Carmine Zoccali1, Guido Scoccianti2, Roberto Biagini3, Primo Andrea Daolio4, Fabio Luca Giardina4, Domenico Andrea Campanacci2. 1. Oncological Orthopedics Department, IFO - Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy. carminezoccali@libero.it. 2. Department of Orthopaedic Oncology and Reconstructive Surgery, University of Florence, Azienda Ospedaliera Universitaria Careggi, Largo Brambilla, 3, 50134, Florence, Italy. 3. Oncological Orthopedics Department, IFO - Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy. 4. Oncologic Surgery Centre, Gaetano Pini Orthopedic Institute, Via Quadronno, 25, 20122, Milan, Italy.
Abstract
PURPOSE: Joint mega-prosthesis after bone tumors, severe trauma or infection is associated with high rates of post-surgical septic complications. A fast-resorbable antibacterial hydrogel coating (DAC®, Defensive Antibacterial Coating) has previously been shown to be able to significantly reduce surgical site infection in various clinical settings. Aim of the present study was to evaluate the safety and efficacy of the DAC hydrogel coating to prevent early periprosthetic joint infection after joint mega-prosthesis. METHODS: In this three-centers, case-control study, 43 patients, treated with an antibacterial hydrogel coated mega-prosthesis for oncological (N = 39) or non-oncological conditions (N = 4), were retrospectively compared with 43 matched controls, treated with mega-implants without the coating. Clinical, laboratory and radiographic examinations were performed to evaluate the occurrence of post-surgical infection, complications and adverse events. RESULTS: At a mean follow-up of 2 years, no evidence of infection or adverse events were observed in the DAC-treated group, compared to six cases of post-surgical infection in the control group. CONCLUSION: This matched case-control study shows that a fast-resorbable, antibiotic-loaded coating can be safely used to protect joint mega-prosthesis, providing a reduction of early surgical site infections with no side effects. Larger prospective trials with longer follow-ups are warranted to confirm this report. TRIAL REGISTRATION: RS1229/19 (Regina Elena National Cancer Institute Experimental Registry Number).
PURPOSE: Joint mega-prosthesis after bone tumors, severe trauma or infection is associated with high rates of post-surgical septic complications. A fast-resorbable antibacterial hydrogel coating (DAC®, Defensive Antibacterial Coating) has previously been shown to be able to significantly reduce surgical site infection in various clinical settings. Aim of the present study was to evaluate the safety and efficacy of the DAC hydrogel coating to prevent early periprosthetic joint infection after joint mega-prosthesis. METHODS: In this three-centers, case-control study, 43 patients, treated with an antibacterial hydrogel coated mega-prosthesis for oncological (N = 39) or non-oncological conditions (N = 4), were retrospectively compared with 43 matched controls, treated with mega-implants without the coating. Clinical, laboratory and radiographic examinations were performed to evaluate the occurrence of post-surgical infection, complications and adverse events. RESULTS: At a mean follow-up of 2 years, no evidence of infection or adverse events were observed in the DAC-treated group, compared to six cases of post-surgical infection in the control group. CONCLUSION: This matched case-control study shows that a fast-resorbable, antibiotic-loaded coating can be safely used to protect joint mega-prosthesis, providing a reduction of early surgical site infections with no side effects. Larger prospective trials with longer follow-ups are warranted to confirm this report. TRIAL REGISTRATION: RS1229/19 (Regina Elena National Cancer Institute Experimental Registry Number).
Authors: Michael C Wyatt; Michael Foxall-Smith; Andrew Roberton; Andrew Beswick; David C Kieser; Michael R Whitehouse Journal: Hip Int Date: 2018-11-16 Impact factor: 2.135
Authors: Werner H Hettwer; Peter Frederik Horstmann; Thea Bechmann Hovgaard; Tomas Andreas Grum-Scwensen; Michael M Petersen Journal: Adv Orthop Date: 2015-02-01
Authors: Jean Marie Arduino; Keith S Kaye; Shelby D Reed; Senaka A Peter; Daniel J Sexton; Luke F Chen; N Chantelle Hardy; Steven Yc Tong; Steven S Smugar; Vance G Fowler; Deverick J Anderson Journal: Antimicrob Resist Infect Control Date: 2015-05-15 Impact factor: 4.887
Authors: Paolo Di Benedetto; Enrico Daniele Di Benedetto; Michele Mario Buttironi; D De Franceschi; Alessandro Beltrame; Renato Gissoni; Vanni Cainero; Araldo Causero Journal: Acta Biomed Date: 2017-06-07