[Risk factors and management strategies for early and late infections following reconstruction with special tumour endoprostheses].
Risikofaktoren und Managementstrategien des Früh- und Spätinfektes nach Rekonstruktion mit Tumorspezialendoprothesen.
Biofilm
Bone Cancer
Endoprosthesis
Prosthesis failure
Prosthesis-related infections
Journal
Der Orthopade
ISSN: 1433-0431
Titre abrégé: Orthopade
Pays: Germany
ID NLM: 0331266
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
pubmed:
6
2
2020
medline:
29
2
2020
entrez:
5
2
2020
Statut:
ppublish
Résumé
Periprosthetic joint infection (PJI) of megaprostheses occur in about 10% of all cases. The criteria for PJI are defined by the "Musculoskleletal Infection Society" (MSIS) and apply to both primary arthroplasty and megaprostheses. The management strategies of PJI in megaprostheses are dependent on the duration of infection and the maturity of the bacterial biofilm. Implant retention with an exchange of the mobile components is only possible in the presence of an immature biofilm. In the presence of a mature biofilm, a one- or two-stage exchange must be performed. A complete exchange of all endoprosthetic components should be performed, if possible, since a partial retention of isolated components results in inferior treatment success rates. The highest success rates are achievable with two-stage exchanges. Multiple risk factors such as skin necrosis, postoperative haematoma, prolonged wound secretion and operative times ≥ 2.5 h are risk factors for the development of PJI in megaprostheses. Knowledge regarding these risk factors allows for an identification of high-risk patients and early management of PJI.
Sections du résumé
BACKGROUND
BACKGROUND
Periprosthetic joint infection (PJI) of megaprostheses occur in about 10% of all cases. The criteria for PJI are defined by the "Musculoskleletal Infection Society" (MSIS) and apply to both primary arthroplasty and megaprostheses.
MANAGEMENT
RESULTS
The management strategies of PJI in megaprostheses are dependent on the duration of infection and the maturity of the bacterial biofilm. Implant retention with an exchange of the mobile components is only possible in the presence of an immature biofilm. In the presence of a mature biofilm, a one- or two-stage exchange must be performed. A complete exchange of all endoprosthetic components should be performed, if possible, since a partial retention of isolated components results in inferior treatment success rates.
RESULTS
RESULTS
The highest success rates are achievable with two-stage exchanges. Multiple risk factors such as skin necrosis, postoperative haematoma, prolonged wound secretion and operative times ≥ 2.5 h are risk factors for the development of PJI in megaprostheses. Knowledge regarding these risk factors allows for an identification of high-risk patients and early management of PJI.
Identifiants
pubmed: 32016498
doi: 10.1007/s00132-020-03872-1
pii: 10.1007/s00132-020-03872-1
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Review
Langues
ger
Sous-ensembles de citation
IM
Pagination
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