No abstract

The aim of the study is to analyze possible options for treating patients with deep paraprothetic infection of major joints performing a literature review. Arthroplasty has occupied its specific place in a range of surgical operations used in treating patients with joint diseases. The rate of possible complications developing on different stages of treatment does not decrease while the number of operations increase. The most difficulties are associated with deep paraprothetic infection, because in this case in is only possible to save the implant in 20% of patients mainly with early infections. The rate for infective complications in specialized orthopedic centers while ward treatment does not exceed 1% in case of primary arthroplasty, but significantly increases several years after the surgery. The most used treatment for paraprothetic infection is serial revision arthroplasty. The comparative analysis of single-staged and two-staged treatment was performed. The second one is based on using antibiotic-loaded bone cement spacers. The analysis reveals that using antibiotic-loaded bone cement spacers is an effective method of treatment for deep paraprothetic infection. Two-staged treatment method with temporary spacer implantation is preferable in treating infective complications of arthroplasty. Furhter progress of this method may be associated with optimizing the choice of antibiotic filling, developing new spacer structures and forms, and in combining local and general antibiotic administration.

In special literature more and more attention is paid to the problem of periprosthetic infection that is stipulated by increasing number of arthroplasties performed all over the world including Russia. Not declining rate of such complications is grounded by the conditions of intervention performance, concomitant diseases and peculiarities of pathogenic microflora. Unfortunately the conventional schemes of systemic therapy are not always applicable in purulent periprosthetic process development that requires local antibiotic delivery. Review of foreign literate is dedicated to the modern aspects of treatment by adding antibiotics to bone cement.

No abstract

Endoprosthetics of joints has firmly taken its place in a number of orthopedic interventions in the treatment of diseases of the musculoskeletal system. Unfortu-nately, with an increase in the number of operations, the number of complications that develop at various stages of treatment does not decrease. Deep infections in the area of the endoprosthesis (paraprosthetic infection) are especially difficult in treatment, since only 20% of patients, and mainly in early forms of complications, manage to save the implant. The incidence of infectious complications at the stationary stage in specialized endoprosthetics centers does not exceed 1% during primary operations, but their number, as a rule, multiplies several years after the intervention. The most common treatment option for paraprosthetic infection is staged revision arthroplasty. The authors of the review conduct a comparative analysis of the effectiveness of one- and two-stage treatment options. The latter is based on the use of bone cement spacers impregnated with antibiotics.