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Local antibiotic treatment with calcium sulfate as carrier material improves the outcome of debridement, antibiotics, and implant retention procedures for periprosthetic joint infections after hip arthroplasty – a retrospective study
Purpose: Debridement, antibiotics, and implant retention (DAIR) is an established treatment modality in periprosthetic joint infections (PJIs), but success rates vary. This study compared the success of DAIR for PJIs after a total hip arthroplasty (THA), with or without local antibiotic delivery wit...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Copernicus GmbH
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8795886/ https://www.ncbi.nlm.nih.gov/pubmed/35111565 http://dx.doi.org/10.5194/jbji-7-11-2022 |
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author | Reinisch, Katharina Schläppi, Michel Meier, Christoph Wahl, Peter |
author_facet | Reinisch, Katharina Schläppi, Michel Meier, Christoph Wahl, Peter |
author_sort | Reinisch, Katharina |
collection | PubMed |
description | Purpose: Debridement, antibiotics, and implant retention (DAIR) is an established treatment modality in periprosthetic joint infections (PJIs), but success rates vary. This study compared the success of DAIR for PJIs after a total hip arthroplasty (THA), with or without local antibiotic delivery with CaSO [Formula: see text] as the carrier material. Methods: A retrospective review of DAIR for PJIs after THA performed between 2010 and 2018, including 41 patients is conducted. A total of 27 patients were treated by DAIR with local antibiotics with CaSO [Formula: see text] as the carrier material, and 14 patients were treated by a standard DAIR. The endpoints were treatment failure, defined as the need for a reoperation, either a second DAIR or a prosthesis removal or exchange due to persistent or recurrent infection, the initiation of a long-term suppressive antibiotic treatment, or death related to infection. Results: Considering any reoperation as an outcome, 11 of 14 cases treated without AB-CaSO [Formula: see text] (79 %) and 4 of the 27 cases treated with AB-CaSO [Formula: see text] failed (15 %). Considering revision as an outcome, 9 out of 14 cases treated without AB-CaSO [Formula: see text] (64 %) and 4 of the 27 cases treated with AB-CaSO [Formula: see text] (15 %) failed. A Kaplan–Meier survival analysis showed that local antibiotic delivery with CaSO [Formula: see text] as the carrier material led to a significantly longer infection-free survival, considering any surgical revision ( [Formula: see text] ; hazard ratio 8.9 (95 % CI 2.8–28.2)) or revision with component exchange ( [Formula: see text] ; hazard ratio 5.6 (95 % CI 1.7–18.2)) as the endpoint. Conclusion: The addition of local antibiotics with CaSO [Formula: see text] as the carrier material to DAIR for PJIs after THA significantly increases success rates, such as infection-free survival, any reoperation, and revision with component exchange in particular. |
format | Online Article Text |
id | pubmed-8795886 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Copernicus GmbH |
record_format | MEDLINE/PubMed |
spelling | pubmed-87958862022-01-31 Local antibiotic treatment with calcium sulfate as carrier material improves the outcome of debridement, antibiotics, and implant retention procedures for periprosthetic joint infections after hip arthroplasty – a retrospective study Reinisch, Katharina Schläppi, Michel Meier, Christoph Wahl, Peter J Bone Jt Infect Original Full-Length Article Purpose: Debridement, antibiotics, and implant retention (DAIR) is an established treatment modality in periprosthetic joint infections (PJIs), but success rates vary. This study compared the success of DAIR for PJIs after a total hip arthroplasty (THA), with or without local antibiotic delivery with CaSO [Formula: see text] as the carrier material. Methods: A retrospective review of DAIR for PJIs after THA performed between 2010 and 2018, including 41 patients is conducted. A total of 27 patients were treated by DAIR with local antibiotics with CaSO [Formula: see text] as the carrier material, and 14 patients were treated by a standard DAIR. The endpoints were treatment failure, defined as the need for a reoperation, either a second DAIR or a prosthesis removal or exchange due to persistent or recurrent infection, the initiation of a long-term suppressive antibiotic treatment, or death related to infection. Results: Considering any reoperation as an outcome, 11 of 14 cases treated without AB-CaSO [Formula: see text] (79 %) and 4 of the 27 cases treated with AB-CaSO [Formula: see text] failed (15 %). Considering revision as an outcome, 9 out of 14 cases treated without AB-CaSO [Formula: see text] (64 %) and 4 of the 27 cases treated with AB-CaSO [Formula: see text] (15 %) failed. A Kaplan–Meier survival analysis showed that local antibiotic delivery with CaSO [Formula: see text] as the carrier material led to a significantly longer infection-free survival, considering any surgical revision ( [Formula: see text] ; hazard ratio 8.9 (95 % CI 2.8–28.2)) or revision with component exchange ( [Formula: see text] ; hazard ratio 5.6 (95 % CI 1.7–18.2)) as the endpoint. Conclusion: The addition of local antibiotics with CaSO [Formula: see text] as the carrier material to DAIR for PJIs after THA significantly increases success rates, such as infection-free survival, any reoperation, and revision with component exchange in particular. Copernicus GmbH 2022-01-20 /pmc/articles/PMC8795886/ /pubmed/35111565 http://dx.doi.org/10.5194/jbji-7-11-2022 Text en Copyright: © 2022 Katharina Reinisch et al. https://creativecommons.org/licenses/by/4.0/This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/ |
spellingShingle | Original Full-Length Article Reinisch, Katharina Schläppi, Michel Meier, Christoph Wahl, Peter Local antibiotic treatment with calcium sulfate as carrier material improves the outcome of debridement, antibiotics, and implant retention procedures for periprosthetic joint infections after hip arthroplasty – a retrospective study |
title | Local antibiotic treatment with calcium sulfate as carrier material improves the outcome of debridement, antibiotics, and implant retention procedures for periprosthetic joint infections after hip arthroplasty – a retrospective study |
title_full | Local antibiotic treatment with calcium sulfate as carrier material improves the outcome of debridement, antibiotics, and implant retention procedures for periprosthetic joint infections after hip arthroplasty – a retrospective study |
title_fullStr | Local antibiotic treatment with calcium sulfate as carrier material improves the outcome of debridement, antibiotics, and implant retention procedures for periprosthetic joint infections after hip arthroplasty – a retrospective study |
title_full_unstemmed | Local antibiotic treatment with calcium sulfate as carrier material improves the outcome of debridement, antibiotics, and implant retention procedures for periprosthetic joint infections after hip arthroplasty – a retrospective study |
title_short | Local antibiotic treatment with calcium sulfate as carrier material improves the outcome of debridement, antibiotics, and implant retention procedures for periprosthetic joint infections after hip arthroplasty – a retrospective study |
title_sort | local antibiotic treatment with calcium sulfate as carrier material improves the outcome of debridement, antibiotics, and implant retention procedures for periprosthetic joint infections after hip arthroplasty – a retrospective study |
topic | Original Full-Length Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8795886/ https://www.ncbi.nlm.nih.gov/pubmed/35111565 http://dx.doi.org/10.5194/jbji-7-11-2022 |
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