Osseointegrated titanium implants for limb prostheses attachments: infectious complications
| Autor: | Jonatan Tillander, Kerstin Hagberg, Lars Hagberg, Rickard Brånemark |
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| Rok vydání: | 2010 |
| Předmět: |
Male
Time Factors medicine.medical_treatment Dentistry Prosthesis Orthopedics and Sports Medicine Prospective Studies Prosthesis-Related Infection Amputation Skin Titanium Assistive Technology Rehabilitation General Medicine Middle Aged Anti-Bacterial Agents Treatment Outcome Infectious Diseases Female Infection Reoperation Adult medicine.medical_specialty Prosthesis-Related Infections Clinical Sciences Artificial Limbs Bioengineering Prosthesis Design Osseointegration Amputation Surgical Clinical Research medicine Humans Surgical Wound Infection Device Removal Aged Sweden 5.3 Medical devices business.industry Prevention Implant Infection Surgery Radiography Emerging Infectious Diseases Orthopedics Musculoskeletal Orthopedic surgery Implant Complication business |
| Zdroj: | Clinical orthopaedics and related research, vol 468, iss 10 Clinical Orthopaedics and Related Research |
| Popis: | Background The concept of osseointegration involves direct contact between titanium implant and bone. This transcutaneous prosthetic system for amputees is intended to assure stable long-term fixation. Most metal transcutaneous implants have failed, primarily owing to infection. Questions/purposes We determined the frequency and describe the presentation of infectious complications with this novel method. We also evaluated the bacterial flora at the skin-penetration area and its relation to the development of local and implant-related infection. Patients and Methods We prospectively followed 39 patients with arm and leg amputations fitted with transcutaneous osseointegrated titanium implants a mean of 56 months earlier (range, 132–133 months). There were 33 femoral, one tibial, four ulnar, four radial, and three humeral implants. Patients were selected during a 6-month period in 2005 and identically reevaluated after 3 years. Implant infection was defined as definite, probable, or possible based on clinical, radiologic, and microbiologic evidence. Results The frequency of implant infection was 5% at inclusion and 18% at followup. One patient with infection recovered owing to antibiotic treatment and another patient had the implant removed. Most implant infections had low infectious activity, and in five of the seven patients with infections, prosthetic use was not affected. The most common bacteria in superficial and deep cultures were Staphylococcus aureus and coagulase-negative staphylococci. Conclusions Despite frequent colonization around the skin-implant interface by potentially virulent bacteria such as Staphylococcus aureus and bacteria associated with biomedical device infections such as coagulase-negative staphylococci, this titanium implant system for bone-anchored prostheses caused few infections leading to disability or implant removal. Level of Evidence Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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