Correction to: Reducing surgical site infections following total hip and knee arthroplasty: an Israeli experience.

In the original article, one of the co-author's family name has been published incorrectly.

Reducing surgical site infections following total hip and knee arthroplasty: an Israeli experience.

PURPOSE: To assess the changes observed in surgical site infection (SSI) rates following total joint arthroplasty (TJA) after the introduction of an infection control programme and evaluate the risk factors for the development of these infections. DESIGN: Prospective cohort study. SETTING: Large tertiary medical centre in Israel. METHODS: Data about SSIs and potential prophylaxis-, patient-, and procedure-related risk factors were collected for all patients who underwent elective total hip and total knee arthroplasty during the study period. Multivariant analyses were conducted to determine which significant covariates affected the outcome. RESULTS: During the 76-month study period, SSIs (superficial and deep) occurred in 64 (4.4%) of 1554 patients. As compared with the 34 (7.7%) SSIs that occurred in the first 25 months, there were 23 (4.7%) SSIs in the following 25 months, and only 7 (1.3%) SSIs in the last third of the study (p = 0.058 and <0.001, respectively). A multiple logistic regression model indicated that risk factors for prosthetic joint infection were a National Nosocomial Infections Surveillance (NNIS) System surgical patient risk index score of 1 (OR 1.8; 95% CI 1.1-3.1) or 2 (OR 2.8; 95% CI 1.2-11.8). The incidence of SSI was not correlated with the timing, nor the duration of antibiotic prophylaxis. CONCLUSIONS: The introduction of preventive measures and surveillance coincided with a significant reduction in SSIs following TJA in our institution. The risk of infection correlated with higher scores in the NNIS System surgical patient risk.

Pyknodysostosis: imaging and laboratory observations.

Pyknodysostosis is a rare form of sclerosing bone dysplasia with autosomal recessive inheritance. Affected members of two families were assessed as follows: three patients underwent densitometry measurements and bone scans; four patients underwent magnetic resonance imaging (MRI) and an immunological investigation, as well as a detailed endocrinological and biochemical laboratory review. Densitometry measurements revealed values of up to 291% of age-matched normal controls; this increased bone density was mainly in the trabecular bone and not in the cortical bone. The MRI showed the cortex to be of normal thickness, whereas the increase in trabecular bone limited the space within the medullary canal. Bone scans and single photon emission computerized tomography in three patients showed an increased uptake of [99mTc]methylene diphosphonate of up to 538% of age-matched controls, which reflected the increased bone density. Monocyte function tests demonstrated a normal phagocytic capacity, but their killing activity was impaired. Interleukin-1 secretion was also impaired, which may point to the pathogenesis of the disease, in view of its function as an osteoclast activator and its role in bone resorption.

Fibular bowing due to tibial shortening in isolated fracture of the tibia: failure of late segmental fibulectomy to relieve ankle pain.

Fracture of the tibia with an intact fibula is prone to delayed and nonunion or varus malunion and, as a complication of the latter, late arthrosis of the ankle joint. A less well-known type of malunion is tibial shortening with fibular bowing due to relative fibular lengthening. We present such a case with chronic ankle pain. Late segmental fibulectomy failed to improve the symptoms. We recommend primary segmental fibulectomy in all isolated fractures of the tibial shaft in adults and adolescents, in order to forestall the early and late complications.