ReviewCureus2021
The Risk of Iatrogenic Hypercalcemia in Patients Undergoing Calcium Sulphate Beads Implantation in Prosthetic Joint Surgery: A Systematic Review.
Review in Cureus, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
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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.
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.
Who cites it
12 citing papers in PubMed, 15 citations in OpenAlex.
- Antibiotic-Impregnated Calcium Sulfate Beads for Local Therapy of Severe Skull Base Osteomyelitis.Clinical case reports · 2026Article
- Outcomes and safety of antibiotic-loaded calcium sulfate beads in orthopaedics: A systematic review and meta-analysis.Journal of orthopaedics · 2026Review
- Article
- Use of antibiotic loaded absorbable calcium beads in the treatment of infective endocarditis: A case report.Journal of cardiology cases · 2025Article
- Orthopaedic infections: novel treatment strategies and evolving concepts.OTA international : the open access journal of orthopaedic trauma · 2025Article
- Adjuvant local antibiotic therapy in the management of diabetic foot osteomyelitis.Clinical diabetes and endocrinology · 2024Article
- Pathogens in FRI - Do bugs matter? - An analysis of FRI studies to assess your enemy.Journal of orthopaedics · 2024Article
- Are Biodegradable Calcium Sulfate Antibiotic Beads Effective and Safe Adjuvants for Diabetic Foot Osteomyelitis?Cureus · 2024Article
- Local Antibiotic Delivery Options in Prosthetic Joint Infection.Antibiotics (Basel, Switzerland) · 2023Review
- Hypercalcaemia caused by calcium sulfate beads.BMJ case reports · 2022Article
- Severe hypercalcemia in a cat following treatment with antibiotic impregnated calcium sulfate carrier material for chronic pyogranulomatous panniculitis.JFMS open reportsArticle
- Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Calcium sulphate beads are increasingly being used in the management of prosthetic joint infections (PJI). Traditionally their use was limited to a void or dead space-filling combined with other additives such as Hydroxyapatite. Over the last decade, they have been developed to act more frequently as an antibiotics delivery system. Stimulan, a bio-absorbable form of Calcium sulfate, theoretically has an increased risk of hypercalcemia. Over the last few years, there have been published case reports which report it as an isolated cause of iatrogenic hypercalcemia. The sparsity of literature on this topic makes it difficult for surgeons to decide on the use of Calcium sulphate beads in patients with hypercalcemia predisposition in conditions like autoimmune disorders, sarcoidosis, malignancy, granulomatous diseases, heterotopic ossification, and hyperparathyroidism. The study was performed to assess the risk of hypercalcemia in patients after Calcium sulphate beads implantation in PJI. Two reviewers searched relevant literature in 3 online databases using cochrane methodology for systematic reviews. Studies reporting complications with the use of calcium sulphate beads in prosthetic joints were included. Studies reporting on less than five patients and studies reporting use in any other surgeries were excluded. The search of databases resulted in a total of 96 articles. After screening, a total of four articles were deemed suitable to be included in the analysis. A total of 1049 patients underwent calcium sulfate beads implantation, out of which 44 (4.2%) reported hypercalcemia with 41 (3.91%) transient in nature and 3 (0.28%) required management, including one with ICU admission. The result of this systematic review shows that calcium sulphate beads are safe and effective against PJI. There is a significant risk of transient hypercalcemia in susceptible patients and a low risk of symptomatic hypercalcemia.
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Registered trials
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.