Radiographic Loosening After Revision with Gentamicin-containing Cement for Deep Infection in Total Hip Arthroplasties

Carlsson, Åke; Egund, Niels; Gentz, C F; Hussenius, Å.; Josefsson, G; Lindberg, L

doi:10.1097/00003086-198504000-00043

Cited by 15 publications

(6 citation statements)

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“…The primary endpoint was the rate of infection recurrence defined according to MSIS criteria [39]. Secondary endpoints were the length of hospital stay after surgery, including the first and the second stage for two-stage procedures, the duration of antibiotic therapy, and the clinical scores at Radiographic examination, including the evaluation of osteolysis or progressive (> 2 mm) radiolucent lines around the implant or signs of implant loosening or subsidence [7], was also performed.…”

Section: Follow-up and Endpointsmentioning

confidence: 99%

One-stage exchange with antibacterial hydrogel coated implants provides similar results to two-stage revision, without the coating, for the treatment of peri-prosthetic infection

Capuano¹,

Logoluso

Gallazzi

et al. 2018

Knee Surg Sports Traumatol Arthrosc

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Section: Follow-up and Endpointsmentioning

confidence: 99%

One-stage exchange with antibacterial hydrogel coated implants provides similar results to two-stage revision, without the coating, for the treatment of peri-prosthetic infection

Capuano¹,

Logoluso

Gallazzi

et al. 2018

Knee Surg Sports Traumatol Arthrosc

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“…36 We obtained a similar or lower rate of re-infection when compared with the use of antibiotic-loaded cement. [37][38][39] Combining antibiotics and cement has some disadvantages. Contemporary cementing techniques include vacuum-mixing in a negative pressure environment to reduce the number and size of air bubbles and increase resistance.…”

Section: Discussionmentioning

confidence: 99%

Vancomycin-supplemented impacted bone allografts in infected hip arthroplasty

Buttaro

Pusso

Piccaluga

2005

The Journal of Bone and Joint Surgery. British volume

103

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Bone allografts can store and release high levels of vancomycin. We present our results of a two-stage treatment for infected hip arthroplasty with acetabular and femoral impaction grafting using vancomycin-loaded allografts. We treated 29 patients (30 hips) by removal of the implants, meticulous debridement, parenteral antibiotic therapy and second-stage reconstruction using vancomycin-supplemented impacted bone allografts and a standard, cemented Charnley femoral component. The mean follow-up was 32.4 months (24 to 60). Infection control was obtained in 29 cases (re-infection rate of 3.3%; 95% confidence interval 0.08 to 17) without evidence of progressive radiolucent lines, demarcation or graft resorption. One patient had a further infection ten months after revision caused by a different pathogen. Associated post-operative complications were one traumatic periprosthetic fracture at 14 months, a single dislocation in two hips and four displacements of the greater trochanter. Vancomycin-supplemented allografts restored bone stock and provided sound fixation with a low incidence of further infection.

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“…Delivering an effective antimicrobial at sufficiently high concentrations to the area of infection in combination with surgery is a recognized treatment for bone infection. [3][4][5][6][7][8][9][10][11][12] It is usually performed with the use of polymethylmethacrylate (PMMA) bone cement beads in combination with standard treatments for bone infection. The success rate varies from 40 -90%.…”

Section: Introductionmentioning

confidence: 99%

In vitroelution of vancomycin from biodegradable beads

Liu

Ueng

Chan

et al. 1999

J. Biomed. Mater. Res.

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The current antibiotics delivery system for orthopedic infection treatment uses polymethylmethacrylate (PMMA) beads as a drug release. However the nonbiodegradable nature of the PMMA necessitates a second operation to remove the beads. This article explores the alternative of using biodegradable polymers as antibiotic beads for a long-term drug release. The effect of different processing factors on the release rate of the beads was investigated. To manufacture an antibiotic bead, polylactide-polyglycolide copolymers were mixed with vancomycin. The mixture was compressed and sintered at 55 degrees C to form beads of different sizes. An elution method was employed to characterize the release rate of antibiotic over a 35-day period at 37 degrees C. Biodegradable beads released high concentrations of antibiotic (well above the breakpoint sensitivity concentration) in vitro for the period of time needed to treat bone infection; i.e., 4-6 weeks. A bacterial inhibition test was carried out to determine the relative activity of the released antibiotics. The diameter of the sample inhibition zone ranged from 6.5-10 mm, which is equivalent to 12.5-100% of relative activity. By changing the processing parameters, we were able to control the release rate of the beads. This provides advantages of meeting the specific antibiotics requirement for patients with various surgical infections.

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Radiographic Loosening After Revision with Gentamicin-containing Cement for Deep Infection in Total Hip Arthroplasties

Cited by 15 publications

References 0 publications

One-stage exchange with antibacterial hydrogel coated implants provides similar results to two-stage revision, without the coating, for the treatment of peri-prosthetic infection

One-stage exchange with antibacterial hydrogel coated implants provides similar results to two-stage revision, without the coating, for the treatment of peri-prosthetic infection

Vancomycin-supplemented impacted bone allografts in infected hip arthroplasty

In vitroelution of vancomycin from biodegradable beads

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