المؤلفون: Hamad, Christopher, Chowdhry, Madhav, Sindeldecker, Devin, Bernthal, Nicholas M, Stoodley, Paul, McPherson, Edward J

المصدر: The Bone & Joint Journal, vol 104-B. (5)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Oncology and Carcinogenesis, Vaccine Related, Antimicrobial Resistance, Infectious Diseases, Prevention, Biodefense, Infection, Anti-Bacterial Agents, Anti-Infective Agents, Arthritis, Infectious, Drug Resistance, Bacterial, Humans, Prosthesis-Related Infections, Adaptive resistance, Microbial variants, PJI, Periprosthetic joint infection, Persister cells, Phoenix colonies, Small colony variants, Transient antimicrobial resistance, Transient hypermutability, Variant selection, antibiotic, antimicrobial agents, biofilms, calcium sulphate, clinicians, organism(s), surgical debridement, toxin

الوصف: Periprosthetic joint infection (PJI) is a difficult complication requiring a comprehensive eradication protocol. Cure rates have essentially stalled in the last two decades, using methods of antimicrobial cement joint spacers and parenteral antimicrobial agents. Functional spacers with higher-dose antimicrobial-loaded cement and antimicrobial-loaded calcium sulphate beads have emphasized local antimicrobial delivery on the premise that high-dose local antimicrobial delivery will enhance eradication. However, with increasing antimicrobial pressures, microbiota have responded with adaptive mechanisms beyond traditional antimicrobial resistance genes. In this review we describe adaptive resistance mechanisms that are relevant to the treatment of PJI. Some mechanisms are well known, but others are new. The objective of this review is to inform clinicians of the known adaptive resistance mechanisms of microbes relevant to PJI. We also discuss the implications of these adaptive mechanisms in the future treatment of PJI. Cite this article: Bone Joint J 2022;104-B(5):575-580.

وصف الملف: application/pdf

URL الوصول: https://escholarship.org/uc/item/6jp5f9cq

المؤلفون: McPherson, Edward J., Crawford, Brooke M., Kenny, Steven G., Dipane, Matthew V., Salarkia, Shahrzad, Stavrakis, Alexandra I., Chowdhry, Madhav

المصدر: In Arthroplasty Today February 2024 25

المؤلفون: Stavrakis, Alexandra, Mayer, Erik N, Devana, Sai, Chowdhry, Madhav, Dipane, Matthew, McPherson, Edward

المصدر: JAAOS Global Research and Reviews. 6(8)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Infectious Diseases, Clinical Research, Infection, Aged, Arthritis, Infectious, Arthrodesis, Arthroplasty, Replacement, Knee, Humans, Knee Prosthesis, Prosthesis-Related Infections, Reinfection, Reoperation, Replantation, Retrospective Studies

الوصف: BackgroundModular knee arthrodesis (MKU) is a salvage treatment for recurrent periprosthetic joint infection (PJI) or PJI associated with notable bone loss. Reimplantation endoprosthetic reconstruction (REI) is an option in patients with MKU who have PJI clearance but are not satisfied with pain or functional outcomes with MKU. The purpose of this study was to evaluate the outcomes of MKU to REI conversion.MethodsThis was a single-center retrospective cohort study of 56 patients who underwent MKU to REI from 2010 to 2019. All patients were staged according to the McPherson staging system. An infecting organism was documented based on pre-MKU aspiration or intraoperative cultures at the time of MKU. Rate ratios were calculated for relevant patient factors. Rate ratios were calculated using Poisson regression with a log link.ResultsThe mean REI patient age was 67 years, most of the patients were McPherson B hosts (62.5%) with a type 2 (46.4%) or type 3 (51.8%) limb score, and all PJI were chronic. The most common infecting organisms at the time of MKU were Staphylococcus epidermidis (23.2%) and Staphylococcus aureus (23.2%, MSSA 14.3%, MRSA 8.9%). The mean time from MKU to REI was 220 days. An 8.9% REI index hospitalization complication rate and a 21.4% overall complication rate (excluding reinfection) were observed. Sixty-seven percent of the patients remained infection-free at an average follow-up of 37 months, among those there was 96.4% implant survivorship. No notable association was observed between index PJI organism or McPherson staging and REI failure secondary to PJI.DiscussionApproximately two thirds of patients who undergo conversion from MKU to REI have infection-free survival at the midterm follow-up. An index infecting organism and a McPherson host type do not seem to be markedly associated with reinfection risk. These findings help guide expectations of PJI MKU conversion to REI.

وصف الملف: application/pdf

URL الوصول: https://escholarship.org/uc/item/7pf0t603

المؤلفون: Khan, Abdul Qayyum, Qamar, Rayed, Chowdhry, Madhav^{Aff1, IDs43465023008318_cor3}, Siddiqui, Bushra, Khan, Saad Mohammad, Gupta, Divas

المصدر: Indian Journal of Orthopaedics. 57(4):603-607

المؤلفون: Ahmad, Sohail, Alam, Intekhab, Khan, Abdul Qayyum, Abbas, Mohammad Baqar, Chowdhry, Madhav

المصدر: In Journal of Orthopaedics December 2023 46:143-149

المؤلفون: Shekhar, Anshu, Chowdhry, Madhav, Subramaniam, Dhiyaneswaran, Dipane, Matthew V., Michael Mynatt, H., Tapasvi, Sachin R., McPherson, Edward J.

المصدر: In The Knee August 2023 43:89-96

المؤلفون: Tapasvi, Sachin R., Shekhar, Anshu, Chowdhry, Madhav, Dipane, Matthew V., McPherson, Edward J.

المصدر: In The Journal of Arthroplasty July 2022 37(7):1283-1288

المؤلفون: Stavrakis, Alexandra I., Mayer, Erik N., Devana, Sai K., Chowdhry, Madhav, Dipane, Matthew V., McPherson, Edward J.

المصدر: In Arthroplasty Today February 2022 13:199-204

المؤلفون: Tapasvi, Sachin R., Shekhar, Anshu, Patil, Shantanu S., Dipane, Matthew V., Chowdhry, Madhav, McPherson, Edward J.

المصدر: In The Journal of Arthroplasty March 2020 35(3):732-740

المؤلفون: Alam, Noor, Abbas, Mohd Baqar, Siddiqui, Yasir S, Julfiqar, Mohd, Abbas, Mazhar, Khan, Mohd Jesan, Chowdhry, Madhav

المصدر: Int J Burns Trauma

مصطلحات موضوعية: Original Article

الوصف: Background: Clubfoot constitutes roughly 70 percent of all foot deformities in arthrogryposis syndrome and 98% of those in classic arthrogryposis. Treatment of arthrogrypotic clubfoot is difficult and challenging due to a combination of factors like stiffness of ankle-foot complex, severe deformities and resistance to conventional treatment, frequent relapses and the challenge is further compounded by presence of associated hip and knee contractures. Method: A prospective clinical study was conducted using a sample of nineteen clubfeet in twelve arthrogrypotic children. During weekly visits Pirani and Dimeglio scores were assigned to each foot followed by manipulation and serial cast application according to the classical Ponseti technique. Mean initial Pirani score and Dimeglio score were 5.23 ± 0.5 and 15.79 ± 2.4 respectively. Mean Pirani and Dimeglio score at last follow up were 2.37 ± 1.9 and 8.26 ± 4.93 respectively. An average of 11.3 casts was required to achieve correction. Tendoachilles tenotomy was required in all 19 AMC clubfeet. Result: The primary outcome measure was to evaluate the role of Ponseti technique in management of arthrogrypotic clubfeet. The secondary outcome measure was to study the possible causes of relapses and complications with additional procedures required to manage clubfeet in AMC an initial correction was achieved in 13 out of 19 arthrogrypotic clubfeet (68.4%). Relapse occurred in 8 out of 19 clubfeet. Five of those relapsed feet were corrected by re-casting ± tenotomy. 52.6% of arthrogrypotic clubfeet were successfully treated by the Ponseti technique in our study. Three patients failed to respond to Ponseti technique required some form of soft tissue surgery. Conclusion: Based on our results, we recommend the Ponseti technique as the first line initial treatment for arthrogrypotic clubfeet. Although such feet require a higher number of plaster casts with a higher rate of tendo-achilles tenotomy but the eventual outcome is satisfactory. Although, relapses are higher than classical idiopathic clubfeet, most of them respond to re-manipulation and serial casting ± re-tenotomy.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=pmid________::33a6d1715028bb2f545f3bd0218c238f
https://europepmc.org/articles/PMC10195217/