Antibiotic coated nails: Rationale, development, indications and outcomes

Kalbas, Yannik; Klingebiel, Felix; Pape, Hans‐Christoph

doi:10.1177/10225536221118521

Cited by 6 publications

(3 citation statements)

References 39 publications

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“…The most common complications are similar to those that come with uncoated IMNs including persistent infection and non-union. Additionally, while the following cases are rare, it is essential to be vigilant regarding challenging removal in custom-made implants and potential allergic reactions to the antibiotic agents [32].…”

Section: Discussionmentioning

confidence: 99%

Antibiotic-Coated Intramedullary Nailing Managing Long Bone Infected Non-Unions: A Meta-Analysis of Comparative Studies

Ghaseminejad-Raeini,

Azarboo,

Pirahesh

et al. 2024

Antibiotics

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Long bone infected non-unions are such an orthopedic challenge that antibiotic-coated intramedullary nailing (ACIN) has become a viable therapeutic option for their management. This study aims to provide a comprehensive assessment of the available data about the use of antibiotic-coated nailing in the treatment of long bone infected non-unions. Following the PRISMA guideline in this meta-analysis, a systematic literature search was conducted across major databases for studies evaluating ACIN in long bone infected non-unions. The primary outcome measures included union rates, infection control, complications and functional status. Five eligible studies encompassing 183 patients in total met the inclusion criteria. The meta-analysis revealed no difference in the union rate in the antibiotic-coated intramedullary nailing group compared to that of the control group (OR = 1.73 [0.75–4.02]). Antibiotic-coated intramedullary nailing demonstrated no association with higher infection eradication (OR = 2.10 [0.97–4.54]). Also, functional outcome measure was mostly not significantly different between ACIN and control interventions. According to this meta-analysis, compared to the management of controls, ACIN is neither linked to increased union rates nor decreased infection rates. The paucity of research on this topic emphasizes the continuous need for additional well-designed randomized controlled trials for the application of antibiotics-coated intramedullary nailing in long bone non-unions.

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Section: Discussionmentioning

confidence: 99%

Antibiotic-Coated Intramedullary Nailing Managing Long Bone Infected Non-Unions: A Meta-Analysis of Comparative Studies

Ghaseminejad-Raeini,

Azarboo,

Pirahesh

et al. 2024

Antibiotics

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“…Franz et al demonstrated that the use of gentamicin-coated nails in patients with Gustilo-Anderson (GA) type III open tibial fracture led to a lower infection rate and was cost-saving [51]. In their review, Kalbas et al support the use of antibiotic-coated nails [52], in line with De Meo et al, who sustained their use in open fractures and nonunion in high-infectious-risk settings [53]. To modify the kinetic properties, antibiotic-loaded hydrogel coatings such as Defensive Antibacterial Coatings (DACs) have been employed in trauma and prosthetic settings [9,10,45,53].…”

Section: Antibiotic Coatingsmentioning

confidence: 99%

What to Know about Antimicrobial Coatings in Arthroplasty: A Narrative Review

Onorato,

Masoni,

Gagliardi

et al. 2024

Medicina

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Periprosthetic joint infections (PJIs) are one of the most worrying complications orthopedic surgeons could face; thus, methods to prevent them are evolving. Apart from systemic antibiotics, targeted strategies such as local antimicrobial coatings applied to prosthetics have been introduced. This narrative review aims to provide an overview of the main antimicrobial coatings available in arthroplasty orthopedic surgery practice. The search was performed on the PubMed, Web of Science, SCOPUS, and EMBASE databases, focusing on antimicrobial-coated devices used in clinical practice in the arthroplasty world. While silver technology has been widely adopted in the prosthetic oncological field with favorable outcomes, recently, silver associated with hydroxyapatite for cementless fixation, antibiotic-loaded hydrogel coatings, and iodine coatings have all been employed with promising protective results against PJIs. However, challenges persist, with each material having strengths and weaknesses under investigation. Therefore, this narrative review emphasizes that further clinical studies are needed to understand whether antimicrobial coatings can truly revolutionize the field of PJIs.

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“…2 Three excellent treatment-focused review articles address the relevance of surgical care to the prevention and treatment of fracture related infections, 3 the currently available highest level of evidence to guide our practice 4 and specific aspects on the utilisation of antibiotic coated nails. 5…”

mentioning

confidence: 99%