Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Amerstorfer, F; Schober, M; Valentin, T; Klim, S; Leithner, A; Fischerauer, S; Glehr, M.
Risk of reinfection after two- or multiple-stage knee revision surgery using superficial vancomycin coating and conventional spacers.
J Orthop Res. 2021; 39(8):1700-1709
Doi: 10.1002/jor.24892
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- Führende Autor*innen der Med Uni Graz
- Amerstorfer Florian Ludwig
- Fischerauer Stefan Franz
- Co-Autor*innen der Med Uni Graz
- Glehr Mathias
- Klim Sebastian Martin
- Leithner Andreas
- Valentin Thomas
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- Abstract:
- This study investigates the effect of superficial vancomycin coating (SVC) in two- or more-stage exchange procedures of prosthetic knee joint infections. We hypothesized that spacer treatment with SVC result in lower reinfection rates than conventional spacers after prosthetic reimplantation. Our secondary aim was to determine the demographic and treatment factors associated with reinfection rates. This retrospective cohort study compromised 96 cases with prosthetic knee infections. Twenty-four cases were treated with a temporary SVC spacer and 72 cases with conventional spacers. Prosthetic reinfection occurred after a median observation period of 1.7 ± 4.0 years in 24 cases (25%). The prevalence of having a reinfection was not significantly different between the two treatment groups (13% [3 cases] in the SVC group vs. 29% [21 cases] in the conventional spacer group [p = .104]). In seven cases (7.3%), two in the SVC group (8.3%) and five (6.9%) in the conventional spacer group (p ≥ .999), histological, respectively microbiological evaluations from the intraoperative specimens revealed persistent infection at the second stage. Nevertheless, in all seven cases no significant higher risk of periprosthetic reinfection was observed during follow-up (p = .750). Our secondary investigation of cofactors revealed that spacers additionally stabilized by nails were significantly associated with a 3.9-fold higher hazard ratio of sustaining a reinfection of revision prosthesis (p = .005).
- Find related publications in this database (Keywords)
- coating
- failed knee arthroplasty
- spacer
- two‐
- stage revision
- vancomycin