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Iodine-Supported Hip Implants: Short Term Clinical Results.

Kabata T, Maeda T, Kajino Y, Hasegawa K, Inoue D, Yamamoto T, Takagi T, Ohmori T, Tsuchiya H - Biomed Res Int (2015)

Bottom Line: No abnormalities of thyroid gland function were detected.Excellent bone ingrowth and ongrowth were found around prostheses.No cytotoxicity or adverse effects were detected.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa 920-8641, Japan.

ABSTRACT
We developed a new povidone iodine coating technology for titanium hip implants and performed a clinical trial to assess its usefulness in suppressing postoperative infection. Results indicate that iodine-supported titanium has favorable antibacterial activity, biocompatibility, and no cytotoxicity. Thirty joints in 28 patients were treated using iodine-supported implants. Fourteen joints were revision total hip arthroplasty (THA) after periprosthetic infection, 13 were primary THA for immunosuppressive conditions or pyogenic arthritis, and 3 were conversions from hemiarthroplasty to THA for immunosuppressive conditions. Two examinations were conducted sequentially until final follow-up: white blood cell (WBC) and C-reactive protein (CRP) were measured pre- and postoperatively and thyroid hormone levels in the blood were examined. The mean follow-up period was 33 months (14-78). There were no signs of infection in any patient at the last follow-up. WBC and CRP levels returned to normal within several weeks. No abnormalities of thyroid gland function were detected. Loosening of the implants did not occur in any patient. Excellent bone ingrowth and ongrowth were found around prostheses. No cytotoxicity or adverse effects were detected. These results suggest that iodine-supported THA implants can be highly effective in preventing and treating postoperative infections.

No MeSH data available.


Related in: MedlinePlus

Case of a 65-year-old man. PJI with methicillin-resistant coagulase-negative staphylococcus. Previous treatments including single-stage revision, implant removal, several irrigation, debridement, and ALAC treatments were performed by former surgeon, but suppression of PJI could not be obtained (a). Before iodine-supported prosthesis implantation, inflammation was still active, but the infection was cured after thorough debridement and implantation of iodine-supported hip prosthesis. CRP was 0.1 mg/dL and WBC was 4,400/ll 12 months later (b).
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fig3: Case of a 65-year-old man. PJI with methicillin-resistant coagulase-negative staphylococcus. Previous treatments including single-stage revision, implant removal, several irrigation, debridement, and ALAC treatments were performed by former surgeon, but suppression of PJI could not be obtained (a). Before iodine-supported prosthesis implantation, inflammation was still active, but the infection was cured after thorough debridement and implantation of iodine-supported hip prosthesis. CRP was 0.1 mg/dL and WBC was 4,400/ll 12 months later (b).

Mentions: In the series of revision THAs after PJI, isolated microorganisms included methicillin-resistant coagulase-negative Staphylococci (MRCNS) in 6 patients, methicillin-resistant Staphylococcus aureus (MRSA) in 1 patient, and unknown organisms in 6. One case underwent single-stage revision because of the patient's advanced age and general status. Thirteen cases underwent a two-stage ALAC treatment before implantation, which was effective in 10 cases but could not control PJI in the remaining 3 (Figure 3). Regardless of the preoperative treatment for PJI, complete suppression of PJI was obtained at the final evaluation in all cases except one pelvic tumor reconstruction case, which showed a slight elevation of CRP levels at 24 months after temporary suppression was obtained.


Iodine-Supported Hip Implants: Short Term Clinical Results.

Kabata T, Maeda T, Kajino Y, Hasegawa K, Inoue D, Yamamoto T, Takagi T, Ohmori T, Tsuchiya H - Biomed Res Int (2015)

Case of a 65-year-old man. PJI with methicillin-resistant coagulase-negative staphylococcus. Previous treatments including single-stage revision, implant removal, several irrigation, debridement, and ALAC treatments were performed by former surgeon, but suppression of PJI could not be obtained (a). Before iodine-supported prosthesis implantation, inflammation was still active, but the infection was cured after thorough debridement and implantation of iodine-supported hip prosthesis. CRP was 0.1 mg/dL and WBC was 4,400/ll 12 months later (b).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4637032&req=5

fig3: Case of a 65-year-old man. PJI with methicillin-resistant coagulase-negative staphylococcus. Previous treatments including single-stage revision, implant removal, several irrigation, debridement, and ALAC treatments were performed by former surgeon, but suppression of PJI could not be obtained (a). Before iodine-supported prosthesis implantation, inflammation was still active, but the infection was cured after thorough debridement and implantation of iodine-supported hip prosthesis. CRP was 0.1 mg/dL and WBC was 4,400/ll 12 months later (b).
Mentions: In the series of revision THAs after PJI, isolated microorganisms included methicillin-resistant coagulase-negative Staphylococci (MRCNS) in 6 patients, methicillin-resistant Staphylococcus aureus (MRSA) in 1 patient, and unknown organisms in 6. One case underwent single-stage revision because of the patient's advanced age and general status. Thirteen cases underwent a two-stage ALAC treatment before implantation, which was effective in 10 cases but could not control PJI in the remaining 3 (Figure 3). Regardless of the preoperative treatment for PJI, complete suppression of PJI was obtained at the final evaluation in all cases except one pelvic tumor reconstruction case, which showed a slight elevation of CRP levels at 24 months after temporary suppression was obtained.

Bottom Line: No abnormalities of thyroid gland function were detected.Excellent bone ingrowth and ongrowth were found around prostheses.No cytotoxicity or adverse effects were detected.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa 920-8641, Japan.

ABSTRACT
We developed a new povidone iodine coating technology for titanium hip implants and performed a clinical trial to assess its usefulness in suppressing postoperative infection. Results indicate that iodine-supported titanium has favorable antibacterial activity, biocompatibility, and no cytotoxicity. Thirty joints in 28 patients were treated using iodine-supported implants. Fourteen joints were revision total hip arthroplasty (THA) after periprosthetic infection, 13 were primary THA for immunosuppressive conditions or pyogenic arthritis, and 3 were conversions from hemiarthroplasty to THA for immunosuppressive conditions. Two examinations were conducted sequentially until final follow-up: white blood cell (WBC) and C-reactive protein (CRP) were measured pre- and postoperatively and thyroid hormone levels in the blood were examined. The mean follow-up period was 33 months (14-78). There were no signs of infection in any patient at the last follow-up. WBC and CRP levels returned to normal within several weeks. No abnormalities of thyroid gland function were detected. Loosening of the implants did not occur in any patient. Excellent bone ingrowth and ongrowth were found around prostheses. No cytotoxicity or adverse effects were detected. These results suggest that iodine-supported THA implants can be highly effective in preventing and treating postoperative infections.

No MeSH data available.


Related in: MedlinePlus