A case of treatment of a fungal periprosthetic infection with a carbon-coated implant
Background. Arthroplasty is the most common surgical treatment for patients with end-stage knee arthrosis. From 2 to 7% of those operated on are patients with rheumatoid arthritis. The inflammatory process in the joint, low rehabilitation potential, long-term therapy with hormonal and genetically en...
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| Format: | Article |
| Language: | Russian |
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Private institution educational organization of higher education "Medical University "ReaViz"
2023-01-01
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| Series: | Вестник медицинского института «Реавиз»: Реабилитация, врач и здоровье |
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| Online Access: | https://vestnik.reaviz.ru/jour/article/view/533 |
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| author | L. I. Malyuchenko N. S. Nikolaev L. V. Lyubimova E. V. Preobrazhenskaya D. N. Efimov |
| author_facet | L. I. Malyuchenko N. S. Nikolaev L. V. Lyubimova E. V. Preobrazhenskaya D. N. Efimov |
| author_sort | L. I. Malyuchenko |
| collection | DOAJ |
| description | Background. Arthroplasty is the most common surgical treatment for patients with end-stage knee arthrosis. From 2 to 7% of those operated on are patients with rheumatoid arthritis. The inflammatory process in the joint, low rehabilitation potential, long-term therapy with hormonal and genetically engineered biological agents, poor bone quality form a high risk of periprosthetic infection. In this group of patients, the saprophytic microorganism Candida albicans more often forms biofilms on endoprosthesis components, which presents difficulties in the treatment of periprosthetic infection.Aims: demonstration of a clinical case and rationale for the treatment of periprosthetic knee infection caused by Candida albicans using a revision implant with an anti-biofilm coating.Materials and methods. A clinical case presents the results of examination and treatment of a 46-year-old patient with secondary gonarthrosis on the background of rheumatoid arthritis with developed periprosthetic infection are evaluated. Surgical treatment was carried out by two-stage sanitation, using as part of the spacer an implant coated with silver-doped two-dimensionally ordered linear-chain carbon, against the background of etiotropic intravenous treatment with fluconazole.Results. The likely cause of the development of a fungal periprosthetic infection is a decrease in the activity of the immune system against the background of taking cytostatics and hormonal drugs in combination with the frequent uncontrolled use of antibacterial drugs. The choice of surgical tactics in favor of a two-stage revision is justified by the isolation of a «difficult to treat» Candida albicans. Timely diagnosis and the chosen method of treatment in combination allowed to no recurrence during the observation period of 12 months after the 2nd stage of revision.Conclusions. The results demonstrate the effectiveness of a spacer coated with silver-doped two-dimensionally ordered linear-chain carbon at the stage of sanitation for the treatment of periprosthetic infection caused by the «difficult to treat» Candida albicans. |
| first_indexed | 2024-03-12T04:19:47Z |
| format | Article |
| id | doaj.art-3cd72f2b98c040c3a553bddadf2ab2d3 |
| institution | Directory Open Access Journal |
| issn | 2226-762X 2782-1579 |
| language | Russian |
| last_indexed | 2024-03-12T04:19:47Z |
| publishDate | 2023-01-01 |
| publisher | Private institution educational organization of higher education "Medical University "ReaViz" |
| record_format | Article |
| series | Вестник медицинского института «Реавиз»: Реабилитация, врач и здоровье |
| spelling | doaj.art-3cd72f2b98c040c3a553bddadf2ab2d32023-09-03T10:34:14ZrusPrivate institution educational organization of higher education "Medical University "ReaViz"Вестник медицинского института «Реавиз»: Реабилитация, врач и здоровье2226-762X2782-15792023-01-0112611912610.20340/vmi-rvz.2022.6.CASE.1369A case of treatment of a fungal periprosthetic infection with a carbon-coated implantL. I. Malyuchenko0N. S. Nikolaev1L. V. Lyubimova2E. V. Preobrazhenskaya3D. N. Efimov4Федеральный центр травматологии, ортопедии и эндопротезированияФедеральный центр травматологии, ортопедии и эндопротезирования; Чувашский государственный университет имени И.Н. УльяноваФедеральный центр травматологии, ортопедии и эндопротезированияФедеральный центр травматологии, ортопедии и эндопротезированияФедеральный центр травматологии, ортопедии и эндопротезирования; Чувашский государственный университет имени И.Н. УльяноваBackground. Arthroplasty is the most common surgical treatment for patients with end-stage knee arthrosis. From 2 to 7% of those operated on are patients with rheumatoid arthritis. The inflammatory process in the joint, low rehabilitation potential, long-term therapy with hormonal and genetically engineered biological agents, poor bone quality form a high risk of periprosthetic infection. In this group of patients, the saprophytic microorganism Candida albicans more often forms biofilms on endoprosthesis components, which presents difficulties in the treatment of periprosthetic infection.Aims: demonstration of a clinical case and rationale for the treatment of periprosthetic knee infection caused by Candida albicans using a revision implant with an anti-biofilm coating.Materials and methods. A clinical case presents the results of examination and treatment of a 46-year-old patient with secondary gonarthrosis on the background of rheumatoid arthritis with developed periprosthetic infection are evaluated. Surgical treatment was carried out by two-stage sanitation, using as part of the spacer an implant coated with silver-doped two-dimensionally ordered linear-chain carbon, against the background of etiotropic intravenous treatment with fluconazole.Results. The likely cause of the development of a fungal periprosthetic infection is a decrease in the activity of the immune system against the background of taking cytostatics and hormonal drugs in combination with the frequent uncontrolled use of antibacterial drugs. The choice of surgical tactics in favor of a two-stage revision is justified by the isolation of a «difficult to treat» Candida albicans. Timely diagnosis and the chosen method of treatment in combination allowed to no recurrence during the observation period of 12 months after the 2nd stage of revision.Conclusions. The results demonstrate the effectiveness of a spacer coated with silver-doped two-dimensionally ordered linear-chain carbon at the stage of sanitation for the treatment of periprosthetic infection caused by the «difficult to treat» Candida albicans.https://vestnik.reaviz.ru/jour/article/view/533перипротезная инфекцияcandida albicansдвухэтапная ревизияспейсеруглеродное покрытиесеребряное напыление |
| spellingShingle | L. I. Malyuchenko N. S. Nikolaev L. V. Lyubimova E. V. Preobrazhenskaya D. N. Efimov A case of treatment of a fungal periprosthetic infection with a carbon-coated implant Вестник медицинского института «Реавиз»: Реабилитация, врач и здоровье перипротезная инфекция candida albicans двухэтапная ревизия спейсер углеродное покрытие серебряное напыление |
| title | A case of treatment of a fungal periprosthetic infection with a carbon-coated implant |
| title_full | A case of treatment of a fungal periprosthetic infection with a carbon-coated implant |
| title_fullStr | A case of treatment of a fungal periprosthetic infection with a carbon-coated implant |
| title_full_unstemmed | A case of treatment of a fungal periprosthetic infection with a carbon-coated implant |
| title_short | A case of treatment of a fungal periprosthetic infection with a carbon-coated implant |
| title_sort | case of treatment of a fungal periprosthetic infection with a carbon coated implant |
| topic | перипротезная инфекция candida albicans двухэтапная ревизия спейсер углеродное покрытие серебряное напыление |
| url | https://vestnik.reaviz.ru/jour/article/view/533 |
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