Removal of Antibiotic Cement-Coated Interlocking Nails

Abalkhail, Talal B.; Elhessy, Ahmed H; Conway, Janet D.

doi:10.1097/bot.0000000000002287

Cited by 4 publications

(5 citation statements)

References 19 publications

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“…A complication specific to ACCIN is delamination of the cement, both at the time of insertion and removal [ 2 , 15 ]. Techniques to decrease the risk of this complication are to create a smooth cement mantle and over-ream the canal by 2 mm [ 9 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

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Antibiotic impregnated cement coated intramedullary nail (ACCIN) using bronchoscopy tubing: technical tips, case series and a review of the literature

Graff,

Mathur

2023

Eur J Orthop Surg Traumatol

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Antibiotic impregnated cement coated intramedullary nails (ACCINs) have been used in clinical practice for many years and have been shown to help eradicate infection in tibial osteomyelitis while providing stability. We present a novel technique for preparation using bronchoscopy tubing, as well as technical tips and a review of the literature, for ease of preparation and potential subsequent retrieval.

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Section: Discussionmentioning

confidence: 99%

“…One challenge in this technique remains the lack of consensus on the optimal preparation method of these nails [ 2 ]. Removal can be difficult due to the risk of delamination of cement; a successful ACCIN removal usually starts with the preparation [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Antibiotic impregnated cement coated intramedullary nail (ACCIN) using bronchoscopy tubing: technical tips, case series and a review of the literature

Graff,

Mathur

2023

Eur J Orthop Surg Traumatol

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“…Hardware removal after ACCIN insertion can be done for variable reasons and has been discussed in literature [ 14 ]. The most common reason for removal of rods in our series was recurrent infection ( Table 2 ).…”

Section: Discussionmentioning

confidence: 99%

“…The most common reason for removal of rods in our series was recurrent infection ( Table 2 ). Reasons for removal, pearls, and complications were previously detailed in our 2021 work [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Infection Eradication in Antibiotic Cement-Coated Intramedullary Nails for Fracture-Related Infections, Nonunions, and Fusions

et al. 2022

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Antibiotic cement-coated intramedullary nails (ACCINs) are increasing in popularity as a viable solution for the treatment of fracture-related infections (FRIs), infected long bone nonunions, and arthrodeses without an external fixator. ACCINs effectively manage to fulfill three of the basic principles for eradicating osteomyelitis: dead space management, antibiotic delivery, and bone stability. We performed a retrospective review of 111 patients who were treated with ACCINs between January 2014 and December 2020. In our series, 87.4% (n = 97) of patients achieved healed and uninfected bone or stable arthrodesis at a mean follow-up of 29.2 months (range, 6–93 months). Additionally, 69.1% (n = 67) of healed patients were resolved after only one procedure, and the remainder (30.9%, n = 30) healed after one or more additional procedures. The mean number of additional procedures was 2.1 (range, 1–6 additional procedures). The overall limb salvage rate was 93.7% (n = 104). The majority of the total cohort were successfully treated in only one surgery. This study suggests that ACCINs are effective in the treatment of FRIs, infected long bone nonunions, and infected ankle and knee arthrodeses.

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“…Other complications include persistence of infection or non-union. 30 Furthermore, one needs to consider hypersensitivities and allergic reactions to the antibiotic agents, which, although rare, can cause sustained complications. 31 Therefore, potential allergies should always be clarified before insertion of an antibiotic coated product.…”

Section: Indicationsmentioning

confidence: 99%

Antibiotic coated nails: Rationale, development, indications and outcomes

Kalbas

Klingebiel

Pape

2022

J Orthop Surg (Hong Kong)

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The concept of antibiotic-coated implants, mainly coated intramedullary nails, has become increasingly used for the treatment of fracture related infections. After a long period of hand-made implants, commercially fabricated implants combine several benefits. Antibiotic-coated nails constitute a solid treatment option for unstable diaphyseal infections with fractures or non-unions. They release high concentrations of antibiotics locally, while retaining reduction and providing axial stability. This review aims to provide an overview about the background, the development, the indications, the treatment strategies and the outcomes of antibiotic-coated intramedullary nails.

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Removal of Antibiotic Cement-Coated Interlocking Nails

Abstract: Supplemental Digital Content is Available in the Text.

Cited by 4 publications

References 19 publications

Antibiotic impregnated cement coated intramedullary nail (ACCIN) using bronchoscopy tubing: technical tips, case series and a review of the literature

Antibiotic impregnated cement coated intramedullary nail (ACCIN) using bronchoscopy tubing: technical tips, case series and a review of the literature

Efficacy of Infection Eradication in Antibiotic Cement-Coated Intramedullary Nails for Fracture-Related Infections, Nonunions, and Fusions

Antibiotic coated nails: Rationale, development, indications and outcomes

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