Evidence map›Paper›PMID 31801510›Full record

Trial reportBMC musculoskeletal disorders2019

Does the use of a closed-suction drain reduce the effectiveness of an antibiotic-loaded spacer in two-stage exchange Arthroplasty for Periprosthetic hip infection? A prospective, randomized, controlled study.

Chi Xu, Cheng-Qi Jia, Feng-Chih Kuo, Wei Chai, Ming-Hua Zhang, Ji-Ying Chen

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC musculoskeletal disorders, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Review
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 2 countries.

Chi XuDepartment of Orthopaedic Surgery, General Hospital of Peoples Liberation Army, No. 28 Fuxing Road, Beijing, 100853, Haidian District, China.
Cheng-Qi JiaDepartment of Orthopaedic Surgery, General Hospital of Peoples Liberation Army, No. 28 Fuxing Road, Beijing, 100853, Haidian District, China.
Feng-Chih KuoDepartment of Orthopaedic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung, Taiwan.
Wei ChaiDepartment of Orthopaedic Surgery, General Hospital of Peoples Liberation Army, No. 28 Fuxing Road, Beijing, 100853, Haidian District, China.
Ming-Hua ZhangDepartment of Clinical Pharmacy Laboratory, General Hospital of Peoples Liberation Army, No. 28 Fuxing Road, Beijing, 100853, Haidian District, China.
Ji-Ying ChenDepartment of Orthopaedic Surgery, General Hospital of Peoples Liberation Army, No. 28 Fuxing Road, Beijing, 100853, Haidian District, China. jiying_chen301@163.com.
Hainan Branch of People's Liberation Army General Hospital · CNChang Gung University · TW

Funding

National Natural Science Foundation of China 81503089National Natural Science Foundation of China 81672192
6 · The paper itself

Abstract

backgroundThere is a concern regarding the use of a closed-suction drain (CSD) in two-stage exchange arthroplasty for periprosthetic joint infection as it may decrease the antibiotic concentrations in the joint fluids. The purpose of this study was to identify whether the use of a CSD could reduce local antibiotic concentrations following spacer implantation.

methodsA prospective, randomized, controlled trial was conducted at our institution between January 2018 and November 2018. We enrolled 32 patients undergoing two-stage exchange arthroplasty for periprosthetic hip infection with an interim cement spacer containing 4-g vancomycin and 2-g meropenem per 40-g methyl-methacrylate cement polymer. Patients were randomized and evenly divided into the study group (non-CSD) and control group (CSD group) by sealed envelopes. Drainage samples of joint fluids (n = 160) were collected every 24 h for the first five days following spacer implantation. The antibiotic concentrations of drainage samples were measured by high-performance liquid chromatography, and the bioactivities of the drainage samples against methicillin-sensitive and methicillin-resistant Staphylococcus aureus (MSSA and MRSA) and E. coli were assessed.

resultsThere was no significant difference in the decrease of vancomycin (study group vs. control group: 163.20 ± 77.05 vs. 162.39 ± 36.31; p = 0.917) and meropenem concentration (123.78 ± 21.04 vs. 117.27 ± 19.38; P = 0.548) between the two groups during the first five days following spacer implantation. All joint drainage samples in each group exhibited antibacterial activity against MSSA, MRSA and E. coli.

conclusionsThe use of CSD following the implantation of an antibiotic-loaded cement spacer does not reduce the effectiveness of such a spacer in two-stage exchange arthroplasty. (Chinese Clinical Trial Registry, ChiCTR-INR-17014162. Registered 26 December 2017.).

Indexed as

AgedAnti-Bacterial AgentsArthritis, InfectiousArthroplasty, Replacement, HipBone CementsFemaleHip JointHip ProsthesisHumansMaleMeropenemMethylmethacrylateMiddle AgedProspective StudiesProsthesis-Related InfectionsSuctionAnti-Bacterial AgentsBone CementsMeropenemMethylmethacrylateVancomycinAntibiotic concentrationAntibiotic-loaded cement spacerClosed-suction drainPeriprosthetic joint infectionTwo-staged exchange arthroplasty

Identifiers

PMID31801510
PMCPMC6894212
OpenAlexW2991915157

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.