Purpose: Aim of this study was to verify the hypothesis that a one-stage exchange procedure, performed with an antibiotic-loaded, fast-resorbable hydrogel coating, provides similar infection recurrence rate than a two-stage procedure without the coating, in patients affected by peri-prosthetic joint infection (PJI). Methods: In this two-center case–control, study, 22 patients, treated with a one-stage procedure, using implants coated with an antibiotic-loaded hydrogel [defensive antibacterial coating (DAC)], were compared with 22 retrospective matched controls, treated with a two-stage revision procedure, without the coating. Results: At a mean follow-up of 29.3 ± 5.0 months, two patients (9.1%) in the DAC group showed an infection recurrence, compared to three patients (13.6%) in the two-stage group. Clinical scores were similar between groups, while average hospital stay and antibiotic treatment duration were significantly reduced after one-stage, compared to two-stage (18.9 ± 2.9 versus 35.8 ± 3.4 and 23.5 ± 3.3 versus 53.7 ± 5.6 days, respectively). Conclusions: Although in a relatively limited series of patients, our data shows similar infection recurrence rate after one-stage exchange with DAC-coated implants, compared to two-stage revision without coating, with reduced overall hospitalization time and antibiotic treatment duration. These findings warrant further studies in the possible applications of antibacterial coating technologies to treat implant-related infections. Level of evidence: III.
One-stage exchange with antibacterial hydrogel coated implants provides similar results to two-stage revision, without the coating, for the treatment of peri-prosthetic infection / N. Capuano, N. Logoluso, E. Gallazzi, L. Drago, C.L. Romano. - In: KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY. - ISSN 0942-2056. - 26:11(2018), pp. 3362-3367.
|Titolo:||One-stage exchange with antibacterial hydrogel coated implants provides similar results to two-stage revision, without the coating, for the treatment of peri-prosthetic infection|
|Parole Chiave:||Coating; DAC; Infection; One-stage revision; PJI; Two-stage revision; Aged; Anti-Bacterial Agents; Case-Control Studies; Female; Humans; Hydrogels; Length of Stay; Male; Prospective Studies; Prosthesis-Related Infections; Recurrence; Reoperation; Retrospective Studies; Coated Materials, Biocompatible; Knee Prosthesis|
|Settore Scientifico Disciplinare:||Settore MED/07 - Microbiologia e Microbiologia Clinica|
|Data di pubblicazione:||2018|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1007/s00167-018-4896-4|
|Appare nelle tipologie:||01 - Articolo su periodico|