Anterior cervical discectomy and fusion with Zero-P-Plate in the treatment of cervical disc prolapse

/in /by

Journal of Clinical Orthopaedics | Vol 4 | Issue 2 |  July-Dec 2019 | page:57-60 | Rajendraprasad R Butala, Shikhar D Singh, Sachin Y Kale, Prasad Chaudhari, Sanjay Dhar, Prakash Samant

Author: Rajendraprasad R Butala [1], Shikhar D Singh [1], Sachin Y Kale [1], Prasad Chaudhari [1], Sanjay Dhar [1] , Prakash Samant [1]

[1] Department of Orthopaedics, Dr. DY Patil Medical College, Navi Mumbai

Address of Correspondence

[1] Department of Orthopaedics, Dr. DY Patil Medical College, Navi Mumbai

Address of Correspondence
Dr. Shikhar D Singh,
Department of Orthopaedics, Dr. DY Patil Medical College
Sector 7, Nerul, Navi Mumbai, Maharashtra 400706
E-mail: drsinghshikhar@gmail.com

Abstract

Introduction: Anterior cervical discectomy and fusion (ACDF) is an effective treatment of intervertebral disc herniation. The zero-profile interbody fusion device, Zero-P was invented to reduce complications due to previously used anterior constructs. The present study investigates the outcome of surgical decompression and stabilization by anterior approach using Zero-P-Plate.
Methodology: We collected data of 22 patients of cervical disc prolapse with neurological deficits treated with ACDF using Zero-P implant. The patients were assessed pre-operatively and during follow up on outpatient basis at 2 weeks, 6 weeks, 12 weeks, 24 weeks and then on yearly basis for 2 years. The outcome was assessed based on Visual Analogue Scale (VAS) score, Nurick grading and Odom’s criteria and success of fusion.
Results: Radiculopathy was present in all patients pre-operatively. We observed that 77% of the patients had VAS score of 4 or higher pre-operatively, which reduced to 13% in the immediate post-operative period and 0% at the last follow up. Nurick grade 2 or higher was seen in 31% pre-operatively, a percentage which reduced to 0% in the post-operative period. Final clinical outcome using Odom’s criteria revealed excellent outcome in 87% of the patients and good outcome in 13%.
Conclusions: ACDF by Zero-P-Plate can be considered in treatment of patients with cervical disc prolapse with neurological deficit.
Keywords: Anterior cervical discectomy and fusion; Cervical disc disease; Intervertebral fusion device.

References

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6. Njoku I, Alimi M, Leng LZ, Shin BJ, James AR, Bhangoo S, Tsiouris AJ, Härtl R. Anterior cervical discectomy and fusion with a zero-profile integrated plate and spacer device: a clinical and radiological study. Journal of Neurosurgery: Spine. 2014 Oct 1;21(4):529-37.
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How to Cite this article: Butala R R, Singh S D, Kale S T, Chaudhari P, Dhar S, Samant P. Anterior cervical discectomy and fusion with Zero-P-Plate in the treatment of cervical disc prolapse. Journal of Clinical Orthopaedics July-Dec 2019;4(2):57-60.

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Preventive Strategy for Surgical Site Infections in Orthopaedics

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Journal of Clinical Orthopaedics | Vol 4 | Issue 2 |  July-Dec 2019 | page:51-56 | Dr. Anoop C. Dhamangaonkar

Author: Dr. Anoop C. Dhamangaonkar [1]

[1] Department of Orthopaedics, LTMGH, Mumbai

Address of Correspondence
Dr. Anoop C. Dhamangaonkar,
Department of Orthopaedics, LTMGH, Mumbai

Abstract

Surgical site infections are serious complication of any surgery. There are many factors that affect the incidence of surgical site infections and if these factors are understood and controlled to a certain extent, it will help in reducing the incidence of SSIs. In current review, an overview of patient factors, Operative set up and intraoperative precautions are presented which will help in understanding and preventing SSIs.
Keywords: Surgical site infection, Orthoapedics, Prevention.

References

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53. Wang Q, Goswami K, Shohat N, Aalirezaie A, Manrique J, Parvizi J. Longer Operative Time Results in a Higher Rate of Subsequent Periprosthetic Joint Infection in Patients Undergoing Primary Joint Arthroplasty.J Arthroplasty. 2019;34(5):947-953.

How to Cite this article: Dhamangaonkar A C. Preventive Strategy for Surgical Site Infections in Orthopaedics. Journal of Clinical Orthopaedics July-Dec 2019;4(2):51-56.

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Peri-proshthetic Joint Infection

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Journal of Clinical Orthopaedics | Vol 4 | Issue 2 |  July-Dec 2019 | page:45-50 | Shubhranshu S. Mohanty, Swapnil A. Keny

Author: Shubhranshu S. Mohanty [1], Swapnil A. Keny [1]

[1] Dept. of Orthopaedics, Seth GS Medical College & King Edward Memorial Hospital, Mumbai.

Address of Correspondence
Dr. Shubhranshu S. Mohanty,
Dept. of Orthopaedics, Seth GS Medical College & King Edward Memorial Hospital, Mumbai.
E-mail: drssmohanty@hotmail.com

Abstract

Prosthetic joint infections in one of the most serious complication of Joint Arthroplasty. Over the years the understanding and management of PJI has evolved. The current review presents and overviews of the recent advances in the field
Keywords: Prosthetic joint infection, arthroplasty.

References

1. Duff GR Lachiewicz PF, Kelley SS. Aspiration of the knee joint before revision arthroplasty. Clin Orthop Relal Res, 1996:132-9
2. Parvizi J, Ghanem E, Menashe S, Barrack RL, Bauer TW. Periprosthetic infection: what are the diagnostic challenges? J Bone Joint Surg Am. 2006 Dec;88 Suppl 4:138-47. .
3. Pulido L, Ghanem E, Joshi A, Purtill JJ, Parvizi J. Periprosthetic joint infection: the incidence, timing, and predisposing factors. Clin Orthop Relat Res. 2008 Jul;466(7):1710-5.
4. Gristina AG, Costerton JW. Bacterial adherence and the glycocalyx and their role in musculoskeletal infection. Orthop Clin North Am 1984;15:517‑35.
5. Aggarwal VK, Rasouli MR, Parvizi J. Periprosthetic joint infection: Current concept. Indian J Orthop 2013;47:10-7.
6. Zmistowski B, Fedorka CJ, Sheehan E, Deirmengian G, Austin MS, Parvizi J. Prosthetic joint infection caused by gram‑negative organisms. J Arthroplasty 2011;26:104‑8.
7. Marculescu CE, Cantey JR. Polymicrobial prosthetic joint infections: risk factors and outcome. Clin Orthop Relat Res. 2008;466(6):1397–1404.
8. Namba RS, Inacio MC, Paxton EW. Risk factors associated with deep surgical site infections after primary total knee arthroplasty: an analysis of 56,216 knees. J Bone Joint Surg Am. 2013 May.1;95(9):775-82.
9. Kurtz SM, Lau E, Schmier J, Ong KL, Zhao K, Parvizi J. Infection burden for hip and knee arthroplasty in the United States. J Arthroplasty. 2008 Oct;23(7):984-91.
10. Parvizi J, Zmistowski B, Berbari EF, Bauer TW, Springer BD, Della Valle CJ, Garvin KL, Mont MA, Wongworawat MD, Zalavras CG. New definition for periprosthetic joint infection: from the Workgroup of the Musculoskeletal Infection Society. Clin Orthop Relat Res. 2011 Nov;469(11):2992-4.
11. Chun KC, Kim KM, Chun CH. Infection following total knee arthroplasty. Knee Surg Relat Res. 2013;25(3):93–99.
12. Tsukayama DT, Goldberg VM, Kyle R. Diagnosis and management of infection after total knee arthroplasty. J Bone Joint Surg Am. 2003;85 Suppl 1:S75-80.
13. Spangehl MJ, Masri BA, O’Conneii JX, Duncan CP Prospective analysis of preoperative and intraoperative investigations for the diagnosis of infection at the sites of two hundred and two revision total hip arthroplasties. J Bone Joint Surg Am. 1999:81:672-83.
14. Ghanem E, Parvizi J, Burnett RS, Sharkey PF, Keshavarzi N, Aggarwal A, Barrack RL. Cell count and differential of aspirated fluid in the diagnosis of infection at the site of total knee arthroplasty. J Bone Joint Surg Am. 2008 Aug;90(8):1637-43.
15. Feldman DS, Lonner JH, Desai p Zuckerman JD. The role of intra operative frozen sections in revision total joint arthroplasty. J Bone Jomt Surg Am. 1995:77:1807-13.
16. Zywiel MG, Stroh DA, Johnson AJ, Marker DR, Mont MA. Gram stains have limited application in the diagnosis of infected total knee arthroplasty. Int J Infect Dis. 2011 Oct;15(10):e702-5.
17. Schoof B, Jakobs O, Schmidl S, et al. Fungal periprosthetic joint infection of the hip: a systematic review. Orthop Rev (Pavia). 2015;7(1):5748. Published 2015 Mar 31.
18. Berbari EF, Marculescu C, Sia I, Lahr BD, Hanssen AD, Steckelberg JM, et al. Culture‑negative prosthetic joint infection. Clin Infect Dis 2007;45:1113‑9.
19. Tsaras G, Maduka-Ezeh A, Inwards CY, Mabry T, Erwin PJ, Murad MH, Montori VM,West CP, Osmon DR, Berbari EF. Utility of intraoperative frozen section histopathology in the diagnosis of periprosthetic joint infection: a systematic review and meta-analysis. J Bone Joint Surg Am. 2012 Sep 19;94(18):1700-11.Review.
20. Parvizi J, Jacovides C, Antoci V, Ghanem E. Diagnosis of periprosthetic joint infection: The utility of a simple yet unappreciated enzyme. J Bone Joint Surg Am 2011;93:2242‑8.
21. Berbari E, Mabry T, Tsaras G, Spangehl M, Erwin PJ, Murad MH, Steckelberg J,Osmon D. Inflammatory blood laboratory levels as markers of prosthetic joint infection: a systematic review and meta-analysis. J Bone Joint Surg Am. 2010 Sep1;92(11):2102-9.
22. ungerford DS. Infected total knee arthroplasty treated by arthroscopic irrigation and débridement. J Arthroplasty. 2000 Jun;15(4):430-6.
24. Thakrar RR, Horriat S, Kayani B, Haddad FS. Indications for a single-stage exchange arthroplasty for chronic prosthetic joint infection: a systematic review. Bone Joint J. 2019 Jan;101-B(1_Supple_A):19-24.
25. Gehrke T, Zahar A, Kendoff D. One-stage exchange: it all began here. Bone Joint J. 2013 Nov;95-B(11 Suppl A):77-83.
26. Lee YS, Chen AF. Two-Stage Reimplantation in Infected Total Knee Arthroplasty. Knee Surg Relat Res. 2018;30(2):107–114.

How to Cite this article: Mohanty S S, Keny S A. Peri-proshthetic Joint Infection. Journal of Clinical Orthopaedics July-Dec 2019;4(2):45-50.

(Abstract    Full Text HTML)   (Download PDF)

 

 

 

Peri-proshthetic Joint Infection

/in /by

Journal of Clinical Orthopaedics | Vol 4 | Issue 2 |  July-Dec 2019 | page:45-50 | Dr. Shubhranshu S. Mohanty, Dr. Swapnil A. Keny

Author: Dr. Shubhranshu S . Mohanty [1], Dr. Swapnil A. Keny [1]

[1] Dept. of Orthopaedics, Seth GS Medical College & King Edward Memorial Hospital, Mumbai.

Address of Correspondence
Dr. Shubhranshu S. Mohanty,
Dept. of Orthopaedics, Seth GS Medical College & King Edward Memorial Hospital, Mumbai.
E-mail: drssmohanty@hotmail.com

Abstract

Prosthetic joint infections in one of the most serious complication of Joint Arthroplasty. Over the years the understanding and management of PJI has evolved. The current review presents and overviews of the recent advances in the field
Keywords: Prosthetic joint infection, arthroplasty.

References

1. Duff GR Lachiewicz PF, Kelley SS. Aspiration of the knee joint before revision arthroplasty. Clin Orthop Relal Res, 1996:132-9
2. Parvizi J, Ghanem E, Menashe S, Barrack RL, Bauer TW. Periprosthetic infection: what are the diagnostic challenges? J Bone Joint Surg Am. 2006 Dec;88 Suppl 4:138-47. .
3. Pulido L, Ghanem E, Joshi A, Purtill JJ, Parvizi J. Periprosthetic joint infection: the incidence, timing, and predisposing factors. Clin Orthop Relat Res. 2008 Jul;466(7):1710-5.
4. Gristina AG, Costerton JW. Bacterial adherence and the glycocalyx and their role in musculoskeletal infection. Orthop Clin North Am 1984;15:517‑35.
5. Aggarwal VK, Rasouli MR, Parvizi J. Periprosthetic joint infection: Current concept. Indian J Orthop 2013;47:10-7.
6. Zmistowski B, Fedorka CJ, Sheehan E, Deirmengian G, Austin MS, Parvizi J. Prosthetic joint infection caused by gram‑negative organisms. J Arthroplasty 2011;26:104‑8.
7. Marculescu CE, Cantey JR. Polymicrobial prosthetic joint infections: risk factors and outcome. Clin Orthop Relat Res. 2008;466(6):1397–1404.
8. Namba RS, Inacio MC, Paxton EW. Risk factors associated with deep surgical site infections after primary total knee arthroplasty: an analysis of 56,216 knees. J Bone Joint Surg Am. 2013 May.1;95(9):775-82.
9. Kurtz SM, Lau E, Schmier J, Ong KL, Zhao K, Parvizi J. Infection burden for hip and knee arthroplasty in the United States. J Arthroplasty. 2008 Oct;23(7):984-91.
10. Parvizi J, Zmistowski B, Berbari EF, Bauer TW, Springer BD, Della Valle CJ, Garvin KL, Mont MA, Wongworawat MD, Zalavras CG. New definition for periprosthetic joint infection: from the Workgroup of the Musculoskeletal Infection Society. Clin Orthop Relat Res. 2011 Nov;469(11):2992-4.
11. Chun KC, Kim KM, Chun CH. Infection following total knee arthroplasty. Knee Surg Relat Res. 2013;25(3):93–99.
12. Tsukayama DT, Goldberg VM, Kyle R. Diagnosis and management of infection after total knee arthroplasty. J Bone Joint Surg Am. 2003;85 Suppl 1:S75-80.
13. Spangehl MJ, Masri BA, O’Conneii JX, Duncan CP Prospective analysis of preoperative and intraoperative investigations for the diagnosis of infection at the sites of two hundred and two revision total hip arthroplasties. J Bone Joint Surg Am. 1999:81:672-83.
14. Ghanem E, Parvizi J, Burnett RS, Sharkey PF, Keshavarzi N, Aggarwal A, Barrack RL. Cell count and differential of aspirated fluid in the diagnosis of infection at the site of total knee arthroplasty. J Bone Joint Surg Am. 2008 Aug;90(8):1637-43.
15. Feldman DS, Lonner JH, Desai p Zuckerman JD. The role of intra operative frozen sections in revision total joint arthroplasty. J Bone Jomt Surg Am. 1995:77:1807-13.
16. Zywiel MG, Stroh DA, Johnson AJ, Marker DR, Mont MA. Gram stains have limited application in the diagnosis of infected total knee arthroplasty. Int J Infect Dis. 2011 Oct;15(10):e702-5.
17. Schoof B, Jakobs O, Schmidl S, et al. Fungal periprosthetic joint infection of the hip: a systematic review. Orthop Rev (Pavia). 2015;7(1):5748. Published 2015 Mar 31.
18. Berbari EF, Marculescu C, Sia I, Lahr BD, Hanssen AD, Steckelberg JM, et al. Culture‑negative prosthetic joint infection. Clin Infect Dis 2007;45:1113‑9.
19. Tsaras G, Maduka-Ezeh A, Inwards CY, Mabry T, Erwin PJ, Murad MH, Montori VM,West CP, Osmon DR, Berbari EF. Utility of intraoperative frozen section histopathology in the diagnosis of periprosthetic joint infection: a systematic review and meta-analysis. J Bone Joint Surg Am. 2012 Sep 19;94(18):1700-11.Review.
20. Parvizi J, Jacovides C, Antoci V, Ghanem E. Diagnosis of periprosthetic joint infection: The utility of a simple yet unappreciated enzyme. J Bone Joint Surg Am 2011;93:2242‑8.
21. Berbari E, Mabry T, Tsaras G, Spangehl M, Erwin PJ, Murad MH, Steckelberg J,Osmon D. Inflammatory blood laboratory levels as markers of prosthetic joint infection: a systematic review and meta-analysis. J Bone Joint Surg Am. 2010 Sep1;92(11):2102-9.
22. ungerford DS. Infected total knee arthroplasty treated by arthroscopic irrigation and débridement. J Arthroplasty. 2000 Jun;15(4):430-6.
24. Thakrar RR, Horriat S, Kayani B, Haddad FS. Indications for a single-stage exchange arthroplasty for chronic prosthetic joint infection: a systematic review. Bone Joint J. 2019 Jan;101-B(1_Supple_A):19-24.
25. Gehrke T, Zahar A, Kendoff D. One-stage exchange: it all began here. Bone Joint J. 2013 Nov;95-B(11 Suppl A):77-83.
26. Lee YS, Chen AF. Two-Stage Reimplantation in Infected Total Knee Arthroplasty. Knee Surg Relat Res. 2018;30(2):107–114.

How to Cite this article: Mohanty S S, Keny S A. Peri-proshthetic Joint Infection. Journal of Clinical Orthopaedics July-Dec 2019;4(2):45-50.

(Abstract    Full Text HTML)   (Download PDF)

 

 

 

Surgical Site Infections in Orthopaedics: Epidemiology & Microbiology

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Journal of Clinical Orthopaedics | Vol 4 | Issue 2 |  July-Dec 2019 | page:7-11 | Dr. Kedar Deogaonkar, Aditya Menon, Gautam Zaveri

Author: Dr. Kedar Deogaonkar [1], Aditya Menon [2], Gautam Zaveri [3]

[1] Department of Spine Surgery, Jaslok Hospital & Research Centre.

Address of Correspondence
Dr. Gautam Zaveri,
Department of Spine Surgery, Jaslok Hospital & Research Centre
E-mail: gautamzaveri1969@gmail.com

Abstract

Surgical site infections are one of the most common nosocomial infections. understanding epidemiology and microbiology of SSI will help in defining the problem and developing stratergies for prevention and management
Keywords: Surgical Site infection, Diagnosis.

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How to Cite this article: Deogaonkar K, Menon A, Zaveri G. Surgical Site Infections in Orthopaedics: Epidemiology & Microbiology. Journal of Clinical Orthopaedics July-Dec 2019;4(2):7-11.

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