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OBJECTIVE: Surgical site infection (SSI) is a devastating complication in orthopedic surgery. Methicillin-resistant Staphylococcus aureus (MRSA) is a notorious organism in SSI, especially in orthopedic patients. We aimed to understand the association between MRSA carriers and the rate of SSI caused by MRSA in orthopedic patients. PATIENTS AND METHODS: We prospectively performed a cohort investigation on patients admitted to the Department of Orthopedic between April and August 2023. Samples were taken preoperatively from the nose and post-operatively in surgical wounds. All samples were grown in MeReSa Agar and defined as positive with MRSA characteristics. Data analysis was performed using SPSS Statistics. A significant difference between groups was assessed using either the Chisquare test or Fisher's exact test. Statistical significance was set at p<0.05. RESULTS: We obtained 526 nasal swabs of patients, and 140 (26.6%) samples were positive for MRSA. Our study revealed significant associations between MRSA carriers and the following factors: history of recent hospitalization (OR: 1.81; 95% CI: 1.172-2.795; p=0.007), smoking history (OR: 1.55; 95% CI: 1.011-2.383; p=0.044), and antibiotic exposures (OR: 2.19; 95% CI: 1.305-3.703; p=0.003). Our findings showed a significant association between SSI and the following factors: history of antibiotic exposures (OR: 2.89; 95% CI: 1.264-6.566; p=0.003), blood loss volume >500 ml (OR: 2.522; 95% CI: 1.245-5.108; p=0.008) and contaminated surgical wounds (OR: 5.97; 95% CI: 2.907-12.266; p=0.001). Patients with MRSA carriers tended to have an increased risk of having an MRSA SSI with an odds ratio of 3.44 (95% CI: 1.13-10.48; p=0.047). CONCLUSIONS: Our study highlights the increased risk of MRSA carriage in patients with a history of smoking, recent hospital admission, or antibiotic exposure. Our reports also identify potential risk factors for SSI, such as previous antibiotic exposure, blood loss, and contaminated wounds. Furthermore, our research establishes an association between MRSA colonization and MRSA SSI, which emphasizes the criticality of decolonization strategies. A further prospective multicenter study is needed to elaborate on our study findings. [ABSTRACT FROM AUTHOR]

Introduction and Importance: Glomus tumors are rare mesenchymal neoplasms. These tumors originate from the glomus bodies and are commonly found in the fingertips, especially in the subungual location. The cause of this tumor is unknown. Clinically, the symptoms are non-specific and often not identified on physical examination and radiologically accompanied by rare cases, making it difficult to diagnose a glomus tumor., Case Presentation: Current report present a case of pain at the tip of the middle finger of the left hand in a woman for six years and worsening in the last two years. The patient has visited several doctors with analgesic therapy, but the complaints have not improved. A bluish nail was found on physical examination, and a clinical study with the Love's pin test and the Hildreth test had positive results. Radiographic examination showed destruction with cortical thinning of the medial aspect of the distal phalanx of the left middle finger, and MRI showed a lesion with an erosion of the distal middle finger. In this case, complete surgical excision and biopsy were performed using a transungual surgical approach. The sample was sent for microscopic examination, showing a glomus tumor., Clinical Discussion: Cases with clinical symptoms of intense paroxysmal pain, exquisite point tenderness, and sensitivity to cold allow a clinical diagnosis in 90 % of cases. On clinical examinations such as Love's pin test, Hildreth's test, cold sensitivity test, and trans-illumination test with positive results and confirmed by MRI or ultrasound, the diagnosis of glomus tumor can be established., Conclusion: This case shows a glomus tumor in the distal phalanges of the middle finger of the left hand-diagnosis enforcement through detailed history taking and physical examination, confirmed by MRI and microscopic examination. Complete surgical excision is an effective treatment. In this case, using a transungual surgical approach based on preoperative MRI, the subungual lesion was found to provide the best exposure., Competing Interests: Conflicts of interest The authors declare that there are no conflicts of interest regarding the publication of this article., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: Osteoarthritis is one of the leading causes of disability and the most common degenerative disease of the knee that causes enormous pain. As many as 10-15 % of patients requiring total knee arthroplasty (TKA) present with valgus knee deformity. When fully constrained TKA is not possible, the surgeon must use a different method to achieve a good result., Case Description: A 56-year-old female with 3rd degree (48-degree) and a 62-year-old male with 2nd degree valgus knee (13-degree) with painful osteoarthritis were examined. Both have valgus thrust gait and medial collateral ligament (MCL) laxity and underwent TKA using non-constrained implants. During surgical exposure, MCL insufficiency was found in both patients, and MCL augmentation was performed. Post-operative assessment and 4-month follow-up were done through clinical and radiological parameters using the knee scoring system., Discussion: A good outcome could still be achieved with a primary TKA implant in severe and moderate valgus knees with MCL insufficiency using MCL augmentation. The primary TKA implant proved to improve clinical and radiological parameters after 4 months of follow-up. Clinically, both patients no longer felt pain in their knees and were able to walk with better stability. Radiologically, there was a much-reduced valgus degree. The results were the first case went from 48-degree to 2-degree and the second case went from 13-degree to 6-degree., Conclusion: Knee osteoarthritis with valgus deformity and MCL insufficiency present surgical challenges during TKA. It is still possible to use in severe or moderate valgus with MCL insufficiency, which was proven by satisfactory clinical and radiological findings. Although a non-constrained option is not ideal, it is still the first choice in certain cases., Competing Interests: Declaration of competing interest N/A., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction and Importance: Granulomatous Mycobacterium Tuberculosis Infection Causes Secondary Knee Osteoarthritis is still a point of contention in terms of therapy, whether it is done early in the first stage or later in the second stage of knee surgery. Early Total Knee Arthroplasty as a therapy for secondary knee osteoarthritis induced by Granulomatous mycobacterium tuberculosis infection is still performed rarely., Case Presentation: A case of left pain and swollen knee in males for 8 months. Because of pain and reduced knee range of motion, the patient now has an antalgic gait, which make him difficult to do daily activities. Treatment with medications and physiotherapy failed. Radiographs revealed juxta-articular osteoporosis, peripherally distributed osseous erosions, joint space narrowing, and a bony defect in the medial femoral condyle. This case was successfully treated using Unconstrained Knee Arthroplasty PS Design., Clinical Discussion: Case selection for granulomatous infection case is key element to determine whether a single TKA procedure can be used to treat knee pain problems as a result of secondary osteoarthritis., Conclusion: This case shows secondary knee osteoarthritis caused by Granulomatous Mycobacterium Tuberculosis Infection without pyogenic pus production might allow for early one-stage total knee arthroplasty. Three months following surgery, the patient's knee was stable and painless, with good wound healing and no signs of infection., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Secondary hip osteoarthritis with acetabular bone defect is still a challenging case in hip arthroplasty surgery. The incidence of revision total hip arthroplasty is estimated to be between 10% and 15% in 10 years. Simple revision cementless acetabular cup after a prior complex cemented-THA rarely performed., Case Presentation: A case of aseptic loosening with prosthesis dislocation after THA was reported in a 54 year-old female patient. The patient had prior surgery of THA 10 years ago due to secondary post-traumatic hip osteoarthritis with acetabular bone defect. At the first surgery, cemented acetabular cup with acetabular bone grafting was performed to fill the defect. A complete new acetabulum bone formation was encountered at 10 years after the surgery which lead to simple revision THA with primary cementless acetabular cup. Excellent functional outcome was also reported at the final follow-up after revision THA., Conclusion: This case showed that the potential of bone healing of the acetabulum cannot be underestimated. Therefore, it is suggested to always put an adequate bone graft to manage acetabular bone defect in THA surgery and a new acetabulum bone formation can be expected., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)