Management of infected non-union in long bones: our experience with bone cement

Agrawal, Mayank; Yuvarajan, P; Maini, Lalit; Gautam, VK

doi:10.1016/s0976-5662(11)60009-x

Cited by 3 publications

(4 citation statements)

References 22 publications

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“…They rely on expert opinion with some indirect information from past animal studies or in vitro experiments [3,4]. Traditionally, a six-to 12-week course of antibiotic therapy is recommended [5,9,10,13,16], of which the first two to four weeks are usually given intravenously [1,11]. This general recommendation has been continuously challenged in recent years in favour of shorter antibiotic administration time with decreased parenteral regimen [7,10,11].…”

Section: Discussionmentioning

confidence: 99%

“…In the literature the duration of antimicrobial administration after implant removal, and the variables associated with remission, have been investigated thus far for arthroplastyassociated infections [5][6][7], but less for chronic osteomyelitis cases [3,8], and even less for fracture device-associated infections, the latter often with fewer than 30 episodes included per publication [9][10][11][12][13]. Theoretically, complete implant removal is the essential part of treatment, and therefore a relatively short period of antibiotic administration might be sufficient for sterilisation of superficial bone layers adjacent to the implant.…”

Section: Introductionmentioning

confidence: 99%

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Remission rate of implant-related infections following revision surgery after fractures

Al-Mayahi

Betz

Müller

et al. 2013

International Orthopaedics (SICOT)

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Purpose In contrast to a large amount of epidemiological data regarding the incidence of implant infections after fracture management, surprisingly few have been published concerning the success of their treatment. Methods This was a single-centre cohort study at Geneva University Hospitals from 2000 to 2012 investigating the remission rates of orthopaedic implant infections after fracture repair and associated variables. Results A total of 139 episodes were included: There were 51 women (37 %) and 28 immunosuppressed (20 %) patients with a median age and American Society of Anaesthesiologists (ASA) score of 51 years and 2 points, respectively. The infected implants were plates (n =75, 54 %), nails (24, 17 %), wires (20), screws (10), cerclage cables or wires (3), hip screws (4) or material for spondylodesis (3). A pathogen was identified in 135 (97 %) cases, including Staphylococcus aureus (73, 52 %), coagulase-negative staphylococci (20), streptococci (7) and 19 Gram-negative rods. All patients underwent antibiotic treatment, and 128 (92 %) remained in remission at a median follow-up time of 2.6 years (range one to 13 years). In multivariate logistic regression analysis, the plate infections were significantly associated with lower remission rates [65/75, 87 %, odds ratio ( Conclusions Among all infected and removed orthopaedic implants, plates were associated with slightly lower remission rates, while the overall treatment success exceeded 90 %. The duration of antibiotic therapy did not alter the outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Remission rate of implant-related infections following revision surgery after fractures

Al-Mayahi

Betz

Müller

et al. 2013

International Orthopaedics (SICOT)

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“…Many studies have been conducted to assess the efficacy of antibiotic beads. 1 , 2 , 3 , 11 , 12 , 13 , 14 , 15 Inspired by these studies, the present study was conducted to assess their efficacy in musculoskeletal infections and identify the various influencing factors on infection recurrence. Several authors 15 , 16 have opined that Cefuroxime and Vancomycin can be used because of their safety, broad spectrum of action, heat stability, and low systemic side effects when used locally .…”

Section: Discussionmentioning

confidence: 99%

Outcome analysis of antibiotic-loaded poly methyl methacrylate (PMMA) beads in musculoskeletal infections

Patel

Bhat

Hosapatna

2021

Journal of Taibah University Medical Sciences

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Objective Despite the availability of an extensive array of antibiotics, musculoskeletal infections are not cured successfully. It is necessary to remove sequestra, infected necrotic tissue, and implants. This study was undertaken to assess the efficacy of poly methyl methacrylate (PMMA) beads and identify the variables that influence eradication and recurrence in the treatment of musculoskeletal infections. Methods This study was conducted on 82 patients with chronic osteomyelitis who were treated over a period of 6 years at our tertiary care hospital. We followed up with 71 patients for one year. Clinicoradiological data for the control of infection and bone healing were assessed at the final follow up visit. The correlation between antibiotic sensitivity/resistance and infection was evaluated for Gentamicin + Cefuroxime and Gentamicin + Vancomycin combinations. Chi-squared testing, using SPSS version 16.0, was used for statistical analysis, and a p -value < 0.05 was considered significant. Results Fifty-three patients (65.4%) had an exogenous route of infection. Fifty-six patients (68.51%) presented with a discharging sinus on first presentation. In 42 patients (59%), the diagnosis was verified with a positive bacterial culture. In addition, we used antibiotic beads of Gentamicin + Cefuroxime in 74 patients (90%), while in 8 patients (10%), we used Gentamicin + Vancomycin, based on culture and sensitivity results. Recurrence was found in five cases of Gentamicin + Cefuroxime and two cases of Gentamicin + Vancomycin ( p = 0.065). Conclusion Antibiotics containing PMMA beads are effective in the treatment of chronic osteomyelitis and in preventing the recurrence of infection. It is imperative to identify various factors responsible for the recurrence of infection. This may help clinicians predict the prognosis of the disease and minimise the risk of adverse outcomes.

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“…2 We have been using the cement spacer in different forms. [3][4][5] We want to share our method of preparing cement spacer in tumor surgeries using syringe in syringe technique which is easier and cost-effective.…”

Section: To the Editormentioning

confidence: 99%