We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Lower limb reconstruction in tumor patients using modular silver-coated megaprostheses with regard to perimegaprosthetic joint infection: a case series, including 100 patients and review of the literature.
- Authors
Schmolders, J.; Koob, S.; Schepers, P.; Pennekamp, P.; Gravius, S.; Wirtz, D.; Placzek, R.; Strauss, A.; Pennekamp, P H; Wirtz, D C; Strauss, A C
- Abstract
<bold>Purpose and Objective: </bold>Bone resection regarding adequate surgical margins is the treatment of choice for malignant bone tumors. In the case of metastasis-related complications, so-called skeletal-related events, it is highly important to achieve pain relief and a stable joint situation to re-mobilize the patients immediately following surgery. To bridge the often large osseous defect zones after tumor resection, both cemented and uncemented modular endoprosthetic systems are widely used. Patients undergoing tumor-related endoprosthetic orthopedic surgery are facing high risk for developing a periprosthetic joint infection (PJI). The immunocompromised condition due to anti-neoplastic treatment and long operation time with large exposure of tissue contributes to a high risk of infection.<bold>Methods: </bold>The authors present a case series of 100 patients (31% primary bone tumor and 69% metastasis-related surgery) undergoing tumor-related lower limb salvage surgery with special regard to periprosthetic joint infection and the management of this "difficult to treat" situation. Furthermore, a review of the current literature regarding infection following bone tumor resection and endoprosthetic reconstruction is performed and discussed.<bold>Results: </bold>The median follow-up was 24 months (range 12-108 months). Ten patients (10%) suffered from a periprosthetic joint infection. We recorded six acute infections (type I) <4 weeks after surgery, one infection >4 weeks after surgery (type II), and three late infections (type III). According to the definition of Laffer et al., three of our patients (30%) are probably free of infection, one patient died of PJI-associated sepsis, and five patients were free of infection, but without restoration of the affected joint.<bold>Conclusion: </bold>In conclusion, our own results show that perimegaprosthetic joint infection among silver-coated implants, in patients undergoing tumor-related surgery of the lower limb, is lower compared to non-silver-coated implants. Due to heterogeneity of patients and potential treatment options, the treatment regime should be tailored for the patients' individual situation.
- Subjects
BONE tumors; LEG; JOINT infections; ANALGESIA; ORTHOPEDIC implants; TRANSPLANTATION of organs, tissues, etc.; TUMOR treatment; SILVER; BIOMEDICAL materials; INFECTION; INFECTIOUS arthritis; COMPLICATIONS of prosthesis; THERAPEUTICS
- Publication
Archives of Orthopaedic & Trauma Surgery, 2017, Vol 137, Issue 2, p149
- ISSN
0936-8051
- Publication type
journal article
- DOI
10.1007/s00402-016-2584-8