Peri-Prosthetic Knee Infection Management: Spacers Loaded with Two or Three Antibiotic Agents
| Autor: | Michele Attilio Rosa, F. Centofanti, Domenico Fenga, D. Ortolà, Sandra Marcellino, Massimiliano Rosi |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Adult Male medicine.medical_specialty Prosthesis-Related Infections Knee Joint medicine.medical_treatment 030106 microbiology Prosthesis 03 medical and health sciences 0302 clinical medicine Patient satisfaction Vancomycin medicine Infection control Humans Prosthesis-Related Infection Arthroplasty Replacement Knee Antibiotic agents orthopedic infection prosthesis Staphylococcus aureus Surgery Infectious Diseases Aged Retrospective Studies 030222 orthopedics business.industry Clindamycin Bone Cements Retrospective cohort study Middle Aged Anti-Bacterial Agents Gentamicin Female Gentamicins business Knee Prosthesis medicine.drug |
| Zdroj: | Surgical infections. 18(5) |
| ISSN: | 1557-8674 |
| Popis: | The purpose of this work was to compare pre-made antibiotic-loaded spacers with two commercially available antibiotic agents and custom-made cements with three antibiotic agents added. We evaluated: (a) the validity of our procedures, (b) the control of the rate of infection in the long term, (c) complications, and (d) quality of life and patient satisfaction.A retrospective cohort study was performed on 112 consecutively treated patients between January 2010 and December 2013; 56 patients were treated with a pre-formed cement spacer (clindamycin + gentamicin), and 56 patients were treated with a spacer loaded with three antibiotic agents (clindamycin + gentamicin + vancomycin). Demographic data were collected: Classification of infection according to criteria of Cierny-Mader; microbiologic results; number of previous operations; and years of disease. Infection control or relapse after at least 18 months of follow-up was evaluated. Complications were recorded. Every patient completed the SF-36 test and Oxford Knee Score.With a follow-up of 32.87 months (standard deviation 12.04), at the end of treatment, amputation occurred in three of 112 patients because of recurrence of infection, and one patient died from other causes not related to the infection. The study population presented a rate of recurrence of infection of 2.70%.Our results suggest that a two stage re-implant with three antibiotic agents added to the spacer should be considered to avoid rescue procedures, especially in patients with multi-resistant micro-organism infections. |
| Databáze: | OpenAIRE |
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