2019, Number 2
<< Back Next >>
Acta Ortop Mex 2019; 33 (2)
Prophylactic application of medicated calcium sulphate in uncemented total hip prosthesis
Vélez-de Lachica JC, Santos-Briones JI, Inzunza-Sánchez JM
Language: Spanish
References: 18
Page: 67-72
PDF size: 193.16 Kb.
ABSTRACT
The increase in total hip arthroplasty occurs by many factors, such as increasing life expectancy, improving surgical technique as well as innovating the design and implant material. However, despite technological advances, peri-prosthetic infection has remained one of the most devastating complications. This study evaluates the prophylactic application of calcium sulfate pearls medicated in the femoral canal and acetabular surface to prevent peri-prosthetic infections in patients who underwent total uncemented primary hip arthroplasty against a control group by measuring acute phase reactants. 146 patients, 67 were applied calcium sulfate pearls medicated and 79 prophylactic antibiotic intravenous in the period from 2013 to 2016. To perform the diagnosis of peri-prosthetic infection was assessed PCR associated with VSG, communication between fistula and prostheses and positive culture in 2 or more different sites. There was a decrease in the values of acute-phase reactants in patients who were given calcium sulfate pearls. 14 patients presented infection in the control group and 3 in the study group. The prophylactic use of calcium sulphate pearls within the medullary canal and acetabular surface is an option for the prophylaxis of peri-prosthetic infections, however the study deserves follow-up with more patients.
REFERENCES
Bernad PM: Actualizaciones en artrosis. SANED; 2007.
Guías de práctica clínica: Guías de referencia rápida para el diagnóstico y tratamiento de osteoartrosis de rodilla y cadera. CENETEC; 2014.
Bombelli R: Artrosis de la cadera. Salvat Editores, SA; 1985.
Kurtz SM, Lau E, Schmier J, Ong KL, Zhao K, Parvizi J: Infection burden for hip and knee arthroplasty in the United States. J Arthroplasty. 2008; 23(7): 984-91.
Kurtz SM, Lau E, Watson H, Schmier JK, Parvizi J: Economic burden of periprosthetic joint infection in the United States. J Arthroplasty. 2012; 27: 61-5e1.
Ong KL, Kurtz SM, Lau E, Bozic KJ, Berry DJ, Pravizi J: Prosthetic joint infection risk after total hip arthroplasty in the Medicare population. J Arthroplasty. 2009; 24(6 Suppl): 105-9.
Pulido L, Ghanem E, Joshi A, Purtill JJ, Parvizi J: Periprosthetic joint infection: the incidence, timing and predisposing factors. Clin Orthop Relat Res. 2008; 466: 1710-5.
Lai K, Bohm ER, Burnell C, Hedden DR: Presence of medical comorbidities in patients with infected primary hip or knee arthroplasties. J Arthroplasty. 2007; 22: 651-6.
Santaguida PL, Hawker GA, Hudak PL, Glazier R, Mahomed NN, Kreder HJ, et al: Patient characteristics affecting the prognosis of total hip and knee joint arthroplasty: a systematic review. Can J Surg. 2008; 51(6): 428-36.
Rao N, Cannella BA, Crossett LS, Yates AJ Jr, McGough RL 3rd, Hamilton CW: Prospective screening/decolonization for Staphyococcus aureus to prevent orthopedic surgical site infection: prospective cohort study with 2-year follow-up. J Arthroplasty. 2011; 26: 1501-7.
Matar WY, Jafari SM, Restrepo C, Austin M, Purtill JJ, Parvizi J: Preventing infection in total joint arthroplasty. J Bone Joint Surg Am. 2010; 92: 36-46.
Prokuski L: Prophylactic antibiotics in orthopaedic surgery. J Am Acad Orthop Surg. 2008; 16 (5): 283-93.
Ambrose CG, Clyburn TA, Mika J, Gogola GR, Kaplan H, Wanger A, et al: Evaluation of antibiotic-impregnated microspheres for the prevention of implant-associated orthopaedic infections. J Bone Joint Surg Am. 2014; 96: 128-34.
Howlin RP, Brayford MJ, Webb JS, Cooper JJ, Aiken SS, Stoodley P. Antibiotic-loaded synthetic calcium sulfate beads for prevention of bacterial colonization and biofilm formation in periprosthetic infections. Antimicrob Agents Chemother. 2015; 59(1): 111-20.
Parvizi J, Zmistowski B, Berbari EF, Bauer TW, Springer BD, Della Valle CJ, et al. New definition for periprosthetic joint infection: from the workgroup of the musculoskeletal infection society. Clin Orthop Relat Res. 2011; 469: 2992-4.
Yi BA P, Cross M, Moric M, Spororer S, Berger R, Della VC: Diagnosis of infection in the early post-operative period after total hip arthroplasty. Clin Orthop Relat Res. 2014; 472: 424-9.
American Academy of Orthopaedic Surgeons: The diagnosis of periprosthetic joint infections of the hip and knee. Rosemont, IL: American Academy of Orthopaedic Surgeons (AAOS); 2010. p. 286.
Drago L, Boot W, Dimas K, Malizos K, Hänsch GM, Stuyck J, et al. Does implant coating with antibacterial-loaded hydrogel reduce bacterial colonization and biofilm formation in vitro? Clin Orthop Relat Res. 2014; 472(11): 3311-23.