Hip arthroplasty infection: Current concepts

Antti-Poĭka, I; Josefsson, G; Konttinen, Yrjö T.; Lidgren, Lars; Santavirta, Seppo; Sanzén, Lennart

doi:10.3109/17453679009006513

Cited by 75 publications

(38 citation statements)

References 66 publications

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“…The infection rate ranges between 0.5% and 3.0% after primary total hip arthroplasty despite strict antiseptic operative procedures, including systemic prophylaxis [1][2][3][4][5][6]. Infection rates between 5% and 35% have been described for endoprosthetic replacement of large bone defects after tumor resection [7][8][9][10][11][12], while external fixation produced infection in 2-30% of cases found during a literature review [13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Antibacterial iodine-supported titanium implants

et al. 2011

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Deep infection remains a serious complication in orthopedic implant surgery. In order to reduce the incidence of implant-associated infections, several biomaterial surface treatments have been proposed. This study focused on evaluating the antibacterial activity of iodine-supported titanium (Ti-I 2 ) and impact on post-implant infection, as well as determining the potential suitability of Ti-I 2 as a biomaterial.External fixation pins were used in this experiment as trial implants because it was easy to make the septic models.The antibacterial activity of the metal was measured using a modification of the Japanese Industrial Standards method. Activity was evaluated by exposing the implants to Staphylococcus aureus or Escherichia coli and comparing reaction of pathogens to the Ti-I 2 versus the stainless steel and titanium controls. The Ti-I 2 clearly inhibited bacterial colonization more than the control metals. In addition, cytocompatibility was assessed by counting the number of colonies that formed on the metals. The three metals showed the same amount of fibroblast colony formation.Japanese white rabbits were used as an in vivo model. Three pins were inserted into both femora of six rabbits for histological analysis. Pin sites were inspected and graded for infection and inflammation. Fewer signs of infection and inflammatory changes were observed in conjunction with the Ti-I 2 pins. Furthermore, osteoconductivity of the implant was evaluated with osteoid formation surface of the pin. Consecutive bone formation was observed around the Ti-I 2 and titanium pins, while little osteoid formation was found around the stainless steel pins. These findings suggest that Ti-I 2 has antimicrobial activity and cytocompatibility.Therefore, Ti-I 2 substantially reduces the incidence of implant infection and shows particular promise as a biomaterial.

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Section: Introductionmentioning

confidence: 99%

Antibacterial iodine-supported titanium implants

et al. 2011

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“…ranging between 1% and 3%, and has many consequences [3,18,22]. Thus, accuracy of the preoperative diagnosis of possible infection becomes especially important in patients with loosened and painful hip endoprostheses [12].…”

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confidence: 99%

High Diagnostic Value of Synovial Biopsy in Periprosthetic Joint Infection of the Hip

Fink

Gebhard

Fuerst³

et al. 2013

Clinical Orthopaedics &Amp; Related Research

100

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“…Two-stage exchange arthroplasty is generally considered the preferred method of treatment of periprosthetic joint infection [6][7][8][9] . A preoperative evaluation that incorrectly identifies the presence or absence of infection can lead to either inappropriate surgical intervention or a delay in appropriate treatment.…”

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confidence: 99%