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- Title
One-stage exchange with antibacterial hydrogel coated implants provides similar results to two-stage revision, without the coating, for the treatment of peri-prosthetic infection.
- Authors
Capuano, Nicola; Logoluso, Nicola; Gallazzi, Enrico; Drago, Lorenzo; Romanò, Carlo Luca
- Abstract
<bold>Purpose: </bold>Aim of this study was to verify the hypothesis that a one-stage exchange procedure, performed with an antibiotic-loaded, fast-resorbable hydrogel coating, provides similar infection recurrence rate than a two-stage procedure without the coating, in patients affected by peri-prosthetic joint infection (PJI).<bold>Methods: </bold>In this two-center case-control, study, 22 patients, treated with a one-stage procedure, using implants coated with an antibiotic-loaded hydrogel [defensive antibacterial coating (DAC)], were compared with 22 retrospective matched controls, treated with a two-stage revision procedure, without the coating.<bold>Results: </bold>At a mean follow-up of 29.3 ± 5.0 months, two patients (9.1%) in the DAC group showed an infection recurrence, compared to three patients (13.6%) in the two-stage group. Clinical scores were similar between groups, while average hospital stay and antibiotic treatment duration were significantly reduced after one-stage, compared to two-stage (18.9 ± 2.9 versus 35.8 ± 3.4 and 23.5 ± 3.3 versus 53.7 ± 5.6 days, respectively).<bold>Conclusions: </bold>Although in a relatively limited series of patients, our data shows similar infection recurrence rate after one-stage exchange with DAC-coated implants, compared to two-stage revision without coating, with reduced overall hospitalization time and antibiotic treatment duration. These findings warrant further studies in the possible applications of antibacterial coating technologies to treat implant-related infections.<bold>Level Of Evidence: </bold>III.
- Subjects
ANTIBIOTICS; HYDROGELS; COATING processes; JOINT infections; HOSPITAL care; INFECTION treatment; COMPLICATIONS of prosthesis; ARTIFICIAL joints; BIOMEDICAL materials; COMPARATIVE studies; PHARMACEUTICAL gels; LENGTH of stay in hospitals; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; REOPERATION; RESEARCH; DISEASE relapse; EVALUATION research; RETROSPECTIVE studies; CASE-control method; THERAPEUTICS
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2018, Vol 26, Issue 11, p3362
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-018-4896-4