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Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2021, Number 1

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Acta Ortop Mex 2021; 35 (1)

Clinical and bacteriological profile in patients with knee tumor arthroplasty and early periprosthetic infection

Alcántara-Corona A, Cario-Méndez G, Amaya-Zepeda R, Álvarez-Jiménez A

Language: Spanish
References: 15
Page: 61-68
PDF size: 206.54 Kb.


ABSTRACT

Introduction: At the national and international levels, there are few studies on early knee tumor periprosthetic infection. We present a review of patients operated by knee tumor arthroplasty, obtaining information on the clinical and bacteriological profile of early tumor periprosthetic infections. Material and methods: Observational, retrospective and descriptive study, review of patient records with knee tumor replacement, from 1 January 2013, to 31 December 2017 and minimum follow-up of 2 years. Results: 35 patients with average age 32. Left knee 71.4%, 77.1% distal femur, 54.2% was osteosarcoma. Complications in 82.8% of patients, prosthetic retention 62.8%; periprosthetic infection accounts for 34.2% of early complications in 90% of cases. Osteosarcomas and GCT had early infection in equal proportion (44%). The most common comorbidity was overweight/obesity at 66%, smoking by 55%. 55% of infected patients received chemotherapy. 58% of the isolated bacteria were Staphylococcus sp. 83.3% of bacteria showed antibiotic resistance. 66% of infected patients required radical management. Conclusions: Early periprosthetic infection represents a devastating pathology in our institution. Prosthetic retention is achieved at 66%. In our unit the bacteriological profile is resistant.


REFERENCES

  1. Secretaría de Salud. Diagnóstico oportuno de osteosarcoma en niños y adolescentes en primer y segundo nivel de atención médica. Guía Práctica Clínica. 2013: 1-52.

  2. Greenspan A, Jundt G, Remagen W. Differential diagnosis in orthopaedic oncology. 2nd, Philadelphia, Pa.: Lippincott Williams & Wilkins 2007.

  3. Secretaría de Salud. Tratamiento de los tumores benignos de tejidos blandos en adultos en el tercer nivel de atención. Guía Práctica Clínica. 2012: 43. Disponible en: www.cenetec.salud.gob.mx.

  4. Capanna R, Scoccianti G, Frenos F, Vilardi A, Beltrami G, Campanacci DA. What Was the survival of megaprostheses in lower limb reconstructions after tumor resections? Clin Orthop Relat Res. 2015; 473(3): 820-30. doi: 10.1007/s11999-014-3736-1.

  5. Smolle MA, Andreou D, Tunn PU, Leithner A. Advances in tumour endoprostheses: a systematic review. EFORT Open Rev. 2019; 4(7): 445-59. doi: 10.1302/2058-5241.4.180081.

  6. Pala E, Trovarelli G, Calabro T, Angelini A, Abati CN, Ruggieri P. Survival of modern knee tumor megaprostheses: failures, functional results, and a comparative statistical analysis. Clin Orthop Relat Res. 2015; 473(3): 891-9. doi: 10.1007/s11999-014-3699-2.

  7. Medellin MR, Fujiwara T, Clark R, Stevenson JD, Parry M, Jeys L. Mechanisms of failure and survival of total femoral endoprosthetic replacements. Bone Joint J. 2019; 101B(5): 522-8. doi: 10.1302/0301-620X.101B5.BJJ-2018-1106.R1.

  8. Henderson ER, O'Connor MI, Ruggieri P, Windhager R, Funovics PT, Gibbons CL, et al. Classification of failure of limb salvage after reconstructive surgery for bone tumours: A modified system including biological and expandable reconstructions. Bone Joint J. 2014; 96B(11): 1436-40. doi:10.1302/0301-620X.96B11.34747.

  9. Arano MM, Huerta GG, Tena SM, VRJ. Diagnóstico y tratamiento de las infecciones asociadas a dispositivos ortopédicos prótesis y/o material de osteosíntesis. Guía Práctica Clínica gpc. 2013, 1-66. www.cenetec.salud.gob.mx.

  10. Gonzalez H, Hagerling C, Werb Z. Roles of the immune system in cancer: from tumor initiation to metastatic progression. Genes Dev. 2018; 32(19-20): 1267-84. doi: 10.1101/GAD.314617.118.

  11. Zuidhof R-JWJ, Lowik CAM, Ploegmakers JJW, Dijkstra SPD, Wouthuyzen-Bakker M, Jutte PC. Periprosthetic joint infection in orthopaedic surgical oncology. Ann Joint. 2019; 4: 26-26. doi: 10.21037/aoj.2019.05.01.

  12. Haddad FS, Ngu A, Negus JJ. Prosthetic joint infections and cost analysis? Adv Exp Med Biol. 2017; 971: 93-100. doi: 10.1007/5584_2016_155.

  13. Janz V, Lochel J, Trampuz A, Schaser KD, Hofer A, Wassilew GI. Risk factors and management strategies for early and late infections following reconstruction with special tumour endoprostheses. Orthopade. 2020; 49(2): 142-8. doi:10.1007/s00132-020-03872-1.

  14. Allison D, Huang E, Ahlmann E, Carney S, Wang PA-C L, Menendez L. Peri-prosthetic infection in the orthopedic tumor patient. Reconstr Rev. 2014; 4(3): 13-7. doi: 10.15438/rr.v4i3.74.

  15. Parvizi J, Tan TL, Goswami K, Higuera C, Della Valle C, Chen AF, Shohat N. The 2018 definition of periprosthetic hip and knee infection: an evidence-based and validated criteria. J Arthroplasty. 2018; 33(5): 1309-14.e2. doi: 10.1016/j.arth.2018.02.078.



EVIDENCE LEVEL

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