Luminance thresholds for motion contingent on colour

Reinfection rates after one- and two-stage revision surgery for hip and knee arthroplasty: a systematic review and meta-analysis

PURPOSE

Revisions for periprosthetic joint infection of knee and hip arthroplasty can be performed following one- or two-stage treatment protocols. Current literature is inconclusive whether one protocol is superior to the other, as prior literature reported similar reinfection rates for both treatment options. We aimed to provide a systematic review and meta-analysis of current literature on septic arthroplasty revisions.

METHODS

Between April 2015 and December 2020, Medline, Embase, and The Cochrane Library were searched for studies reporting reinfection outcomes in patients treated with one-stage and two-stage knee or hip revision arthroplasty. Two reviewers independently extracted data and disagreements were resolved by a third investigator. We utilized a double arcsine transformation, prior to pooling using a random-effects model.

RESULTS

For hip revision arthroplasty, we identified 14 one-stage studies (n = 1237) with a pooled reinfection rate of 5.7% (95% CI 3.7-8.1%), and 46 two-stage studies (n = 5009) with a reinfection rate of 8.4% (95% CI 6.9-9.9%). For knee revision arthroplasty, 6 one-stage studies (n = 527) and 48 two-stage studies (n = 4344) were identified with reinfection rates of 12.7% (7.0-19.7%) and 16.2% (13.7-19.0%), respectively. Overall, reinfection rates did not vary substantially after subgroup analysis. Limitations of our study are the limited amount of one-stage studies that introduce a potential bias.

CONCLUSION

The reinfection rates following one- and two-stage hip and knee arthroplasty revisions were similar. Knee reinfection rates have increased compared to the previous analysis. Individual patient characteristics and adequate treatment algorithms are needed for a more individual selection approach, until a randomized trial is performed.

Genomic characterization and outcome of prosthetic joint infections caused by Staphylococcus aureus

Staphylococcus aureus is a commensal colonizing the skin and mucous membranes. It can also act as a pathogen, and is the most common microorganism isolated from prosthetic joint infections (PJIs). The aim of this study was to explore the genomic relatedness between commensal and PJI S. aureus strains as well as microbial traits and host-related risk factors for treatment failure. Whole-genome sequencing (WGS) was performed on S. aureus isolates obtained from PJIs (n = 100) and control isolates from nares (n = 101). Corresponding clinical data for the PJI patients were extracted from medical records. No PJI-specific clusters were found in the WGS phylogeny, and the distribution of the various clonal complexes and prevalence of virulence genes among isolates from PJIs and nares was almost equal. Isolates from patients with treatment success and failure were genetically very similar, while the presence of an antibiotic-resistant phenotype and the use of non-biofilm-active antimicrobial treatment were both associated with failure.In conclusion, commensal and PJI isolates of S. aureus in arthroplasty patients were genetically indistinguishable, suggesting that commensal S. aureus clones are capable of causing PJIs. Furthermore, no association between genetic traits and outcome could be demonstrated, stressing the importance of patient-related factors in the treatment of S. aureus PJIs.

The Effect of Stationary Patterns on Adaptation for Movement: Evidence for Inhibitory Interaction

Contingent movement aftereffects (CMAEs) can be demonstrated by adapting to a red pattern rotating clockwise (cw) alternating with a green pattern rotating counterclockwise (ccw). After 5 min subjects typically report stationary test patterns as apparently rotating clockwise when they are green and counterclockwise when they are red. Also, luminance thresholds for motion now depend on both the colour and direction of the moving pattern. The thresholds for red—cw and green—ccw motion will be relatively greater than for the opposite colour motion pairings. This is called contingent threshold elevation.

When stationary dots the same colour as the moving patterns are added to the adapting stimuli, subjects report weak CMAEs but no contingent threshold elevation can be demonstrated.

When stationary dots opposite in colour to the moving patterns are added to the adapting stimuli, neither CMAEs nor contingent threshold elevation can be demonstrated. And yet colour specific adaptation does occur, and can be demonstrated in the colour specificity of the simple movement aftereffect. When stationary dots are added to the adapting pattern, the simple movement aftereffect though reduced, is greatest on a test pattern of the same colour as the moving dots. These findings suggest that the CMAE, contingent threshold elevation, and the colour specificity of the movement aftereffect involves neural processes differentially sensitive to the presence of stationary patterns.

Interocular transfer of colour-contingent threshold elevation

Following adaptation to a moving coloured stimulus pattern the contrast threshold for detecting a similar moving pattern is raised. Threshold elevation is greatest when the adaptation and test patterns have the same direction of motion and the same colour. Unlike most other colour-contingent aftereffects, colour-specificity is preserved under dichoptic viewing conditions. The results are discussed in terms of possible underlying neural pathways in the visual system.

Nulling the movement aftereffect: evidence for pattern specificity

A microtextured surface such as a homogeneously illuminated tracing-paper screen provides an excellent test surface for the movement aftereffect. When it is moved against the aftereffect at the appropriate velocity, a null occurs and the screen appears stationary. However, if patterned illumination is superimposed on the homogeneous field, the nulling breaks down. The pattern appears to move in one direction, driven by the aftereffect, and the screen can be clearly seen moving in the opposite direction. This breakdown begins to occur at luminances just above threshold for the detection of the pattern. The implication is that two populations of motion detectors are involved. Evidence in support of this postulate is presented.