Local antibiotic therapy in infection of arteficial joints

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.