S. Epidermidis is among the most frequently isolated microorganisms found in -infection related to implanted devices and the formation of biofilm will be more resistant compared to the planktonic form. This study was carried out to determine the effect of coating on stainless steel orthopaedic implants surfaces with cinnamon oil and chitosan as bioadhesive to prevent biofilms formation of S. Epidermidis.The rod shaped stainless steel 316 L orthopaedic implant with 5 mm diameters was coated 2 times using a mixture of cinnamon oil and chitosan 3% and 2% respectively with serial concentration of cinnamon from 0.125% to 2%. The coated implants were then put into tubes that contained bacterial suspension and incubated. Subsequently, the implants were washed with PBS solution followed by MTT soulution and isopropanol acid solution. that related to biofilm formation. The results were expressed in numbers which represents the absorbance level at ELISA readings on 575 nm (A575) wavelength.The stainless steel implant coated with chitosan and cinnamon oil 2% and 1% has lower absorbance level compared with the absorbance level of S.Epidermidis biofilm only. This study showed that mixture of cinnamon oil and chitosan coated on the surface of stainless steel orthopaedic implant has an effect against S.Epidermidis biofilm formation with the minimum cinnamon oil concentration of 1%.

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Purpose Interleukin-1 is the main proinflammatory cytokine in osteoarthritis (OA). Several single-nucleotide polymorphisms (SNPs) within the IL-1 gene cluster (IL-1β, IL-1R1, and IL-1RN) have been determined, but their associations with knee OA remain poorly understood. The present study aimed to identify the associations between IL-1 SNPs and knee osteoarthritis. Methods This meta-analysis and systematic review included all comparative studies published in the MEDLINE/PubMed, Embase, Google Scholar, and Cochrane Library databases. We performed a systematic search to identify relevant studies on the evaluation of the correlation between the IL-1 gene and knee OA published up to February 2020 that met the eligibility criteria. Nine studies on a total of 2256 knees with OA and 3527 healthy knees met the eligibility criteria. Results associated with IL-1A, IL-1B, IL-1R1, and IL-1RN SNPs were extracted and compared between knees with OA and healthy knees. Methodological quality was assessed using the Newcastle–Ottawa scale (NOS). All studies with fair or good quality were included. Results The meta-analysis showed that the risk of knee OA is decreased by the IL-1RN*1 and IL-1RN*1/*1 genotypes and increased by the IL-1RN*2 and I-L1RN*1/*2 genotypes. The systematic review revealed only two studies associating the IL-1RN allele, none associating the IL-1B polymorphism, and only one study associating IL-1A and IL-1R1 polymorphisms with knee OA. Conclusions Several IL-1RN alleles and genotypes play a role in knee OA but other genetic variations in the IL-1 region were still conflicting in its association with knee OA.

Background: Chronic osteomyelitis remains one of the common problems with the use of orthopaedic implants. Staphylococcus epidermidis is notorious for its biofilm formation on indwelling medical devices and is one of the most frequent pathogenic agents in chronic osteomyelitis. Cinnamon oil has been proven to be an effective antimicrobial agent against several bacteria, including S. epidermidis. The eradication of S. epidermidis and prevention of biofilm formation on medical devices are desirable outcomes. Objective: To study the antimicrobial effect of cinnamon oil coating on K-wire against S. epidermidis and to quantify the most effective concentration of cinnamon oil coating on the K-wire. Method: The cinnamon oil was divided in ten different concentrations, from 0.002% to 1%, and subsequently applied to the Kirschner wire (K-wire). Its antimicrobial effect was determined by agar well diffusion method (MHA). Cinnamon oil coated K-wires were planted on S. epidermidis inoculated Muller-Hinton Agar (MHA) plate. The size of the zone of inhibition was recorded to the nearest mm, and this was compared to gentamycin, fosfomycin, vancomycin, netilmycin. Result: The cream based 1% concentration cinnamon oil coating on K-wire showed the strongest antimicrobial effect on S. epidermidis inoculated MHA plate. This was evident especially in the fourth repetition, with an inhibition zone diameter (IZD) of 19 mm. In the 1% concentration repetitions, the highest mean IZD of the 4 repetitions was 14 mm (intermediate according NCCLS). The mean IZD results demonstrate that cinnamon oil has 46.3% of the effectiveness of gentamycin, 49.1% of fosfomycin, 59.6% of vancomycin, and 43.4% of netilmycin. Conclusion: In this in-vitro study, cream based cinnamon oil coating on K-wire is effective against S. epidermidis, though less effective compared to gentamycin, fosfomycin, vancomycin and netilmycinKey WordsCinnamon oil, K-wire, antimicrobial, S.epidermidis

Introduction The thoracolumbal region is often a difficult area to reconstruct for orthopaedic surgeons. Reconstruction of this area with a standard free tissue transfer is not always possible, and locoregional flaps are often failed due to poor quality outcome and mobilization difficulty. Case report A case was presented with unilateral distally based latissimus dorsi flaps reconstruction in patient with midline thoracal soft tissue defect underwent kyphosis deformity correction surgery. This study reported a patient, male, 33 years old who was diagnosed with ankylosing spondylitis and kyphosis deformity. The patient underwent surgical correction of the kyphosis deformity. After 1 month, the patient complained about his open surgical wounds. Clinical discussion In our institution, this patient underwent second debridement surgery and unilateral reverse latissimus dorsi flap for thoracal soft tissue defect coverage to obtain well-vascularised tissue, with good resistance to bacterial contamination and easy to shape into such defect. After follow-up for 6 months, the patient shows good outcome and postoperative wound healing was favorable. Conclusion We believe that the “reverse” latissimus dorsi flap is a good option to cover this particular region. It is simple, safe, and reliable. It also provides a backup plan for the microsurgery in this region.