Government Medical College, Alappuzha.

Address of Correspondence
Dr. Muhammed Ashraf,
Professor and HOD
Department of Orthopedics
Government Medical College, Alappuzha
E-mail: dr.ashraf.hod@gmail.com

Abstract

Background: Avascular Necrosis / Osteonecrosis of the femoral head is a debilitating condition affecting the hip joint especially in the younger population and is one of the most common causes of total hip replacement in this age group. The available treatments include pharmacological and surgical options with Total hip arthroplasty (THA) being the main stay of treatment. Because of the disadvantages like implant loosening and need for revision surgery especially in young patients. We here is studying a novel technique of combining micro core decompression with intra-lesional bisphosphonate as treatment for osteonecrosis of hip.
Materials and Methods: A prospective study of 19 hips in 15 patients was done. There were 11 males and 4 females with an average age of 54.3 years ranging between 42 – 63 years. Four hips were stage I , ten hips were stage IIA, three hips were stage IIb and two hips were stage III. 16 hips (40%) had stage IIb and 24 hips (60%) had stage III ONFH. The minimum period of follow up was 24 months. All patients were assessed clinically during pre- and post-operative period according to the Harris Hip Score (HHS) and radiologically by X-rays. The operative procedure include decompressing the avascular area with drilling then injecting the zolendronic acid locally through drill holes
Results: The mean preoperative modified Harris Hip Score in stage I(n=4), stage IIa(n=10), stage IIb(n=3) and Stage III(n=2) were 81.9, 72.7, 68.8 and 59.2 respectively. The mean postoperative modified Harris Hip Score at two years in stage I, stage IIa, stage IIb and Stage III were 97.3, 91.1, 88.4 and 82.5 respectively.
Conclusion: We found that the use of micro core-decompression with intra-lesional bisphosphonate will provide higher chances towards hip preservation especially in late cases or cases with larger lesions where core decompression may not be successful.
Keywords: Intra-lesional bisphosphonate, Avascular necrosis hip, Hip preservation surgery, Micro core-decompression.

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How to Cite this article: Ashraf N, George J, Sha II. Micro-core Decompression combined with Intralesional Zoledronic Acid as a treatment of Osteonecrosis of femoral Head: A Novel Technique. Journal of Clinical Orthopaedics Jan-Jun 2020;5(1): 41-46.

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The Role of Serum Procalcitonin in Establishing Diagnosis of Bone and Joint Infections

January 10, 2020/in For New site, Vol 5 | Issue 1 | Jan-June 2020 /by editor.jcorth

Author: John Nolan [1], Putu Feryawan Meregawa [2]

[1] Faculty of Medicine, Udayana University, Denpasar.
[2] Departement of Orthopaedic and Traumatology, Medical Faculty, Udayana University-Sanglah General Hospital Denpasar, Indonesia.

Address of Correspondence
John Nolan,
Faculty of Medicine, Udayana University, Denpasar
E-mail: johnnolan@student.unud.ac.id

Abstract

Background: Acute bone and joint infection such as septic arthritis and osteomyelitis diagnostic are still considered as a pitfall especially in the emergency department. Some laboratory markers, such as total Count (TC), Erythrocyte Sedimentation Rate (ESR) and C – Reactive Protein (CRP) assessed regularly whereas those are not specific. Serum PCT has a role as a sensitive and specific marker in supporting the diagnosis of bone and joint infections.
Method: Literature review is done by searching journals with “serum procalcitonin”, “bone infections”, “diagnosis”, and “joint infections” on the search engines. From 37 journals that were reviewed, 34 were found suitable as reference for this paper.
Outcome: High level of serum PCT indicate the activation of immune system, specifically the innate immune system due to microbial infections. One of the most different aspect with CRP is serum PCT infrequently elevates in response to viral infection, which means PCT is useful in differentiating bacterial and viral infections Serum PCT concentration elevates following the endotoxin or cytokines release such as interleukin (IL)- 6, tumor necrosis factor (TNF)-alpha, and IL-1b which usually appears in bone and joint infections. Although its benefits, there are some limitation interfering the usage and levels of serum PCT.
Conclusion: Serum PCT has a role as a sensitive and specific marker in supporting the diagnosis of bone and joint infections due to its sensitivity following endotoxins release. Further researches and studies are required to identify the appropriate usage, interfering factors, and clinical application of serum PCT in establishing the diagnosis of bone and joint infections.
Keywords: Procalcitonin, Bone infections, joint infections, Diagnosis.

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How to Cite this article: Nolan J, Meregawa P.F. The Role of Serum Procalcitonin in Establishing Diagnosis of Bone and Joint Infections. Journal of Clinical Orthopaedics Jan-Jun 2020;5(1): 3-7.

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