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Li Q, Wang X, Wang Y, Liu F, Fu B. A unilateral external fixator combined with bone transport and tibio-talar fusion for the treatment of severe postoperative infection of peri-ankle fractures: retrospective analysis of 32 cases. J Orthop Surg Res 2024; 19:110. [PMID: 38308313 PMCID: PMC10837972 DOI: 10.1186/s13018-024-04586-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/26/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND To investigate the clinical effects of a unilateral external fixator combined with bone transport and tibio-talar fusion in the treatment of severe postoperative infection of peri-ankle fractures. METHODS The clinical data of 32 patients (22 men and 10 women) with severe postoperative infection of peri-ankle fractures were retrospectively analyzed. Patients' age ranged from 26 to 62 (mean, 42 ± 9.5) years old. The types of fractures were distal tibia fracture (25 cases), distal tibia and fibula fracture (5 cases), and talus fracture (2 cases). All patients underwent treatment with unilateral external fixation combined with bone transport and tibio-talar fusion. 6 patients with severe infection received two-stage treatment involving focal debridement and external fixation, osteotomy, and bone transport. The remaining 26 patients underwent debridement, external fixation, and osteotomy simultaneously. The length of bone transport, total fixation time of the external fixator, and postoperative complications were recorded for all patients. The efficacy of the treatment was assessed using the American Association of Foot and Ankle Society (AOFAS) ankle-hindfoot score. RESULTS Patients were followed up for 16-36 months, with an average follow-up time of 24 months. The length of tibia bone transport ranged from 5 to 15 cm, with a mean length of 8.5 cm. The external fixator was applied for 12-24 months, with an average duration of 16 months. One patient suffered from refracture at tibio-talar fusion site, and one patient had external fixation pin-tract infection. No complications, such as recurrent infections (especially the MRSA infection), poor mineralization, refracture, iatrogenic nerve damage or fusion failure, were found in the remaining patients. The preoperative AOFAS ankle-hindfoot function score was 40.0 ± 3.8 (range, 30-52) points, and it increased to 75.0 ± 3.0 (range, 67-78) points at the last follow-up. CONCLUSION A unilateral external fixator combined with bone transport and tibio-talar fusion is an effective method for treating severe postoperative infection of peri-ankle fractures. This approach is capable of reconstructing large bone defects that remain after clearing the infected lesion. Additionally, it provides stability to the ankle, enhances ankle-hindfoot function, and improves the patient's quality of life.
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Affiliation(s)
- Qinghu Li
- Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No.324, Road Jing Wu Wei Qi, Jinan, 250021, Shandong, China
| | - Xin Wang
- Department of Anesthesiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No.324, Road Jing Wu Wei Qi, Jinan, 250021, Shandong, China
| | - Yonghui Wang
- Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No.324, Road Jing Wu Wei Qi, Jinan, 250021, Shandong, China
| | - Fanxiao Liu
- Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No.324, Road Jing Wu Wei Qi, Jinan, 250021, Shandong, China
| | - Baisheng Fu
- Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No.324, Road Jing Wu Wei Qi, Jinan, 250021, Shandong, China.
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Shane AM, Reeves CL, Nguyen GB, Ferrise TD, Calaj PM. Soft Tissue Pathology. Clin Podiatr Med Surg 2023; 40:381-395. [PMID: 37236677 DOI: 10.1016/j.cpm.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A wide spectrum of pathologies can lead to soft tissue abnormalities within the ankle joint. Many of these disorders can develop into irreversible joint degeneration if left untreated. Arthroscopy is frequently used to treat these soft tissue conditions such as instability, synovitis, impingement, arthrofibrosis, and other inflammatory disorders in the rearfoot and ankle. In general, the etiology of these ankle soft tissue disorders can be classified as traumatic, inflammatory, and congenital/neoplastic. Overall, the goal of diagnosing and treating soft tissue pathologies of the ankle is to restore anatomic and physiologic motion, reduce pain, optimize functional return to activity, and decrease the chance of recurrence while minimizing complications.
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Affiliation(s)
- Amber M Shane
- Department of Podiatric Surgery Advent Health System, Advent Health East Orlando Podiatric Surgery Residency, Upperline Health, 250 North Alafaya Trail Suite 1115, Orlando, FL 32828, USA; Department of Podiatric Surgery, Advent Health East Orlando Podiatric Surgery Residency, 250 North Alafaya Trail Suite 1115, Orlando, FL 32828, USA.
| | - Christopher L Reeves
- Department of Podiatric Surgery, Advent Health East Orlando Podiatric Surgery Residency, 250 North Alafaya Trail Suite 1115, Orlando, FL 32828, USA; Rothman Institute, Foot and Ankle Surgery, Advent Health East Orlando Hospital, 7727 Lake Underhill Road, Orlando, FL 32822, USA
| | - Garrett B Nguyen
- Department of Podiatric Surgery, Advent Health East Orlando Podiatric Surgery Residency, 250 North Alafaya Trail Suite 1115, Orlando, FL 32828, USA
| | - Thomas D Ferrise
- Department of Podiatric Surgery, Advent Health East Orlando Podiatric Surgery Residency, 250 North Alafaya Trail Suite 1115, Orlando, FL 32828, USA
| | - Phillip M Calaj
- Department of Podiatric Surgery, Advent Health East Orlando Podiatric Surgery Residency, 250 North Alafaya Trail Suite 1115, Orlando, FL 32828, USA
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Thompson JC, Tonsager BM, Boffeli TJ. Arthroscopic Treatment of the Septic Ankle. Clin Podiatr Med Surg 2023; 40:539-552. [PMID: 37236690 DOI: 10.1016/j.cpm.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Ankle joint sepsis is a relatively rare but potentially devastating pathologic process of the lower extremity that requires expeditious identification and management. Establishing the diagnosis of ankle joint sepsis is often challenging as it may present with concomitant pathologies and often lacks consistency in regard to classic clinical characteristics. Once a diagnosis has been established, prompt management is imperative to minimize the potential for long-term sequelae. The purpose of this chapter is to address the diagnosis and management of the septic ankle with a focus on arthroscopic treatment.
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Affiliation(s)
- Jonathan C Thompson
- Division of Orthopedics, Mayo Clinic Health System, 1400 Bellinger Street, Eau Claire, WI 54703, USA.
| | - Ben M Tonsager
- Foot & Ankle Surgical Residency Program, Regions Hospital/HealthPartners Institute, 640 Jackson Street, Saint Paul, MN 55101, USA
| | - Troy J Boffeli
- Foot & Ankle Surgical Residency Program, Regions Hospital/HealthPartners Institute, TRIA Woodbury Orthopedic Center, Foot and Ankle Surgery, HealthPartners Medical Group, 640 Jackson Street, Saint Paul, MN 55101, USA
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Muacevic A, Adler JR, Barros C, Varanda P, Carriço F. Native Knee Septic Arthritis Due to Cutibacterium acnes: A Case Report. Cureus 2022; 14:e33183. [PMID: 36726925 PMCID: PMC9886200 DOI: 10.7759/cureus.33183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2022] [Indexed: 01/02/2023] Open
Abstract
Commensal skin anaerobes have been described as causative agents of prosthetic joint infections. Infection of native joints by these agents are, however, less common. We present the case of a 34-year-old male with recurrent joint effusion following closed trauma to the knee, four years ago, refractory to corticosteroid injections and several arthrocenteses. A synovial biopsy revealed Cutibacterium acnes infection leading to antibiotic therapy with clindamycin, and the patient was referred to orthopaedic and submitted to arthroscopic lavage. Atypical cartilage lesions, resembling the "growth of bacterial colonies", were found in the tibial plateaus with repeated isolation of C. acnes. Inpatient treatment with penicillin and vancomycin was conducted, followed by an oral course of amoxicillin, with no further registered recurrences. In this case, the authors describe a rare cause of native knee septic arthritis while highlighting the importance of repeated microbiology studies and adequate collection technique and sample handling, in order to better ascertain whether the isolated agent represents a contaminated sample or a true infection.
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Davis-Havill B, Burrows KR, Baker JF. Ten-Year Single Center Retrospective Analysis of Adult Native Ankle Joint Septic Arthritis. J Foot Ankle Surg 2022; 61:1221-1226. [PMID: 35307158 DOI: 10.1053/j.jfas.2022.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 11/15/2021] [Accepted: 02/07/2022] [Indexed: 02/03/2023]
Abstract
Septic arthritis (SA) of the native ankle joint can result in serious morbidity and mortality but is a poorly quantified issue with little literature available on its clinical features, treatment and outcomes. This was a 10-y review (N ≥ 30) of adults with SA of the native ankle joint presenting to a single center from December 2009 to January 2019. Patients with prior ankle surgery, prosthetic infection, inoculation from trauma, not initially treated at our institution or lost to follow-up were excluded. Thirty-six patients met inclusion criteria. This is the largest cohort of adult native ankle joint SA in the literature. Mean age was 63.5 y (range 28-93 y). Patients most often presented with pain (91.7%), swelling (61.1%), and fever (22%). Staphylococcus aureus was the most common causative pathogen (63.9%). Readmission rate was 60%. The 1-y mortality rate was 14.3% with Charlson Comorbidity Index and age identified as independent predictors of mortality. No statistically significant predictors were found for returns to theatre. When assessing ankle pain in elderly patients, and those with poor physiology, high clinical index of suspicion should be maintained for this potentially life-threatening condition. We recommend development of evidence-based clinical guidelines for adult native ankle joint SA and establishment of a prospective multi-center database to enable further research in this field.
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Affiliation(s)
- Brittany Davis-Havill
- Faculty of Medical and Health Sciences, University of Auckland, Grafton, Auckland, New Zealand.
| | - Kenan R Burrows
- Department of Orthopaedic Surgery, Waikato Hospital, Hamilton, New Zealand
| | - Joseph F Baker
- Department of Orthopaedic Surgery, Waikato Hospital, Hamilton, New Zealand; Department of Surgery, University of Auckland, Grafton, Auckland, New Zealand
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6
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Ramamurti P, Agarwal AR, Gu A, Fassihi SC, Probasco WV, Quan T, Thakkar SC, Chodos MD. Increased Risk of 90-Day Surgical-Site Infection and Hospital Readmission but Not Reoperation After Open Arthrotomy When Compared With Arthroscopy for Septic Ankle Arthritis. Arthroscopy 2022; 38:1999-2006.e1. [PMID: 35093496 DOI: 10.1016/j.arthro.2022.01.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 01/08/2022] [Accepted: 01/16/2022] [Indexed: 02/02/2023]
Abstract
PURPOSE To compare the rates of reoperation and 90-day perioperative complications between open arthrotomy and arthroscopy for the treatment of septic ankle arthritis using a national all-payer claims database. METHODS Patients with a diagnosis of septic ankle arthritis who underwent irrigation and debridement through arthroscopy or arthrotomy were identified in a national data set from 2015-2020 through an all-payer claims database. Demographic and comorbidity characteristics including age, sex, infectious etiologies, and Elixhauser comorbidities were obtained. The rate of reoperation, defined as a proxy for failure of initial intervention, was the primary outcome. Secondary outcomes including readmissions, surgical-site infections, amputations, wound complications, and 90-day medical complications were compared between the 2 cohorts. RESULTS In total, 168 patients undergoing arthroscopy and 794 patients undergoing arthrotomy for septic ankle arthritis were identified. There were no significant differences in reoperation rates between patients who underwent open arthrotomy and those who underwent arthroscopy (P = .997). However, the rates of surgical-site infection (P = .014) and hospital readmission (P < .001) were significantly higher in the open arthrotomy cohort compared with the arthroscopy cohort. CONCLUSIONS Although there was no significant difference in reoperation rates between arthroscopic and open irrigation and debridement for the treatment of septic ankle arthritis, this study showed significantly higher odds of surgical-site infection and hospital readmission in patients who underwent open arthrotomy when compared with arthroscopy. Case-specific patient and technical considerations should guide the surgical decision-making process to limit secondary complications because this study exemplifies similar reoperation rates between the 2 surgical modalities. LEVEL OF EVIDENCE Level III, nonrandomized cohort analysis.
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Affiliation(s)
- Pradip Ramamurti
- Department of Orthopaedic Surgery, George Washington School of Medicine and Health Sciences, Washington, D.C., U.S.A..
| | - Amil R Agarwal
- Department of Orthopaedic Surgery, George Washington School of Medicine and Health Sciences, Washington, D.C., U.S.A
| | - Alex Gu
- Department of Orthopaedic Surgery, George Washington School of Medicine and Health Sciences, Washington, D.C., U.S.A
| | - Safa C Fassihi
- Department of Orthopaedic Surgery, George Washington School of Medicine and Health Sciences, Washington, D.C., U.S.A
| | - William V Probasco
- Department of Orthopaedic Surgery, George Washington School of Medicine and Health Sciences, Washington, D.C., U.S.A
| | - Theodore Quan
- Department of Orthopaedic Surgery, George Washington School of Medicine and Health Sciences, Washington, D.C., U.S.A
| | - Savyasachi C Thakkar
- Department of Orthopedic Surgery, Johns Hopkins Department of Orthopaedic Surgery, Columbia, Maryland, U.S.A
| | - Marc D Chodos
- Department of Orthopaedic Surgery, George Washington School of Medicine and Health Sciences, Washington, D.C., U.S.A
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7
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[Options and limits of arthroscopic treatment of joint empyema]. Unfallchirurg 2021; 125:26-32. [PMID: 34874471 DOI: 10.1007/s00113-021-01111-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2021] [Indexed: 10/19/2022]
Abstract
Due to its low invasive nature, arthroscopy nowadays represents the gold standard in the treatment of native joint empyema. This article gives a summary of the literature with expert recommendations, reviews and case reports on arthroscopic treatment of native joint empyema and the limitations. Most cases of native joint empyema can be successfully cleansed with arthroscopic treatment alone including lavage and débridement. In advanced stages of infection open arthrotomy is often needed for final infection cleansing. In postoperative infections with enclosed foreign material, such as after cruciate ligament reconstruction, the foreign material can in most cases be left in and successful infection eradication can be carried out with several arthroscopic lavages and débridement. In cases of higher grade infections with destruction of the joint, arthroscopic treatment alone is normally insufficient.
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Hong YC, Jung KJ, Chang HJ, Yeo ED, Lee HS, Won SH, Ji JY, Lee DW, Yoo ID, Yoon SJ, Kim WJ. Staged Joint Arthrodesis in the Treatment of Severe Septic Ankle Arthritis Sequelae: A Case Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312473. [PMID: 34886200 PMCID: PMC8656585 DOI: 10.3390/ijerph182312473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/23/2021] [Accepted: 11/25/2021] [Indexed: 12/04/2022]
Abstract
Septic ankle arthritis is a devastating clinical entity with high risks of morbidity and mortality. Prompt treatment is necessary because delayed or inadequate treatment can lead to irreversible damage that may occur on the articular surface, resulting in cartilage erosion, infective synovitis, osteomyelitis, joint deformity, and pain and joint dysfunction. An aggressive surgical approach is required when a joint infection causes severe limb-threatening arthritis. A 58-year-old woman visited our clinic with increasing pain in the right ankle, which had been present for the previous 2 months. She complained of discomfort in daily life due to deformity of the ankle; limping; and severe pain in the ankle even after walking a little. The patient reported a history of right-ankle injury while exiting a bus in her early 20s. Plain radiographs of the right ankle joint revealed that the medial malleolus was nearly absent in the right ankle joint on the anteroposterior view, and severe varus deformity was observed with osteoarthritic changes because of joint space destruction. Magnetic resonance imaging revealed diffuse synovial thickening of the destroyed tibiotalar joint with joint effusion. Hybrid 99mTc white blood cell single-photon emission computed tomography/computed tomography showed increased uptake along the soft tissue around the ankle joint; uptake was generally low in the talocrural and subtalar joints. A two-stage operation was performed to remove the infected lesions and correct the deformity, thus enabling limb salvage. The patient was nearly asymptomatic at the 6-month follow-up, with no discomfort in her daily life and nearly normal ability to carry out full functional activities. She had no complications or recurrent symptoms at the 1-year follow-up. We have described a rare case of a staged limb salvage procedure in a patient with chronic septic arthritis sequelae. For patients with severe joint deformity because of septic ankle sequelae, staged arthrodesis is a reliable method to remove infected lesions, solve soft tissue problems, correct deformities, and maintain leg length.
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Affiliation(s)
- Yong-Cheol Hong
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Cheonan 31151, Korea; (Y.-C.H.); (K.-J.J.); (H.-J.C.); (S.-J.Y.)
| | - Ki-Jin Jung
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Cheonan 31151, Korea; (Y.-C.H.); (K.-J.J.); (H.-J.C.); (S.-J.Y.)
| | - Hee-Jun Chang
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Cheonan 31151, Korea; (Y.-C.H.); (K.-J.J.); (H.-J.C.); (S.-J.Y.)
| | - Eui-Dong Yeo
- Department of Orthopaedic Surgery, Veterans Health Service Medical Center, Seoul 05368, Korea;
| | - Hong-Seop Lee
- Department of Foot and Ankle Surgery, Nowon Eulji Medical Center, Eulji University, Seoul 01830, Korea;
| | - Sung-Hun Won
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Seoul, Seoul 04401, Korea;
| | - Jae-Young Ji
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital Cheonan, Cheonan 31151, Korea;
| | - Dhong-Won Lee
- Department of Orthopaedic Surgery, Konkuk University Medical Center, Seoul 05030, Korea;
| | - Ik-Dong Yoo
- Department of Nuclear Medicine, Soonchunhyang University Hospital Cheonan, Cheonan 31151, Korea;
| | - Sung-Joon Yoon
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Cheonan 31151, Korea; (Y.-C.H.); (K.-J.J.); (H.-J.C.); (S.-J.Y.)
| | - Woo-Jong Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Cheonan 31151, Korea; (Y.-C.H.); (K.-J.J.); (H.-J.C.); (S.-J.Y.)
- Correspondence: ; Tel.: +82-41-570-2176
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Solow M, Sarraj M, Johal H, Al-Asiri J. A Case Report of Pneumococcal Septic Arthritis Following a Respiratory and Gastrointestinal Prodrome with Accompanying Literature Review. J Foot Ankle Surg 2019; 58:1293-1297. [PMID: 31679684 DOI: 10.1053/j.jfas.2018.12.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 12/04/2018] [Accepted: 12/04/2018] [Indexed: 02/03/2023]
Abstract
We report an uncommon case of septic arthritis of the ankle from a Streptococcus pneumoniae infection and provide an update of the literature reported since 2002. A 58-year-old female presented to the hospital with right ankle pain and an inability to bear weight. She reported a history of productive cough, vomiting, diarrhea, and subjective fevers 4 days earlier. Streptococcus pneumonia was identified in her ankle aspirate, and she was treated urgently with operative incision and debridement, followed by postoperative intravenous antibiotics. At her 7-week follow-up, she demonstrated complete resolution of symptoms and near-complete recovery of range of motion. This case demonstrates the importance of early identification, as the majority of patients recover fully with prompt treatment. The literature review included 44 cases of pneumococcal septic arthritis and found that the knee was the most commonly affected joint, followed by the shoulder and ankle. Blood cultures were positive for S. pneumoniae in 27 of 38 adults (71%) and 4 of 6 children (67%). Comorbid conditions were present in 32 of 38 adults (84%) and 4 of 7 children (57%), the most frequent of which were alcoholism and osteoarthritis in adults and malignancy or immunosuppression in children. Additionally, roughly half of included adults had an extra-articular focus of pneumococcal disease, most frequently pneumonia. Operative treatment was undertaken in 32 of 38 adults (84%) and all 7 children. Of adults with data available, 24 of 33 (73%) recovered with complete joint function, compared with 5 of 7 children (71%).
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Affiliation(s)
- Max Solow
- Medical Student, St George's University Medical School, St. George's, West Indies, Grenada
| | - Mohamed Sarraj
- Medical Student, McMaster University Medical School, Hamilton, Ontario, Canada
| | - Herman Johal
- Orthopedic Surgeon, Department of Orthopaedics, Department of Surgery, Center for Evidence-Based Orthopaedics, McMaster University, Hamilton, Ontario, Canada
| | - Jamal Al-Asiri
- Orthopedic Surgeon, Department of Orthopedic Surgery, Hamilton General Hospital, Hamilton, Ontario, Canada.
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Movassaghi K, Wakefield C, Bohl DD, Lee S, Lin J, Holmes GB, Hamid KS. Septic Arthritis of the Native Ankle. JBJS Rev 2019; 7:e6. [DOI: 10.2106/jbjs.rvw.18.00080] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Bilir B, Isyar M, Yilmaz I, Varol Saracoglu G, Cakmak S, Dogan M, Mahirogullari M. Evaluation of neutrophil-to-lymphocyte ratio as a marker of inflammatory response in septic arthritis. EUR J INFLAMM 2015. [DOI: 10.1177/1721727x15607369] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Is neutrophil-to-lymphocyte ratio high in patients with septic arthritis? Septic arthritis may lead to higher rates of morbidity or even mortality if not diagnosed on time. This study was planned to answer the question that “Could neutrophil-to-lymphocyte ratio be utilized to help to diagnose septic arthritis?” The cohort of the study consisted of 39 patients diagnosed with septic arthritis. After ruling out the patients who did not meet the research’s inclusion criteria, the data of 26 patients were evaluated. The control group was collected from healthy volunteers who were admitted to the internal medicine outpatient clinic for a routine medical checkup at the same period (n = 26). Complete blood count (CBC) parameters, C-reactive protein, erythrocyte sedimentation rate, and neutrophil-to-lymphocyte ratios of the septic arthritis and control groups were compared statistically. In comparison, neutrophil-to-lymphocyte ratios of the septic arthritis group were significantly higher than the control group. In conclusion, neutrophil-to-lymphocyte ratio can be utilized in the emergency department or in outpatient clinics to support the diagnosis of septic arthritis.
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Affiliation(s)
- Bülent Bilir
- Department of Internal Medicine, Namik Kemal University School of Medicine, 59100, Tekirdag, Turkey
| | - Mehmet Isyar
- Department of Orthopaedic and Traumatology, Istanbul Medipol University School of Medicine, 34214, Istanbul, Turkey
| | - Ibrahim Yilmaz
- Department of Pharmacovigilance and Rational Drug Use Team, Republic of Turkey, Ministry of Health, State Hospital, 59100, Tekirdag, Turkey
| | - Gamze Varol Saracoglu
- Department of Public Health, Namik Kemal University School of Medicine, 59100, Tekirdag, Turkey
| | - Selami Cakmak
- Department of Orthopaedic and Traumatology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, 34668, Istanbul, Turkey
| | - Mustafa Dogan
- Department of Infectious Diseases, Namik Kemal University School of Medicine, 59100, Tekirdag, Turkey
| | - Mahir Mahirogullari
- Department of Internal Medicine, Namik Kemal University School of Medicine, 59100, Tekirdag, Turkey
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