PDF(Pubmed)
Abstract：
BACKGROUND: Improving local antibiotic delivery is a promising approach to improve infection control and potentially shorten systemic treatment in periprosthetic joint infection (PJI). This study investigates the use of an antibiotic-loaded, mouldable collagen-tricalciumphosphate composite in treatment of hip PJI.
METHODS: 124 application cases in 79 patients were included from a referral centre; systemic adverse infects, local complications, and infection control were analysed.
RESULTS: In most cases, either vancomycin or meropenem were used. Pathogens were previously known in 82 (66%) cases with polymicrobial infection in 20 (25%) patients. There were no cases of hypercalcaemia. Acute kidney injure was present in 14 (11%) cases. Chronic kidney failure persisted in two cases. During a mean follow-up of 12 (SD 9.3; range 3-35) months, implant survival was achieved in 73 (92%) patients; revision due to PJI was performed in 19 cases.
CONCLUSIONS: Mouldable collagen-tricalciumphosphate composite bone substitute as a local antibiotic carrier in revision hip arthroplasty appears to be a valid option for local antibiotic delivery without systemic complications. Implant survival of 92% supports the hypothesis that local antibiotic therapy is an important component in the treatment of PJI.
METHODS: 124 application cases in 79 patients were included from a referral centre; systemic adverse infects, local complications, and infection control were analysed.
RESULTS: In most cases, either vancomycin or meropenem were used. Pathogens were previously known in 82 (66%) cases with polymicrobial infection in 20 (25%) patients. There were no cases of hypercalcaemia. Acute kidney injure was present in 14 (11%) cases. Chronic kidney failure persisted in two cases. During a mean follow-up of 12 (SD 9.3; range 3-35) months, implant survival was achieved in 73 (92%) patients; revision due to PJI was performed in 19 cases.
CONCLUSIONS: Mouldable collagen-tricalciumphosphate composite bone substitute as a local antibiotic carrier in revision hip arthroplasty appears to be a valid option for local antibiotic delivery without systemic complications. Implant survival of 92% supports the hypothesis that local antibiotic therapy is an important component in the treatment of PJI.
摘要：
背景：改善局部抗生素递送是改善感染控制并可能缩短假体周围感染（PJI）的全身治疗的一种有前途的方法。这项研究调查了负载抗生素的使用，可塑胶原-磷酸三钙复合材料治疗髋关节PJI。
方法：纳入转诊中心79例患者的124例应用病例；全身性不良感染，局部并发症,和感染控制进行了分析。
结果：在大多数情况下，使用万古霉素或美罗培南。先前在20（25％）患者中发现了82（66％）例微生物感染的病原体。没有高钙血症病例。14例（11％）出现急性肾损伤。慢性肾衰竭持续2例。在平均12个月（SD9.3；范围3-35个月）的随访期间，73例(92%)患者获得植入物存活;19例患者因PJI进行了翻修。
结论：可模制的胶原-磷酸三钙复合骨替代物作为人工髋关节翻修术中的局部抗生素载体，似乎是一种有效的局部抗生素给药选择，没有全身并发症。92％的植入物存活率支持以下假设：局部抗生素治疗是PJI治疗的重要组成部分。
方法：纳入转诊中心79例患者的124例应用病例；全身性不良感染，局部并发症,和感染控制进行了分析。
结果：在大多数情况下，使用万古霉素或美罗培南。先前在20（25％）患者中发现了82（66％）例微生物感染的病原体。没有高钙血症病例。14例（11％）出现急性肾损伤。慢性肾衰竭持续2例。在平均12个月（SD9.3；范围3-35个月）的随访期间，73例(92%)患者获得植入物存活;19例患者因PJI进行了翻修。
结论：可模制的胶原-磷酸三钙复合骨替代物作为人工髋关节翻修术中的局部抗生素载体，似乎是一种有效的局部抗生素给药选择，没有全身并发症。92％的植入物存活率支持以下假设：局部抗生素治疗是PJI治疗的重要组成部分。
