Scholars@Duke
Rachel Mary Reilly

Rachel Mary Reilly

Associate Professor of Orthopaedic Surgery
Orthopaedic Surgery

Selected Publications

Does Stem Design Affect the Incidence of Periprosthetic Femoral Fractures in Arthroplasty for Femoral Neck Fractures? A Secondary Analysis of the HEALTH Trial.

Journal Article J Arthroplasty · August 2025 BACKGROUND: The aim of this study was to evaluate how stem design influences the risk of periprosthetic femoral fractures (PFFs) after hemiarthroplasty (HA) and total hip arthroplasty for femoral neck fractures. METHODS: We performed a secondary analysis o ... Full text Link to item Cite

Alcohol-Based Versus Aqueous Skin Antisepsis Before Surgical Fixation of Open Fractures: A Combined Analysis of 2 Cluster-Randomized Crossover Trials.

Journal Article J Bone Joint Surg Am · June 18, 2025 BACKGROUND: Skin antisepsis remains a vital component in prophylaxis against surgical site infection (SSI); however, for open fractures, it is unclear whether alcohol-based or aqueous solutions should be preferred. The purpose of this study was to compare ... Full text Link to item Cite

Impact of Living in a Food Desert on Complications After Fracture Surgery.

Journal Article J Bone Joint Surg Am · June 18, 2025 BACKGROUND: Food deserts-communities with limited access to healthy food-have been linked with poor surgical outcomes; however, their impact on orthopaedic trauma outcomes remains unknown. The aims of this study were to determine the prevalence of food des ... Full text Link to item Cite

Outcomes Associated with Choice of Prophylactic Antibiotics in Open Fractures.

Journal Article J Bone Joint Surg Am · June 18, 2025 BACKGROUND: The ideal antibiotic prophylaxis for open fractures is unknown. We evaluated outcomes following different antibiotic prophylaxis regimens for open fractures. METHODS: This is a secondary analysis of data from PREP-IT. Prophylactic antibiotics w ... Full text Link to item Cite

A Portfolio of Secondary Analyses from the PREP-IT Trial.

Journal Article J Bone Joint Surg Am · June 18, 2025 Full text Link to item Cite

Higher Reoperation Rates in Planned, Staged Treatment of Open Fractures Compared with Fix-and-Close: A Propensity Score-Matched Analysis.

Journal Article J Bone Joint Surg Am · June 18, 2025 BACKGROUND: Initial surgical management of Gustilo-Anderson type-I to IIIA open fractures varies from surgical fixation of the fracture with immediate closure of the traumatic wound to various combinations of staged fracture and wound management. The decis ... Full text Link to item Cite

Chlorhexidine Gluconate Bathing Has Limited Ability to Prevent Surgical Site Infection Following Operative Fixation of Extremity and Pelvic Fractures.

Journal Article J Bone Joint Surg Am · June 18, 2025 BACKGROUND: A preoperative chlorhexidine gluconate (CHG) bath is used to reduce the risk of surgical site infection (SSI) in elective surgery, but its efficacy in the trauma setting is unknown. We compared the incidence of SSI between patients who did vers ... Full text Link to item Cite

Deep Infections After Open and Closed Fractures.

Journal Article J Bone Joint Surg Am · June 18, 2025 BACKGROUND: The purpose of this study was to describe the culture and speciation results of patients with surgical site infection (SSI) from the PREPARE and Aqueous-PREP studies from the PREP-IT Investigators. METHODS: Patients with suspected SSI underwent ... Full text Link to item Cite

Local Antibiotics and the Risk of Antimicrobial Resistance in Extremity Fractures Complicated by Fracture-Related Infection.

Journal Article J Bone Joint Surg Am · June 18, 2025 BACKGROUND: We evaluated antimicrobial resistance (AMR) patterns following local antibiotic use in a large cohort of patients with fractures from the PREP-IT (A Program of Randomized Trials to Evaluate Preoperative Antiseptic Skin Solutions in Orthopaedic ... Full text Link to item Cite

Differences in Practice Patterns in the Use of Temporary External Fixation for the Management of Open Lower-Extremity Fractures.

Journal Article J Bone Joint Surg Am · June 18, 2025 BACKGROUND: External fixation is often used in the management of open lower-extremity fractures. The objectives of this study were to identify hospital characteristics that are associated with greater use of temporary external fixation and to determine if ... Full text Link to item Cite

Performance of the OTA-OFC3 Classification System for Open Fractures.

Journal Article J Bone Joint Surg Am · June 18, 2025 BACKGROUND: The purpose of this study was to compare the simplified modification of the Orthopaedic Trauma Association-Open Fracture Classification (OTA-OFC3) with the original OTA-OFC and Gustilo-Anderson classification systems in predicting surgical site ... Full text Link to item Cite

What is the Surgical Burden of Treatment for High-Energy Lower Extremity Trauma? A Secondary Analysis of the OUTLET Study.

Journal Article J Orthop Trauma · May 1, 2025 OBJECTIVES: To describe and enumerate surgeries for patients who underwent reconstruction or amputation after severe distal tibial, ankle, and mid- to hindfoot injuries. DESIGN: Secondary analysis of a multicenter prospective observational study. SETTING: ... Full text Link to item Cite

Are Drains Associated With Infection After Operative Fixation of High-Risk Tibial Plateau and Pilon Fractures?

Journal Article J Orthop Trauma · February 1, 2025 OBJECTIVES: To determine the association between closed suction drainage and postoperative infection in patients with tibial plateau or pilon fractures. Secondarily, this study assessed whether intrawound vancomycin powder modified the association of close ... Full text Link to item Cite

Predicting 90-day return to the emergency department in orthopaedic trauma patients in the Southeastern USA: a machine-learning approach.

Journal Article Inj Prev · January 21, 2025 INTRODUCTION: Return-to-acute-care metrics, such as early emergency department (ED) visits, are key indicators of healthcare quality, with ED returns following surgery often considered avoidable and costly events. Proactively identifying patients at high r ... Full text Link to item Cite

Predicting deep infection in pilon and tibial plateau fractures: A secondary analysis of the VANCO and OXYGEN trials

Journal Article Ota International · November 25, 2024 Objectives:To develop and validate a prediction model for a deep surgical site infection (SSI) after fixation of a tibial plateau or pilon fracture.Design:Pooled data from 2 randomized trials (VANCO and OXYGEN).Setting:Fifty-two US trauma centers.Patients: ... Full text Cite

Synovial Fluid Immune Cell Composition Following Intraarticular Fracture May Contribute to Posttraumatic Osteoarthritis.

Journal Article Int J Mol Sci · November 9, 2024 Intra-articular ankle fracture (IAF) often leads to post-traumatic osteoarthritis (PTOA), resulting in significant long-term morbidity. While previous research has focused on the inflammatory cytokines and matrix metalloproteinases within the synovial flui ... Full text Link to item Cite

Cemented Versus Noncemented Hemiarthroplasty for Femoral Neck Fractures: A Meta-Analysis of Randomized Control Trials.

Journal Article J Am Acad Orthop Surg · October 1, 2024 INTRODUCTION: The purpose of this study was to conduct a meta-analysis of the randomized controlled trials (RCTs) to compare the outcomes after cemented and noncemented hemiarthroplasty for femoral neck fractures. METHODS: A literature search of three data ... Full text Link to item Cite

Does Topical Vancomycin Powder Use in Fracture Surgery Change Bacteriology and Antibiotic Susceptibilities? An Analysis of the VANCO Trial.

Journal Article J Orthop Trauma · April 1, 2024 OBJECTIVE: To determine whether intrawound vancomycin changes the bacteriology of surgical site infection pathogens and investigate the emergence of antibiotic-resistant pathogens. DESIGN: Secondary analysis of phase III, prospective, randomized clinical t ... Full text Link to item Cite

Skin Antisepsis before Surgical Fixation of Extremity Fractures.

Journal Article N Engl J Med · February 1, 2024 BACKGROUND: Studies evaluating surgical-site infection have had conflicting results with respect to the use of alcohol solutions containing iodine povacrylex or chlorhexidine gluconate as skin antisepsis before surgery to repair a fractured limb (i.e., an ... Full text Link to item Cite

The VANCO Trial Findings Are Generalizable to a North American Trauma Registry.

Journal Article J Orthop Trauma · January 1, 2024 OBJECTIVES: To estimate the generalizability of treatment effects observed in the VANCO trial to a broader population of patients with tibial plateau or pilon fractures. METHODS: Design and Setting: Clinical trial data from 36 United States trauma centers ... Full text Link to item Cite

Do superficial infections increase the risk of deep infections in tibial plateau and plafond fractures?

Journal Article Eur J Orthop Surg Traumatol · October 2023 PURPOSE: Open reduction internal fixation of tibial plateau and pilon fractures may be complicated by deep surgical site infection requiring operative debridement and antibiotic therapy. The management of superficial surgical site infection is controversia ... Full text Link to item Cite

The impact of heterotopic ossification prophylaxis after surgical fixation of acetabular fractures: national treatment patterns and related outcomes.

Journal Article Injury · March 6, 2023 BACKGROUND: Heterotopic ossification (HO) is a common complication after surgical fixation of acetabular fractures. Numerous strategies have been employed to prevent HO formation, but results are mixed and optimal treatment strategy remains controversial. ... Full text Link to item Cite

Pragmatic randomized trial evaluating pre-operative aqueous antiseptic skin solution in open fractures (Aqueous-PREP): the feasibility of a cluster randomized crossover study

Journal Article Pilot and Feasibility Studies · December 1, 2021 Background: Preoperative antiseptic skin solutions are used prior to most surgical procedures; however, there is no definitive research comparing infection-related outcomes following use of the various solutions available to orthopedic trauma surgeons. The ... Full text Cite

Outcomes Following Severe Distal Tibial, Ankle, and/or Mid/Hindfoot Trauma: Comparison of Limb Salvage and Transtibial Amputation (OUTLET).

Journal Article J Bone Joint Surg Am · September 1, 2021 BACKGROUND: Selecting the best treatment for patients with severe terminal lower-limb injury remains a challenge. For some injuries, amputation may result in better outcomes than limb salvage. This study compared the outcomes of patients who underwent limb ... Full text Link to item Cite

Implementing stakeholder engagement to explore alternative models of consent: An example from the PREP-IT trials

Journal Article Contemporary Clinical Trials Communications · June 1, 2021 Introduction: Cluster randomized crossover trials are often faced with a dilemma when selecting an optimal model of consent, as the traditional model of obtaining informed consent from participant's before initiating any trial related activities may not be ... Full text Cite

Effect of Intrawound Vancomycin Powder in Operatively Treated High-risk Tibia Fractures: A Randomized Clinical Trial.

Journal Article JAMA Surg · May 1, 2021 IMPORTANCE: Despite the widespread use of systemic antibiotics to prevent infections in surgically treated patients with fracture, high rates of surgical site infection persist. OBJECTIVE: To examine the effect of intrawound vancomycin powder in reducing d ... Full text Link to item Cite

Managing work flow in high enrolling trials: The development and implementation of a sampling strategy in the PREPARE trial

Journal Article Contemporary Clinical Trials Communications · March 1, 2021 Introduction: Pragmatic trials in comparative effectiveness research assess the effects of different treatment, therapeutic, or healthcare options in clinical practice. They are characterized by broad eligibility criteria and large sample sizes, which can ... Full text Cite

Risk Factors Associated With Infection in Open Fractures of the Upper and Lower Extremities.

Journal Article J Am Acad Orthop Surg Glob Res Rev · December 8, 2020 INTRODUCTION: Open fractures are associated with a high risk of infection. The prevention of infection is the single most important goal, influencing perioperative care of patients with open fractures. Using data from 2,500 participants with open fracture ... Full text Link to item Cite

Correction to: Cluster identification, selection, and description in Cluster randomized crossover trials: the PREP-IT trials.

Journal Article Trials · September 30, 2020 An amendment to this paper has been published and can be accessed via the original article. ... Full text Link to item Cite

Case Report: Successful Rescue Therapy of Extensively Drug-Resistant Acinetobacter baumannii Osteomyelitis With Cefiderocol.

Journal Article Open Forum Infect Dis · May 2020 Cefiderocol is a novel catechol siderophore cephalosporin antibiotic developed to treat resistant gram-negative infections. We describe its successful use as rescue therapy, combined with surgical debridement, to treat a patient with osteomyelitis due to e ... Full text Link to item Cite

Wound Surface Area as a Risk Factor for Flap Complications among Patients with Open Fractures.

Journal Article Plast Reconstr Surg · July 2018 BACKGROUND: Soft-tissue complications often dictate the success of limb salvage and the overall outcome of open fractures. Based on prior work at the R Adams Cowley Shock Trauma Center, the authors hypothesize that wounds larger than 200 cm are associated ... Full text Link to item Cite

Are large clinical trials in orthopaedic trauma justified?

Journal Article BMC Musculoskelet Disord · April 20, 2018 BACKGROUND: The objective of this analysis is to evaluate the necessity of large clinical trials using FLOW trial data. METHODS: The FLOW pilot study and definitive trial were factorial trials evaluating the effect of different irrigation solutions and pre ... Full text Link to item Cite

Time-Dependent Effects on Synovial Fluid Composition During the Acute Phase of Human Intra-articular Ankle Fracture.

Journal Article Foot Ankle Int · October 2017 BACKGROUND: The study objective was to examine the effect of time and fracture severity on the undiluted synovial fluid (SF) microenvironment during the acute phase following intra-articular fracture (IAF) of the human ankle. METHODS: Ankle SF from 54 pati ... Full text Link to item Cite

Outcomes After Severe Distal Tibia, Ankle, and/or Foot Trauma: Comparison of Limb Salvage Versus Transtibial Amputation (OUTLET).

Journal Article J Orthop Trauma · April 2017 Severe foot and ankle injuries are complex and challenging to treat, often requiring multiple operations to salvage the limb contributing to a prolonged healing period. There is some evidence to suggest that early amputation for some patients may result in ... Full text Link to item Cite

Local Antibiotic Therapy to Reduce Infection After Operative Treatment of Fractures at High Risk of Infection: A Multicenter, Randomized, Controlled Trial (VANCO Study).

Journal Article J Orthop Trauma · April 2017 A number of clinical studies in the spine literature suggest that the use of local vancomycin powder may substantially reduce surgical site infections (SSIs). These studies are primarily retrospective and observational and few focus on orthopaedic trauma p ... Full text Link to item Cite

Are antibiotic nails effective in the treatment of infected tibial fractures?

Journal Article Injury · December 2016 BACKGROUND: Antibiotic-impregnated cement nails are used to treat postoperative deep infections after primary intramedullary nail insertion for the treatment of tibial fractures. Few data exist regarding the efficacy of this treatment strategy. We hypothes ... Full text Link to item Cite

Articular ankle fracture results in increased synovitis, synovial macrophage infiltration, and synovial fluid concentrations of inflammatory cytokines and chemokines.

Journal Article Arthritis Rheumatol · May 2015 OBJECTIVE: The inflammatory response following an articular fracture is thought to play a role in the development of posttraumatic arthritis (PTA) but has not been well characterized. The objective of this study was to characterize the acute inflammatory r ... Full text Link to item Cite

A retrospective review of the management of Dupuytren's nodules.

Journal Article J Hand Surg Am · September 2005 PURPOSE: To evaluate the progression of Depuytren's nodules with more than 6 years of follow-up study. METHODS: Fifty-nine patients who presented initially with Dupuytren's nodules returned for physical examination at an average follow-up period of 8.7 yea ... Full text Link to item Cite