Economic Evaluation of Antibacterial Coatings on Healthcare Costs in First Year Following Total Joint Arthroplasty

Trentinaglia, Maria Teresa; Straeten, Catherine Van Der; Morelli, Ivano; Logoluso, Nicola; Drago, Lorenzo; Romanò, Carlo Luca

doi:10.1016/j.arth.2018.01.057

Cited by 25 publications

(15 citation statements)

References 64 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additionally, numerous criticisms have been raised regarding the use of these devices, due to their high costs in the context of prevention. In a cost-benefit analysis, some Italian authors have simulated the cost-saving that would occur if on-site prophylaxis strategies were routinely used [36]: in their simulation, the authors highlighted that, currently, the routine use of silver-coated devices in prosthetic tumor surgery is not cost effective, while the routine use of the hydrogel or antibiotic loaded bone cement would be economically beneficial.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic-Loaded Hydrogel Coating to Reduce Early Postsurgical Infections in Aseptic Hip Revision Surgery: A Retrospective, Matched Case-Control Study

et al. 2020

View full text Add to dashboard Cite

Periprosthetic joint infections (PJIs) are a cause of frequent implant failure in revision hip replacement surgery. The purpose of this study is to evaluate the onset of early postoperative infections in patients who underwent hip surgery with cementless prostheses treated with an antibiotic loaded hydrogel on their surface, in addition to systemic prophylaxis, and compare them to a control group. The secondary objective was to evaluate the onset of any local and systemic adverse effects and interference with bone ingrowth processes and functional recovery. A retrospective observational study was conducted on patients who underwent revision hip surgery by performing a 1:1 match between patients treated with an antibiotic hydrogel (ALH) and the control patients. The incidence of PJIs was assessed with a minimum of six months follow-up. Seventeen patients treated with the ALH were compared with 17 patients from the control group. No PJIs were reported in the ALH group versus the six cases encountered in the control group (p < 0.0001). No significant differences were reported with regard to prosthetic osseointegration and functional results, nor were there side effects in the ALH group. Despite the low sample size, the use of on-site prophylaxis with ALH has proven effective and safe in reducing the risk of PJIs in patients with a high risk for infections. Further studies are needed to validate these results in other implant-related surgeries.

show abstract

Section: Discussionmentioning

confidence: 99%

Antibiotic-Loaded Hydrogel Coating to Reduce Early Postsurgical Infections in Aseptic Hip Revision Surgery: A Retrospective, Matched Case-Control Study

et al. 2020

View full text Add to dashboard Cite

show abstract

“…The routine use of silver-coated implants remains rather limited for several reasons, including possible toxicity of silver ions [39], and incomplete protection of the implant, since the intramedullary part of the prosthesis and some modular components cannot be coated. Moreover, only a few implant designs are offered with silver coating protection, while the cost of the technology remains quite high when considering applications outside oncology [40].…”

Section: Silver Coatingsmentioning

confidence: 99%

“…Our group recently proposed an algorithm to calculate the cost-effectiveness of different antibacterial coating strategies applied to joint prostheses, taking both direct and indirect hospital costs into account [40]. According to this model, an antibacterial coating technology able to reduce post-surgical infection by 80%, at a cost per patient of €600, would provide a reduction in hospital costs of €200 per patient if routinely applied in a population that would otherwise have an expected post-surgical infection rate of 2%.…”

Section: Potential Impact Of Large-scale Application Of Antibacterialmentioning

confidence: 99%

Local Antibacterial Implant Protection in Orthopedics and Trauma: What’s New?

Romanò¹,

Божкова

Artyukh

et al. 2019

Traumatology and Orthopedics of Russia

View full text Add to dashboard Cite

Current prophylactic and hygienic measures notwithstanding, implant-related infection remains among leading reasons for failure in orthopaedics and trauma surgery, resulting in extremely high social and economic costs. Various antibacterial coating technologies have been proven safe and effective both in preclinical and in clinical settings and able to reduce post-surgical infections up to 90%, depending on the type of the coating and on the experimental setup. In spite of this findings, the widespread use of these technologies is still limited by several factors. After reviewing the latest evidence on currently available antibacterial coatings, an algorithm is proposed to calculate the impact of the delayed introduction of these technologies in the clinical practice. When applied to joint arthroplasties, our calculator shows that each year of delay to implement an antibacterial coating, able to reduce post-surgical infection by 80% at a final user's cost price of €600, causes an estimated 35 200 new cases of periprosthetic joint infection in Europe and additional annual hospital costs of approximately €440 million. Faster and more affordable regulatory pathways for antibacterial coating technologies and an adequate reimbursement policy for their clinical use appear a feasible solution to mitigate the impact of implant-related infections and may benefit patients, healthcare systems, and related research. реферат несмотря на современные достижения профилактики и гигиены, имплант-ассоциированная инфекция остается одной из основных причин несостоятельных результатов ортопедических и травматологических вмешательств, что приводит к чрезвычайно высоким социальным и экономическим издержкам. Различные технологии антибактериального покрытия имплантатов зарекомендовали себя как безопасное и эффектив-

show abstract

“…The hydrogel, loaded with gentamicin, effectively prevented infection in a rabbit model of contaminated fracture treated with plating osteosynthesis. Furthermore, antibacterial coatings on implants have the potential of decreasing healthcare costs (Trentinaglia et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Prophylaxis of implant-related infections by local release of vancomycin from a hydrogel in rabbits

Boot¹,

Vogely²,

Jiao³

et al. 2020

eCM

View full text Add to dashboard Cite

Local prophylaxis with antibiotic-loaded bone cement is a successful method to prevent post-operative infections in patients receiving orthopaedic implants. No comparable method is available for uncemented implants. Therefore, a hydrogel consisting of hyaluronic and polylactic acids was evaluated in a rabbit model for delivery of antimicrobial agents to prevent post-operative infections. In a pilot study, the suitability of the in vivo model was assessed by testing the hydrogel as carrier material for antimicrobial agents. In the main study, the antimicrobial-agent-loaded hydrogel was evaluated for infection prophylaxis. Rabbits received a titanium rod intramedullary in the tibia after contamination with Staphylococcus aureus. The rods were coated with unloaded hydrogel (Gel), hydrogel loaded with 2 % (Van2) or 5 % vancomycin (Van5), bioactive glass (BAG) or N-acetyl-L-cysteine (NAC). To analyse the infection severity after 28 d, histopathological, bacteriological, micro-computed tomographic and haematological analyses were performed. In the pilot study, the Van5 group had less infection (0/6 infected) as compared to the Gel group (5/5, p = 0.000) and the in vivo model was deemed suitable. In the main study, in the Van2 and Van5 groups, the number of infected animals was lower [1/6 (p = 0.006) and 2/6 (p = 0.044) infected, respectively]. In contrast, BAG and NAC groups showed no infection reduction (5/6 both groups, p = 0.997). The hydrogel can be used as a local carrier of vancomycin for prophylaxis of implant-related infections. The present study showed promising results for local delivery of antibacterial agents by hydrogel to prevent implant-related infections.

show abstract

Economic Evaluation of Antibacterial Coatings on Healthcare Costs in First Year Following Total Joint Arthroplasty

Cited by 25 publications

References 64 publications

Antibiotic-Loaded Hydrogel Coating to Reduce Early Postsurgical Infections in Aseptic Hip Revision Surgery: A Retrospective, Matched Case-Control Study

Antibiotic-Loaded Hydrogel Coating to Reduce Early Postsurgical Infections in Aseptic Hip Revision Surgery: A Retrospective, Matched Case-Control Study

Local Antibacterial Implant Protection in Orthopedics and Trauma: What’s New?

Prophylaxis of implant-related infections by local release of vancomycin from a hydrogel in rabbits

Contact Info

Product

Resources

About