Use of a Hinged Antibiotic-Loaded Cement Spacer for an Infected Periprosthetic Fracture in a Total Elbow Arthroplasty: A Novel Construct Utilizing Ilizarov Rods

Liporace, Frank A.; Kaplan, Daniel J.; Stickney, William; Yoon, Richard S.

doi:10.2106/jbjs.cc.n.00084

Cited by 10 publications

(13 citation statements)

References 17 publications

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“…To avoid these deficiencies and shortcomings, some scholars have attempted to use internal fixations in bone infection. Liporace [4] and Conway [5] attempted to treat infected bone fractures with antibiotic cement-coated locking plates. However, the study had few cases and short follow-up times, and further analysis of the long-term efficacy and application conditions or complications is incomplete.…”

Section: Introductionmentioning

confidence: 99%

An antibiotic cement-coated locking plate as a temporary fixation for treatment of infected bone defects: a new method of stabilization

Jia

Xiao-hua

et al. 2020

J Orthop Surg Res

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Background: The induced membrane technique has achieved good clinical results in the treatment of infected bone defects, and external fixation is the main method, but it causes inconvenience and complications in patients. In this study, our objective was to investigate the outcomes of using an antibiotic cement-coated locking plate as a temporary internal fixation in the first stage of the surgical induced membrane technique for treating extremities with infected bone defects. Methods: We retrospectively analysed patients with lower extremity infected bone defects in our department between January 2013 and December 2017. All patients were treated with the induced membrane technique. In the first stage, the defects were stabilized with an antibiotic cement-coated locking plate as a temporary fixation after debridement, and polymethyl methacrylate cement was implanted to induce the formation of a membrane. In the second stage, bone grafting rebuilt the bone defects after infection control, and the temporary fixation was changed to a stronger fixation. Results: A total of 183 patients were enrolled, with an average follow-up duration of 32.0 (12-66) months. There were 154 males and 29 females with an average age of 42.8 (10-68) years. The infection sites included 81 femurs, 100 tibias and 2 fibulas. After the first stage of treatment (infection control), 16 (8.7%) patients had recurrence of infection. In terms of the incidence of complications, 4 patients had poor wound healing, 2 patients had fixation failure and 1 patient had femoral fracture due to a fall. After the second stage of treatment (bone reconstruction), there were 24 (13.1%) recurrences of infection, with a mean time of 9.9 months (range 0.5 to 36). Among them, 18 patients underwent bone grafting after re-debridement, 6 received permanent placement of antibiotic bone cement after debridement and 2 patients refused further treatment and chose amputation. Bone healing was achieved in 175 (95.9%) patients at the last follow-up, and the average time to bone union was 5.4 (4-12) months. Conclusions: Antibiotic cement-coated locking plates have good clinical effects in the control of bone infection, but attention must be paid to the possible difficulty of skin coverage when applied in calves.

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Section: Introductionmentioning

confidence: 99%

An antibiotic cement-coated locking plate as a temporary fixation for treatment of infected bone defects: a new method of stabilization

Jia

Xiao-hua

et al. 2020

J Orthop Surg Res

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“…The cement may alternatively be formed as beads (see Figures, Supplemental Digital Content 1, http:// links.lww.com/BOT/A538). 15,18,[24][25][26][27][28][29][30][31] Although this does not provide any skeletal stability, it can serve as an easily retrievable method for local antibiotic delivery and dead space obliteration. 14,16,17 There are several ways to increase the elution properties of the cement itself.…”

Section: Utilization Of Polymethylmethacrylate In the Setting Of Deadmentioning

confidence: 99%

“…Intramedullary devices or even locked plates coated in antibiotic cement serve as an effective additional technique that can again allow for focused antibiotic delivery, provide provisional osseous stability, and are retrievable after the infection has been eradicated. 31 …”

Section: Utilization Of Polymethylmethacrylate In the Setting Of Deadmentioning

confidence: 99%

Dead Space Management After Orthopaedic Trauma

Gage

Yoon

Gaines

et al. 2016

Journal of Orthopaedic Trauma

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“…33 Another potential option in the setting of massive femoral or acetabular bone loss has been described using structural allograft with a high rate of success (one reinfection and a Kaplan-Meier survivorship of 93% at 10 years with re-revision for aseptic loosening as the end point) in 27 patients undergoing two-stage exchange. Novel techniques to treat these difficult cases recently have been described using either an antibiotic-impregnated cement coated locking plate 35 or an interlocking prosthesis. Novel techniques to treat these difficult cases recently have been described using either an antibiotic-impregnated cement coated locking plate 35 or an interlocking prosthesis.…”

Section: Special Considerations For Challenging Casesmentioning

confidence: 99%

Management of infection after total hip arthroplasty

Cooper

Valle

2012

Current Orthopaedic Practice

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Recent advances have been made in the treatment of infection after total hip arthroplasty. Although two-stage exchange continues to provide high success rates and remains the gold standard for eradication of infection, there is significant research interest in one-stage exchange. Results of this procedure have been excellent in European studies when a strict algorithmic approach to patient selection is used, and decision analysis modeling suggests this should be further studied. Conversely, irrigation and débridement with component retention has been shown to have a high rate of failure and should be used sparingly. There are numerous new techniques for antibiotic spacer construction, although the literature has failed to demonstrate superiority of any specific design. Other advances are discussed, including better parameters to document the resolution of infection both before and at the time of the second-stage reimplantation, as well as novel techniques to help deal with challenging cases of periprosthetic hip infection.

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Use of a Hinged Antibiotic-Loaded Cement Spacer for an Infected Periprosthetic Fracture in a Total Elbow Arthroplasty: A Novel Construct Utilizing Ilizarov Rods

Abstract: A two-stage revision of an infected TEA with a periprosthetic fracture can be managed successfully with our novel hinged antibiotic-loaded cement spacer.

Cited by 10 publications

References 17 publications

An antibiotic cement-coated locking plate as a temporary fixation for treatment of infected bone defects: a new method of stabilization

An antibiotic cement-coated locking plate as a temporary fixation for treatment of infected bone defects: a new method of stabilization

Dead Space Management After Orthopaedic Trauma

Management of infection after total hip arthroplasty

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