Dr. José Carlos Cortés Sandoval
Instituto de Cirugía Hombro y Codo
martes, 30 de septiembre de 2014
Customizing a prosthesis: shoulder arthroplasty after a total elbow
Customizing a prosthesis: shoulder arthroplasty after a total elbow http://t.co/BARXvh5oR5
— Dr Frederick Matsen (@shoulderarth) agosto 20, 2014
Intra-articular antibiotics as prophylaxis in total shoulder arthroplasty
http://shoulderarthritis.blogspot.mx/2014/09/intra-articular-antibiotics-as.html?utm_source=twitterfeed&utm_medium=twitter
Intraoperative intra-articular injection of gentamicin: will it decrease the risk of infection in total shoulder arthroplasty?
These authors conducted a retrospective study of 507 shoulder arthroplasties (433 primary and 71 revisions) performed between 2005 and 2011. All patients received Cefazolin (or Clindamycin or Vancomycin) intravenous prophylaxis. In 343 patients operated after June 2007, 160 mg of gentamicin in 20 mL of saline was injected into the joint just before closure.
Friday, September 26, 2014
Intra-articular antibiotics as prophylaxis in total shoulder arthroplasty
Intraoperative intra-articular injection of gentamicin: will it decrease the risk of infection in total shoulder arthroplasty?
These authors conducted a retrospective study of 507 shoulder arthroplasties (433 primary and 71 revisions) performed between 2005 and 2011. All patients received Cefazolin (or Clindamycin or Vancomycin) intravenous prophylaxis. In 343 patients operated after June 2007, 160 mg of gentamicin in 20 mL of saline was injected into the joint just before closure.
These cases were reviewed for evidence of deep postoperative infection within 6 month of surgery as evidenced by increasing pain, elevated erythrocyte sedimentation rate and Creactive protein level, clinical appearance of infection at the time of surgery, possible positive culture, and more than 10 white blood cells per high-power field.
Six shoulders were thought to have developed infection, one with Staph aureus, one with Methacillin resistant Staph aureus and one with Staph epidermidis. In three cases the cultures were negative. Five of these cases were operated before June 2007 and one after.
Comment: The use of topical antibiotics to reduce the risk of infection in shoulder arthroplasty is receiving increased attention as shown here. This approach makes sense in that high local concentrations can be achieved without the risk of systemic complications, at least initially (we don't know how long injected or sprinkled antibiotics will hang around in the wound before reabsorption). In this study half of the cases showing signs of infection were culture negative, so we can't be sure that bugs were really there. It is also of note that although the demographics of the patients operated before and after June of 2007 were similar, the surgeon and the team caring for the patients later in the series were more experienced than for the patients earlier in the series. For example, it is possible that open wound times became shorter over the duration of the study, a factor that could also lower the risk of infecton. Finally, the culture protocols for this study were not specified. We know that many apparently 'aseptic' revisions are actually culture positive. The organism accounting for the preponderance of positive cultures at revision arthroplasty isPropionibacterium - this organism requires special means for detecting its presence. Surprisingly, none of these cases were culture positive for this most common arthroplasty infector.
lunes, 29 de septiembre de 2014
Lesión de la unión miotendinosa distal del recto anterior. (Fascia posterior)
Lesión de la unión miotendinosa distal del recto anterior. (Fascia posterior)
#ecografia pic.twitter.com/IrDT3ndHsc
— Eduardo Alvarez Gil (@edufisiomieres) marzo 20, 2014
Pues nuestro amigo @Javier08R ha fracturado su peroné Un simple esguince? Noo! La #ecografía nos ayuda al diagnóstico
Pues nuestro amigo @Javier08R ha fracturado su peroné
Un simple esguince?
Noo!
La #ecografía nos ayuda al diagnóstico pic.twitter.com/YLdTF2Wctw
— Clinica Fisiorama (@Fisiorama) agosto 18, 2014
Ultrasound confirms carpal tunnel syndrome with better specificity and sensitivity
IN THE JOURNALS
Ultrasound confirms carpal tunnel syndrome with better specificity and sensitivity
domingo, 28 de septiembre de 2014
sábado, 27 de septiembre de 2014
Lesiones deportivas. Dolor de hombro.
http://www.hekkafisioterapia.com/Blog/articulo/Lesiones_deportivas_Dolor_de_hombro
Lesiones deportivas. Dolor de hombro.
http://t.co/11Z2WMEGwJ
Ven a @hekka_fis, somos expertos en ecografías para ver el alcance de lesiones.
— Hekka Fisioterapia (@hekka_fisio) diciembre 28, 2013
Discusión entre pares / 65 y female patient poly traumatized with plate humerous...
65 y female patient poly traumatized with plate humerous , plate ulna and plate for supracondylar femur 25 days ago now presented by this x ray
Suscribirse a:
Entradas (Atom)