Are Cement Spacers and Beads Loaded with the Correct Antibiotic(s) at the Site of Periprosthetic Hip and Knee Joint Infections?
The optimal impregnation of antibiotic-loaded bone cement in the treatment of periprosthetic hip and knee joint infection is unknown. It is also unclear, whether a suboptimal impregnation might be associated with a higher persistence of infection. A total of 93 patients (44 knee, 49 hip) were retros...
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| 格式: | 文件 |
| 语言: | English |
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MDPI AG
2021-02-01
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| 丛编: | Antibiotics |
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| 在线阅读: | https://www.mdpi.com/2079-6382/10/2/143 |
| _version_ | 1827604902467076096 |
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| author | Konstantinos Anagnostakos Ismail Sahan |
| author_facet | Konstantinos Anagnostakos Ismail Sahan |
| author_sort | Konstantinos Anagnostakos |
| collection | DOAJ |
| description | The optimal impregnation of antibiotic-loaded bone cement in the treatment of periprosthetic hip and knee joint infection is unknown. It is also unclear, whether a suboptimal impregnation might be associated with a higher persistence of infection. A total of 93 patients (44 knee, 49 hip) were retrospectively evaluated, and the most common organism was a methicillin-resistant <i>Staphylococcus epidermidis</i>, followed by methicillin-susceptible <i>Staphylococcus aureus</i>. Of all the organisms, 37.1% were resistant against gentamicin and 54.2% against clindamycin. All organisms were susceptible against vancomycin. In 41 cases, gentamicin-loaded beads were inserted and in 52 cases, spacers: (2 loaded only with gentamicin, 18 with gentamicin + vancomycin, 19 with gentamicin + clindamycin, and 13 with gentamicin + vancomycin + clindamycin). The analysis of each antibiotic impregnation showed that complete susceptibility was present in 38.7% of the cases and partial susceptibility in 28%. In the remaining 33.3%, no precise statement can be made because either there was a culture-negative infection or the antibiotic(s) were not tested against the specific organism. At a mean follow-up of 27.9 months, treatment failure was observed in 6.7% of the cases. Independent of which antibiotic impregnation was used, when the organism was susceptible against the locally inserted antibiotics or not tested, reinfection or persistence of infection was observed in the great majority of cases. Future studies about the investigation of the optimal impregnation of antibiotic-loaded bone cement are welcome. |
| first_indexed | 2024-03-09T06:09:51Z |
| format | Article |
| id | doaj.art-e46e59a3f772428fb64c3b7c44aef13a |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-09T06:09:51Z |
| publishDate | 2021-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-e46e59a3f772428fb64c3b7c44aef13a2023-12-03T12:00:16ZengMDPI AGAntibiotics2079-63822021-02-0110214310.3390/antibiotics10020143Are Cement Spacers and Beads Loaded with the Correct Antibiotic(s) at the Site of Periprosthetic Hip and Knee Joint Infections?Konstantinos Anagnostakos0Ismail Sahan1Zentrum für Orthopädie und Unfallchirurgie, Klinikum Saarbrücken, D-66119 Saarbrücken, GermanyZentrum für Orthopädie und Unfallchirurgie, Klinikum Saarbrücken, D-66119 Saarbrücken, GermanyThe optimal impregnation of antibiotic-loaded bone cement in the treatment of periprosthetic hip and knee joint infection is unknown. It is also unclear, whether a suboptimal impregnation might be associated with a higher persistence of infection. A total of 93 patients (44 knee, 49 hip) were retrospectively evaluated, and the most common organism was a methicillin-resistant <i>Staphylococcus epidermidis</i>, followed by methicillin-susceptible <i>Staphylococcus aureus</i>. Of all the organisms, 37.1% were resistant against gentamicin and 54.2% against clindamycin. All organisms were susceptible against vancomycin. In 41 cases, gentamicin-loaded beads were inserted and in 52 cases, spacers: (2 loaded only with gentamicin, 18 with gentamicin + vancomycin, 19 with gentamicin + clindamycin, and 13 with gentamicin + vancomycin + clindamycin). The analysis of each antibiotic impregnation showed that complete susceptibility was present in 38.7% of the cases and partial susceptibility in 28%. In the remaining 33.3%, no precise statement can be made because either there was a culture-negative infection or the antibiotic(s) were not tested against the specific organism. At a mean follow-up of 27.9 months, treatment failure was observed in 6.7% of the cases. Independent of which antibiotic impregnation was used, when the organism was susceptible against the locally inserted antibiotics or not tested, reinfection or persistence of infection was observed in the great majority of cases. Future studies about the investigation of the optimal impregnation of antibiotic-loaded bone cement are welcome.https://www.mdpi.com/2079-6382/10/2/143hip spacerknee spacerantibiotic-loaded bone cementantibiotic-impregnated bone cementinfection persistencereinfection |
| spellingShingle | Konstantinos Anagnostakos Ismail Sahan Are Cement Spacers and Beads Loaded with the Correct Antibiotic(s) at the Site of Periprosthetic Hip and Knee Joint Infections? Antibiotics hip spacer knee spacer antibiotic-loaded bone cement antibiotic-impregnated bone cement infection persistence reinfection |
| title | Are Cement Spacers and Beads Loaded with the Correct Antibiotic(s) at the Site of Periprosthetic Hip and Knee Joint Infections? |
| title_full | Are Cement Spacers and Beads Loaded with the Correct Antibiotic(s) at the Site of Periprosthetic Hip and Knee Joint Infections? |
| title_fullStr | Are Cement Spacers and Beads Loaded with the Correct Antibiotic(s) at the Site of Periprosthetic Hip and Knee Joint Infections? |
| title_full_unstemmed | Are Cement Spacers and Beads Loaded with the Correct Antibiotic(s) at the Site of Periprosthetic Hip and Knee Joint Infections? |
| title_short | Are Cement Spacers and Beads Loaded with the Correct Antibiotic(s) at the Site of Periprosthetic Hip and Knee Joint Infections? |
| title_sort | are cement spacers and beads loaded with the correct antibiotic s at the site of periprosthetic hip and knee joint infections |
| topic | hip spacer knee spacer antibiotic-loaded bone cement antibiotic-impregnated bone cement infection persistence reinfection |
| url | https://www.mdpi.com/2079-6382/10/2/143 |
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