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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 an 82-year-old man. Pyogenic arthritis of the right hip joint with methicillin-sensitive Staphylococcus aureus (MSSA). Irrigation and antibiotics treatment in former hospital could not suppress infection, which resulted in femoral head destruction (a). Right hip joint was filled with infected scar tissue and debris of the destructed femoral head. Single-stage implantation was performed after thorough debridement (b). GT: greater trochanter, LT: lesser trochanter, and FH: femoral head. One year after surgery, his hip function was almost normal, and iodine-supported hip prosthesis was well fixed. CRP was 0.2 mg/dL and WBC was 3,810/ll 12 months later (c).
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fig4: Case of an 82-year-old man. Pyogenic arthritis of the right hip joint with methicillin-sensitive Staphylococcus aureus (MSSA). Irrigation and antibiotics treatment in former hospital could not suppress infection, which resulted in femoral head destruction (a). Right hip joint was filled with infected scar tissue and debris of the destructed femoral head. Single-stage implantation was performed after thorough debridement (b). GT: greater trochanter, LT: lesser trochanter, and FH: femoral head. One year after surgery, his hip function was almost normal, and iodine-supported hip prosthesis was well fixed. CRP was 0.2 mg/dL and WBC was 3,810/ll 12 months later (c).

Mentions: In the series of primary THAs for compromised immune conditions, PJI was prevented in all 11 cases. In the series of pyogenic arthritis, isolated microorganisms included methicillin-sensitive Staphylococcus aureus (MSSA) in 3 patients, Pseudomonas aeruginosa in 1, and Streptococcus agalactiae in 1. Although 1 case with Pseudomonas aeruginosa needed additional wound irrigation because of continuous wound discharge, all 5 cases successfully underwent primary THA without recurrence of infectious arthritis (Figure 4).


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 an 82-year-old man. Pyogenic arthritis of the right hip joint with methicillin-sensitive Staphylococcus aureus (MSSA). Irrigation and antibiotics treatment in former hospital could not suppress infection, which resulted in femoral head destruction (a). Right hip joint was filled with infected scar tissue and debris of the destructed femoral head. Single-stage implantation was performed after thorough debridement (b). GT: greater trochanter, LT: lesser trochanter, and FH: femoral head. One year after surgery, his hip function was almost normal, and iodine-supported hip prosthesis was well fixed. CRP was 0.2 mg/dL and WBC was 3,810/ll 12 months later (c).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig4: Case of an 82-year-old man. Pyogenic arthritis of the right hip joint with methicillin-sensitive Staphylococcus aureus (MSSA). Irrigation and antibiotics treatment in former hospital could not suppress infection, which resulted in femoral head destruction (a). Right hip joint was filled with infected scar tissue and debris of the destructed femoral head. Single-stage implantation was performed after thorough debridement (b). GT: greater trochanter, LT: lesser trochanter, and FH: femoral head. One year after surgery, his hip function was almost normal, and iodine-supported hip prosthesis was well fixed. CRP was 0.2 mg/dL and WBC was 3,810/ll 12 months later (c).
Mentions: In the series of primary THAs for compromised immune conditions, PJI was prevented in all 11 cases. In the series of pyogenic arthritis, isolated microorganisms included methicillin-sensitive Staphylococcus aureus (MSSA) in 3 patients, Pseudomonas aeruginosa in 1, and Streptococcus agalactiae in 1. Although 1 case with Pseudomonas aeruginosa needed additional wound irrigation because of continuous wound discharge, all 5 cases successfully underwent primary THA without recurrence of infectious arthritis (Figure 4).

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