Limits...
Revision in cemented and cementless infected hip arthroplasty.

Cherubino P, Puricelli M, D'Angelo F - Open Orthop J (2013)

Bottom Line: Difficulty of therapeutic approach, and poor functional outcomes together with length of treatment and overall cost are the main burden of this issue.Based on the most recently systematic review there is no suggestion that one- or two-stage revision methods have different re-infection outcomes.The two-stage implant-exchange protocol remains the gold standard.

View Article: PubMed Central - PubMed

Affiliation: Department of Biotechnologies and Life Sciences, Section of Orthopedics and Traumatology, University of Insubria, Varese, Italy.

ABSTRACT
Infection is a frequent cause of failure after joint replacement surgery. The infection rate after total hip arthroplasty (THA) has been reduced to 1-2% in the last years. However, it still represents a challenging problem for the orthopedic surgeon. Difficulty of therapeutic approach, and poor functional outcomes together with length of treatment and overall cost are the main burden of this issue. Even the diagnosis of an infected hip could be challenging although it is the first step of an accurate treatment. At the end, many cases require removing the implants. Afterwards, the treatment strategy varies according to authors with three different procedures: no re-implantation, immediate placement of new implants or a two-stage surgery re-implantation. Based on the most recently systematic review there is no suggestion that one- or two-stage revision methods have different re-infection outcomes. The two-stage implant-exchange protocol remains the gold standard. It is considered as the most efficacious clinical approach for the treatment of periprosthetic infection, especially in patients with sinus tracts, swelling, extended abscess formation in depth and infection of Methicillin Resistant Staphylococcus Aureus (MRSA), and other multidrug-resistant bacteria as reported in recent consensus documents.

No MeSH data available.


Related in: MedlinePlus

AP view of the Spacer-G/InterSpace implanted.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3722547&req=5

Figure 4: AP view of the Spacer-G/InterSpace implanted.

Mentions: Italy - Fig. 4). This is a preformed spacer, with a central load-bearing cylindrical rod made of stainless steel and encased in gentamicin-impregnated acrylic cement (1.87 w/w in the polymerized resin, 3.2 w/w in the powder component) and available in three head sizes (46, 54, 60 mm) and two stem lengths (standard and long).


Revision in cemented and cementless infected hip arthroplasty.

Cherubino P, Puricelli M, D'Angelo F - Open Orthop J (2013)

AP view of the Spacer-G/InterSpace implanted.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3722547&req=5

Figure 4: AP view of the Spacer-G/InterSpace implanted.
Mentions: Italy - Fig. 4). This is a preformed spacer, with a central load-bearing cylindrical rod made of stainless steel and encased in gentamicin-impregnated acrylic cement (1.87 w/w in the polymerized resin, 3.2 w/w in the powder component) and available in three head sizes (46, 54, 60 mm) and two stem lengths (standard and long).

Bottom Line: Difficulty of therapeutic approach, and poor functional outcomes together with length of treatment and overall cost are the main burden of this issue.Based on the most recently systematic review there is no suggestion that one- or two-stage revision methods have different re-infection outcomes.The two-stage implant-exchange protocol remains the gold standard.

View Article: PubMed Central - PubMed

Affiliation: Department of Biotechnologies and Life Sciences, Section of Orthopedics and Traumatology, University of Insubria, Varese, Italy.

ABSTRACT
Infection is a frequent cause of failure after joint replacement surgery. The infection rate after total hip arthroplasty (THA) has been reduced to 1-2% in the last years. However, it still represents a challenging problem for the orthopedic surgeon. Difficulty of therapeutic approach, and poor functional outcomes together with length of treatment and overall cost are the main burden of this issue. Even the diagnosis of an infected hip could be challenging although it is the first step of an accurate treatment. At the end, many cases require removing the implants. Afterwards, the treatment strategy varies according to authors with three different procedures: no re-implantation, immediate placement of new implants or a two-stage surgery re-implantation. Based on the most recently systematic review there is no suggestion that one- or two-stage revision methods have different re-infection outcomes. The two-stage implant-exchange protocol remains the gold standard. It is considered as the most efficacious clinical approach for the treatment of periprosthetic infection, especially in patients with sinus tracts, swelling, extended abscess formation in depth and infection of Methicillin Resistant Staphylococcus Aureus (MRSA), and other multidrug-resistant bacteria as reported in recent consensus documents.

No MeSH data available.


Related in: MedlinePlus