2-stage revision of 120 deep infected hip and knee prostheses using gentamicin-PMMA beads

Acta Orthopaedica
Daniël M C JanssenG H Walenkamp

Abstract

Background and purpose - A 2-stage revision is the most common treatment for late deep prosthesis-related infections and in all cases of septic loosening. However, there is no consensus about the optimal interval between the 2 stages. Patients and methods - We retrospectively studied 120 deep infections of total hip (n = 95) and knee (n = 25) prostheses that had occurred over a period of 25 years. The mean follow-up time was 5 (2-20) years. All infections had been treated with extraction, 1 or more debridements with systemic antibiotics, and implantation of gentamicin-PMMA beads. There had been different time intervals between extraction and reimplantation: median 14 (11-47) days for short-term treatment with uninterrupted hospital stay, and 7 (3-22) months for long-term treatment with temporary discharge. We analyzed the outcome regarding resolution of the infection and clinical results. Results - 88% (105/120) of the infections healed, with no difference in healing rate between short- and long-term treatment. 82 prostheses were reimplanted. In the most recent decade, we treated patients more often with a long-term treatment but reduced the length of time between the extraction and the reimplantation. More reimplantations were...Continue Reading

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Citations

Jun 28, 2016·Acta Orthopaedica·Eivind Witsø
Oct 7, 2017·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Madhavan C PapannaAndrew Hamer
Sep 7, 2018·The Journal of Antimicrobial Chemotherapy·Marjan Wouthuyzen-BakkerPaul C Jutte

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Methods Mentioned

BETA
total hip prostheses
amputation
ESR

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