Notes

Recent Improvements throughout Liposomal-Based Anti-Inflammatory Treatment.
This study tests the elution capabilities of a magnesium phosphate cement (MPC). Study objectives were to quantify the passive release of magnesium ions from MPC and to assess the effects of antibiotic-loaded MPC on bacterial growth and osteoblast viability.

MPC constructs were created and incubated in fetal bovine serum (FBS). At 2, 4, and 17 weeks, a sample was collected for magnesium ion concentration analysis. Control and vancomycin-loaded (vanc) MPC beads were also created. Zone of inhibition was measured after incubating beads on
agar plates for 24h. Osteoblasts were seeded onto control and vanc beads and cultured for 9 days. Metabolic activity was measured via a resazurin assay. ANOVA with Tukey HSD post-hoc tests and t-tests were performed.

Magnesium ions were eluted at 2 and 4-week time points without significant difference, but demonstrated a significant spike at the 17-week time point. Zones of inhibition for the bacterial species was observed for Vanc-MPC beads, but not control beads. No cytotoxic effects on osteoblasts were noted.

MPC has potential to improve bone regeneration based on its ability to passively elute magnesium. Additionally, antibiotic-loaded MPC inhibits bacterial growth while avoiding osteoblast cytotoxicity.
MPC has potential to improve bone regeneration based on its ability to passively elute magnesium. Additionally, antibiotic-loaded MPC inhibits bacterial growth while avoiding osteoblast cytotoxicity.
Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are commonly used inflammatory markers utilized to aid in the diagnosis of periprosthetic infection (PJI). Patients with obesity, however, are known to have elevated baseline levels of these inflammatory markers. Therefore, this retrospective study aimed to determine the relationship between elevated ESR and CRP and body mass index (BMI) in patients undergoing total knee arthroplasty (TKA). In doing so, physicians can better determine whether BMI should be taken into account when evaluating the prognostic value of elevated preoperative ESR and CRP levels for risk of PJI in primary TKA patients.

This is a retrospective case series of 181 patients who had undergone primary TKA at a single institution. Patients undergoing primary unilateral TKA were eligible unless they had undergone previous TKA, contralateral knee symptoms, or elevated white blood cell (WBC) count. A linear regression model was utilized to demonstrate the relationship betweeizing ESR and CRP to diagnose periprosthetic joint infection without considering BMI given that increasing preoperative levels of ESR and CRP are correlated with higher BMI.
Caution is advised when utilizing ESR and CRP to diagnose periprosthetic joint infection without considering BMI given that increasing preoperative levels of ESR and CRP are correlated with higher BMI.
Both adductor canal block (ACB) and of Local Infiltrative Analgesia (LIA) have been shown to reduce pain after total knee arthroplasty (TKA). The efficacy of combining ACB and LIA remains controversial. The objective of this study is to analyse the effect of LIA+single dose ACB compared to LIA alone on early post-operative pain and mobilization in TKA.

This Cohort Prospective study analyses the Visual Analogue Score (VAS) pain scores and rehabilitation milestones at 24h between LIA alone and LIA+single dose ACB in unilateral TKA operated by a single surgeon between August 2014 and February 2019.

VAS at rest and on movement were significantly better in the combined LIA+ACB group (n=151) compared to LIA (n=120) alone at 24h. All patients were able to achieve the desired milestones of sitting, standing by the bedside and walking with the help of a walker within 24h of the surgery.

Though the VAS scores were statistically significant, the actual scores at rest and on movement in both groups were significantly better than preoperative scores with excellent pain relief. All patients in both groups were able to ambulate within 24h. LIA alone significantly improved the pain scores and enabled early mobilization. Addition of single dose ACB to LIA did not significantly alter the milestones.
Though the VAS scores were statistically significant, the actual scores at rest and on movement in both groups were significantly better than preoperative scores with excellent pain relief. All patients in both groups were able to ambulate within 24 h. LIA alone significantly improved the pain scores and enabled early mobilization. Addition of single dose ACB to LIA did not significantly alter the milestones.
this study aims to evaluate the relationship between body mass index (BMI), age at which knee joint arthroplasty is performed and complications. selleck chemical The hypothesis is that the higher the BMI, the greater likelihood that the patient will require surgery at an earlier age.Methods this is a cohort study with all patients who underwent a primary knee arthroplasty, between August 2013 and February 2019, in a tertiary level university hospital. Association between BMI, age and complications were analyzed. Quality of life of patients was also evaluated with the Oxford Knee Score (OKS).

565 primary total knee replacements (TKR) were performed. A cut-off point was found in BMI of 30; 348 patients had a BMI ≤30 and 173 patients had a BMI >30. When comparing the two groups, a statistically significant difference (p=0.0186) was found in the age at which the TKR was performed. There was a significant improvement for both groups in functional score (Oxford knee score). Additionally, intra and post-operative complications showed no statistically significant difference.

patients with BMI greater than 30 required primary knee arthroplasty at a younger age (average 3.5 years), compared to patients with a lower BMI. Obesity does not appear to confer and independent risk for surgery in the short and mid-term. Knee arthroplasty improves significantly quality of life in the short and mid-term, regardless of their BMI, as measured with the OKS.
patients with BMI greater than 30 required primary knee arthroplasty at a younger age (average 3.5 years), compared to patients with a lower BMI. Obesity does not appear to confer and independent risk for surgery in the short and mid-term. Knee arthroplasty improves significantly quality of life in the short and mid-term, regardless of their BMI, as measured with the OKS.
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