Evidence map›Paper›PMID 39611436›Full record

ArticleActa orthopaedica2024

The use of antibiotic-loaded calcium sulphate beads in debridement, antibiotics, and implant retention (DAIR) for periprosthetic infections: a retrospective comparative cohort on outcome.

Irene Katharina Sigmund, Antony J R Palmer, Andrew J Hotchen, Martin A McNally, Bernadette C Young, Abtin Alvand, Adrian Taylor, Benjamin John Lee Kendrick

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Acta orthopaedica, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
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

8 citing papers in PubMed.

  1. Short or Long Antibiotic Regimens in Orthopedics.The New England journal of medicine · 2026
    Article
  2. Article
  3. Review
  4. Review
  5. Gentamicin fails to eradicateJournal of bone and joint infection · 2026
    Article
  6. Review
  7. Article
  8. 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

8 authors.

Irene Katharina SigmundNuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, UK; Department of Orthopaedics, Medical University of Vienna, Vienna, Austria.
Antony J R PalmerNuffield Orthopaedic Centre, Oxford University Hospitals, Oxford; Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Andrew J HotchenNuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, UK.
Martin A McNallyNuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, UK.ORCID 0000-0003-2003-9044
Bernadette C YoungNuffield Orthopaedic Centre, Oxford University Hospitals, Oxford; Nuffield Department of Medicine, University of Oxford, Oxford, UK.
Abtin AlvandNuffield Orthopaedic Centre, Oxford University Hospitals, Oxford; Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Adrian TaylorNuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, UK.
Benjamin John Lee KendrickNuffield Orthopaedic Centre, Oxford University Hospitals, Oxford; Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK. Ben.Kendrick@ouh.nhs.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeWe aimed to compare the effect of calcium sulphate (CS) beads loaded with antibiotics on infection eradication in debridement, antibiotics, and implant retention (DAIR) of periprosthetic joint infection relative to DAIR without local antibiotics delivery.

methods176 patients with hip or knee arthroplasty undergoing DAIR were retrospectively identified and divided into a bead group (n = 102) and a control group (n = 74). Infections were classified as early postoperative, acute hematogenous, and chronic. Logistic regression analyses were performed on the use of CS beads. Revision-free and infection-free survival was estimated using Kaplan-Meier analysis.

resultsReinfection occurred in 36% of the bead group, and 39% of the control group (odds ratio [OR] 0.9, 95% confidence interval [CI] 0.5- 1.6); reoperation rates were 34% and 43% (OR 0.7, CI 0.4-1.3). Kaplan-Meier analysis showed no statistically significant difference between the 2 groups regarding infection-free (HR 1.1, CI 0.7-1.8) and revision-free (HR 1.1, CI 0.7-1.9) survival rates. In acute hematogenous PJIs, reinfection (29% vs 56%, OR 0.3, CI 0.1-1.1) and reoperation rates (25% vs 61%, OR 0.2, CI 0.1-0.8) were reduced when CS beads were used; Kaplan-Meier analysis revealed higher infection-free (HR 0.5, CI 0.2-1.4) and revision-free (HR 0.5, CI 0.2-1.3) survival rates in the bead group but not of statistical significance. Wound drainage was not increased by CS beads use (OR 1.0, CI 0.99-1.01), but hypercalcemia was seen in 9% in the bead group.

conclusionDAIR with antibiotic-loaded CS beads did not improve outcome in early postoperative and chronic PJIs, but reduced the reoperation rate in acute haematogenous infections with similar results compared with early postoperative PJIs.

Indexed as

Anti-Bacterial AgentsArthroplasty, Replacement, HipArthroplasty, Replacement, KneeCalcium SulfateDebridementProsthesis-Related InfectionsReoperationAgedAged, 80 and overFemaleHip ProsthesisHumansKaplan-Meier EstimateMaleMiddle AgedRetrospective StudiesAnti-Bacterial AgentsCalcium Sulfate

Identifiers

PMID39611436
PMCPMC11605582

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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.