Cargando…

High Risk for Persistent Peri-Prosthetic Infection and Amputation in Mega-Prosthesis Reconstruction

A peri-prosthetic joint infection is a feared complication after mega-prosthesis reconstruction of large bone defects. The current study investigates how patients operated with a mega-prosthesis due to sarcoma, metastasis, or trauma, are affected by a deep infection focusing on re-operations, risk f...

Descripción completa

Detalles Bibliográficos
Autores principales: Berger, Christina, Parai, Catharina, Tillander, Jonatan, Bergh, Peter, Wennergren, David, Brisby, Helena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10218797/
https://www.ncbi.nlm.nih.gov/pubmed/37240683
http://dx.doi.org/10.3390/jcm12103575
_version_ 1785048859084324864
author Berger, Christina
Parai, Catharina
Tillander, Jonatan
Bergh, Peter
Wennergren, David
Brisby, Helena
author_facet Berger, Christina
Parai, Catharina
Tillander, Jonatan
Bergh, Peter
Wennergren, David
Brisby, Helena
author_sort Berger, Christina
collection PubMed
description A peri-prosthetic joint infection is a feared complication after mega-prosthesis reconstruction of large bone defects. The current study investigates how patients operated with a mega-prosthesis due to sarcoma, metastasis, or trauma, are affected by a deep infection focusing on re-operations, risk for persistent infection, arthrodesis, or subsequent amputation. Time to infection, causative bacterial strains, mode of treatment and length of hospital stay are also reported. A total of 114 patients with 116 prostheses were evaluated, a median of 7.6 years (range 3.8–13.7) after surgery, of which 35 (30%) were re-operated due to a peri-prosthetic infection. Of the infected patients, the prosthesis was still in place in 51%, 37% were amputated, and 9% had an arthrodesis. The infection was persistent in 26% of the infected patients at follow-up. The mean total length of hospital stay was 68 (median 60) days and the mean number of reoperations was 8.9 (median 6.0). The mean length of antibiotic treatment was 340 days (median 183). Coagulase-negative staphylococci and Staphylococcus aureus were the most frequent bacterial agents isolated in deep cultures. No MRSA- or ESBL-producing Enterobacterales were found but vancomycin-resistant Enterococcus faecium was isolated in one patient. In summary, there is a high risk for peri-prosthetic infection in mega-prostheses, resulting in persistent infection or amputation relatively often.
format Online
Article
Text
id pubmed-10218797
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-102187972023-05-27 High Risk for Persistent Peri-Prosthetic Infection and Amputation in Mega-Prosthesis Reconstruction Berger, Christina Parai, Catharina Tillander, Jonatan Bergh, Peter Wennergren, David Brisby, Helena J Clin Med Article A peri-prosthetic joint infection is a feared complication after mega-prosthesis reconstruction of large bone defects. The current study investigates how patients operated with a mega-prosthesis due to sarcoma, metastasis, or trauma, are affected by a deep infection focusing on re-operations, risk for persistent infection, arthrodesis, or subsequent amputation. Time to infection, causative bacterial strains, mode of treatment and length of hospital stay are also reported. A total of 114 patients with 116 prostheses were evaluated, a median of 7.6 years (range 3.8–13.7) after surgery, of which 35 (30%) were re-operated due to a peri-prosthetic infection. Of the infected patients, the prosthesis was still in place in 51%, 37% were amputated, and 9% had an arthrodesis. The infection was persistent in 26% of the infected patients at follow-up. The mean total length of hospital stay was 68 (median 60) days and the mean number of reoperations was 8.9 (median 6.0). The mean length of antibiotic treatment was 340 days (median 183). Coagulase-negative staphylococci and Staphylococcus aureus were the most frequent bacterial agents isolated in deep cultures. No MRSA- or ESBL-producing Enterobacterales were found but vancomycin-resistant Enterococcus faecium was isolated in one patient. In summary, there is a high risk for peri-prosthetic infection in mega-prostheses, resulting in persistent infection or amputation relatively often. MDPI 2023-05-20 /pmc/articles/PMC10218797/ /pubmed/37240683 http://dx.doi.org/10.3390/jcm12103575 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Berger, Christina
Parai, Catharina
Tillander, Jonatan
Bergh, Peter
Wennergren, David
Brisby, Helena
High Risk for Persistent Peri-Prosthetic Infection and Amputation in Mega-Prosthesis Reconstruction
title High Risk for Persistent Peri-Prosthetic Infection and Amputation in Mega-Prosthesis Reconstruction
title_full High Risk for Persistent Peri-Prosthetic Infection and Amputation in Mega-Prosthesis Reconstruction
title_fullStr High Risk for Persistent Peri-Prosthetic Infection and Amputation in Mega-Prosthesis Reconstruction
title_full_unstemmed High Risk for Persistent Peri-Prosthetic Infection and Amputation in Mega-Prosthesis Reconstruction
title_short High Risk for Persistent Peri-Prosthetic Infection and Amputation in Mega-Prosthesis Reconstruction
title_sort high risk for persistent peri-prosthetic infection and amputation in mega-prosthesis reconstruction
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10218797/
https://www.ncbi.nlm.nih.gov/pubmed/37240683
http://dx.doi.org/10.3390/jcm12103575
work_keys_str_mv AT bergerchristina highriskforpersistentperiprostheticinfectionandamputationinmegaprosthesisreconstruction
AT paraicatharina highriskforpersistentperiprostheticinfectionandamputationinmegaprosthesisreconstruction
AT tillanderjonatan highriskforpersistentperiprostheticinfectionandamputationinmegaprosthesisreconstruction
AT berghpeter highriskforpersistentperiprostheticinfectionandamputationinmegaprosthesisreconstruction
AT wennergrendavid highriskforpersistentperiprostheticinfectionandamputationinmegaprosthesisreconstruction
AT brisbyhelena highriskforpersistentperiprostheticinfectionandamputationinmegaprosthesisreconstruction