ArticleInternational orthopaedics2019
Procedure for single-stage implant retention for chronic periprosthetic infection using topical degradable calcium-based antibiotics.
Article in International orthopaedics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 25 citations in OpenAlex.
- Managing Nonunions and Fracture-Related Infections-A Quarter Century of Knowledge, and Still Curious: A Narrative Review.Journal of clinical medicine · 2025Review
- The use of antibiotic-loaded calcium sulphate beads in debridement, antibiotics, and implant retention (DAIR) for periprosthetic infections: a retrospective comparative cohort on outcome.Acta orthopaedica · 2024Article
- Limitations and modifications in the clinical application of calcium sulfate.Frontiers in surgery · 2024Review
- Enough is enough: salvage procedures in severe periprosthetic joint infection.Arthroplasty (London, England) · 2023Review
- The role of antibiotic calcium sulfate beads in acute periprosthetic knee infection: a retrospective cohort study.Arthroplasty (London, England) · 2022Article
- The Incidence of Severe Hypercalcaemia-Induced Mental Status Changes in Patients Treated with Antibiotic-Loaded Calcium Sulphate Depot for Orthopaedic Infections.Journal of clinical medicine · 2022Article
- [Implementation of a standardized clinical test kit for diagnostics of periprosthetic infections in the clinical routine. German version].Der Unfallchirurg · 2022Article
- Implementation of a standardized clinical test kit for diagnostics of periprosthetic infections in the clinical routine.Der Unfallchirurg · 2021Article
- Salvage procedure for chronic periprosthetic knee infection: the application of DAIR results in better remission rates and infection-free survivorship when used with topical degradable calcium-based antibiotics.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020Article
- Two-stage hip revision arthroplasty for periprosthetic joint infection without the use of spacer or cemented implants.International orthopaedics · 2019Article
- Evaluation of comparative soft tissue response to bone void fillers with antibiotics in a rabbit intramuscular model.Journal of biomaterials applications · 2019Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionSurgical treatment using DAIR (debridement, systemic antibiotics, and implant retention) can lead to high rates of treatment success in cases of early periprosthetic joint infection (PJI) but can fail in late-onset cases. Supplementary local antibiotic therapy is not yet generally established and lacks evidence-based proof of efficacy. The aim of this study was to analyze DAIR outcomes in recurrent PJI cases and patients who are not suitable for a two-stage exchange, using additional degradable calcium-based antibiotics.
methodsAll patients fulfilled the Infectious Diseases Society of America (IDSA) guidelines for chronic late-onset PJI but were not suitable for a multistage procedure because of their individual operation risk. A total of 42 patients (mean age, 73 years) were treated using a single-stage algorithm consisting of DAIR, followed by implantation of degradable antibiotics chosen in accordance with an antibiogram. OSTEOSET® (admixed ceftriaxone/vancomycin/tobramycin) and Herafill-Gentamycin® were used as carrier systems. The follow-up period was 23 months (± SD, 10.3). The study is based on institutional review board (IRB) approval.
resultsThe clinical entities were chronic PJI of the hip (45.2%), knee (28.6%), and knee arthrodesis (26.2%). The bacterial spectrum was composed of Staphylococcus epidermidis (29%), Staphylococcus aureus (21%), and Enterococcus faecalis (21%). 21.4% showed a combination of two or more bacteria. In 73.8%, permanent remission was achieved, while 11.9% showed chronic PJI under implant retention. Implant retention could be achieved in 85.7%.
conclusionDAIR usually shows low levels of success in difficult-to-treat cases. However, we could demonstrate the successful treatment of patients with recurrent PJI (typically considered DAIR-inappropriate) using degradable antibiogram-based topical calcium-based antibiotics. Over 70% of the cases went to remission and over 85% of the implants could be retained.
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