Treatment for periprosthetic infection with two-stage revision arthroplasty with a gentamicin loaded spacer. The clinical outcomes.
Journal Title: Ortopedia Traumatologia Rehabilitacja - Year 2012, Vol 14, Issue 1
Abstract
With spreading of joint replacements rises the number of complications of that surgery. Although quite rare (<1%) the periprosthetic infection (PPI) are of the most serious complications of endoprothesoplasty. Infections frustrate results of even best technically performed joint replacement, cause great damage and loss of bone and periprosthetic tissues which handicap restoration surgery. The best solution for PPI patients seems to be two-staged revision arthroplasty. In the first stage excision of implants and radical debridement of infected tissues is performed and then antibiotic-loaded spacer is implanted. After few months the second stage is performed: removal of spacer and implantation of revision endoprosthesis.The aim of the study was to evaluate efficiency of periprosthetic infection treatment with two-stage revision arthroplasty.Between January 2007 and March 2010 forty one patients with diagnosed PPI were treated in Department of Orthopedic and Trauma Surgery of Silesian Medical University in Katowice. The complication followed in 12 cases (29%) after knee arthroplasty and in 29 cases (71%) after hip replacement. During first stage of the treatment 17 cases (41%) had no microorganism and 24 cases (59%) presented grown bacteria in taken intraoperatively smear. Cases with reinfection after revision endoprosthesoplasty (second stage of the treatment) had following results: no microorganism (1), MSSA (1), E.faecalis (1), A. baumanii concomitant with MSSA and MRSE (1).Afterward first stage of the treatment (spacer implantation) one case was not cured of the infection (2,5%). In 4 cases (10%) reinfection was presented after fixation of revision implants.Based on results of our analysis it may be presented a thesis that two-stage revision endoprothesoplasty is effective method of treatment of periprosthetic infections.
Authors and Affiliations
Marcin Borowski , Damian Kusz , Piotr Wojciechowski, Łukasz Cieliński
Keywords
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