Cement Loaded With High-Dose Gentamicin and Clindamycin Reduces the Risk of Subsequent Infection After One-Stage Hip or Knee Arthroplasty Exchange for Periprosthetic Infection: A Preliminary Study
The use of antibiotic-loaded acrylic cement for treating periprosthetic joint infections remains controversial. We hypothesized that the raw rate of surgical site infection (SSI) is lower after using cement loaded with high-dose gentamicin and clindamycin than after using cement loaded with standard...
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| Veröffentlicht in: | The Journal of arthroplasty 2021-12, Vol.36 (12), p.3973-3978 |
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| container_title | The Journal of arthroplasty |
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| creator | Jenny, Jean-Yves Hamon, Marie Klein, Stéphane Reiter-Schatz, Aurélie Rondé-Oustau, Cécile Boéri, Cyril Wisniewski, Sandra Gaudias, Jeannot |
| description | The use of antibiotic-loaded acrylic cement for treating periprosthetic joint infections remains controversial. We hypothesized that the raw rate of surgical site infection (SSI) is lower after using cement loaded with high-dose gentamicin and clindamycin than after using cement loaded with standard-dose gentamicin for implant fixation during 1-stage hip and knee revision arthroplasty for infection.
One hundred seventy-one continuous patients operated by 2 experienced surgeons during a 2-year period were included in the study. All patients were followed for 24 months. The primary endpoint was the raw rate of SSI after 2 years of follow-up time.
The raw rate of SSI after 2 years of follow-up time was significantly lower in the study group (13%) than in the control group (26%) (P = .03) with an odds ratio of 0.42 (P = .03). These SSIs were new infections rather than a recurrence/persistence of the initial infection.
The cement used in the study group significantly reduced the risk of SSI relative to the cement used in the control group. Routine use of this high-dose dual antibiotic-loaded cement can be considered during 1-stage knee or hip revision arthroplasty for infection. |
| doi_str_mv | 10.1016/j.arth.2021.08.014 |
| format | Article |
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One hundred seventy-one continuous patients operated by 2 experienced surgeons during a 2-year period were included in the study. All patients were followed for 24 months. The primary endpoint was the raw rate of SSI after 2 years of follow-up time.
The raw rate of SSI after 2 years of follow-up time was significantly lower in the study group (13%) than in the control group (26%) (P = .03) with an odds ratio of 0.42 (P = .03). These SSIs were new infections rather than a recurrence/persistence of the initial infection.
The cement used in the study group significantly reduced the risk of SSI relative to the cement used in the control group. Routine use of this high-dose dual antibiotic-loaded cement can be considered during 1-stage knee or hip revision arthroplasty for infection.</description><identifier>ISSN: 0883-5403</identifier><identifier>EISSN: 1532-8406</identifier><identifier>DOI: 10.1016/j.arth.2021.08.014</identifier><identifier>PMID: 34511281</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Anti-Bacterial Agents - therapeutic use ; antibiotic-loaded cement ; Arthroplasty, Replacement, Hip - adverse effects ; Arthroplasty, Replacement, Knee - adverse effects ; Bone Cements ; clindamycin ; Clindamycin - therapeutic use ; gentamicin ; Gentamicins ; Humans ; one stage exchange ; periprosthetic infection ; Prosthesis-Related Infections - drug therapy ; Prosthesis-Related Infections - epidemiology ; Prosthesis-Related Infections - prevention & control ; Reoperation ; Retrospective Studies ; total joint arthroplasty</subject><ispartof>The Journal of arthroplasty, 2021-12, Vol.36 (12), p.3973-3978</ispartof><rights>2021 Elsevier Inc.</rights><rights>Copyright © 2021 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-d049c4b4d2b367b7fe2fe60a58d0aecb56c7a0d6321898cc472bffff4d426aff3</citedby><cites>FETCH-LOGICAL-c400t-d049c4b4d2b367b7fe2fe60a58d0aecb56c7a0d6321898cc472bffff4d426aff3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.arth.2021.08.014$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34511281$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jenny, Jean-Yves</creatorcontrib><creatorcontrib>Hamon, Marie</creatorcontrib><creatorcontrib>Klein, Stéphane</creatorcontrib><creatorcontrib>Reiter-Schatz, Aurélie</creatorcontrib><creatorcontrib>Rondé-Oustau, Cécile</creatorcontrib><creatorcontrib>Boéri, Cyril</creatorcontrib><creatorcontrib>Wisniewski, Sandra</creatorcontrib><creatorcontrib>Gaudias, Jeannot</creatorcontrib><title>Cement Loaded With High-Dose Gentamicin and Clindamycin Reduces the Risk of Subsequent Infection After One-Stage Hip or Knee Arthroplasty Exchange for Periprosthetic Infection: A Preliminary Study</title><title>The Journal of arthroplasty</title><addtitle>J Arthroplasty</addtitle><description>The use of antibiotic-loaded acrylic cement for treating periprosthetic joint infections remains controversial. We hypothesized that the raw rate of surgical site infection (SSI) is lower after using cement loaded with high-dose gentamicin and clindamycin than after using cement loaded with standard-dose gentamicin for implant fixation during 1-stage hip and knee revision arthroplasty for infection.
One hundred seventy-one continuous patients operated by 2 experienced surgeons during a 2-year period were included in the study. All patients were followed for 24 months. The primary endpoint was the raw rate of SSI after 2 years of follow-up time.
The raw rate of SSI after 2 years of follow-up time was significantly lower in the study group (13%) than in the control group (26%) (P = .03) with an odds ratio of 0.42 (P = .03). These SSIs were new infections rather than a recurrence/persistence of the initial infection.
The cement used in the study group significantly reduced the risk of SSI relative to the cement used in the control group. Routine use of this high-dose dual antibiotic-loaded cement can be considered during 1-stage knee or hip revision arthroplasty for infection.</description><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>antibiotic-loaded cement</subject><subject>Arthroplasty, Replacement, Hip - adverse effects</subject><subject>Arthroplasty, Replacement, Knee - adverse effects</subject><subject>Bone Cements</subject><subject>clindamycin</subject><subject>Clindamycin - therapeutic use</subject><subject>gentamicin</subject><subject>Gentamicins</subject><subject>Humans</subject><subject>one stage exchange</subject><subject>periprosthetic infection</subject><subject>Prosthesis-Related Infections - drug therapy</subject><subject>Prosthesis-Related Infections - epidemiology</subject><subject>Prosthesis-Related Infections - prevention & control</subject><subject>Reoperation</subject><subject>Retrospective Studies</subject><subject>total joint arthroplasty</subject><issn>0883-5403</issn><issn>1532-8406</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u1DAUhS0EokPLC7BAXrJJsB3nZxCb0VDaqiO16oBYWo593XhInKntIOb9eDAcTQu7emNZ99xP5_gg9I6SnBJafdzl0scuZ4TRnDQ5ofwFWtCyYFnDSfUSLUjTFFnJSXGC3oSwI4TSsuSv0UnBS0pZQxfozxoGcBFvRqlB4x82dvjS3nfZlzEAvkgjOVhlHZZO43VvnZbDYX7fgZ4UBBw7wHc2_MSjwdupDfAwzbwrZ0BFOzq8MhE8vnGQbaO8h0Tf49HjaweAV8m_H_e9DPGAz3-rTrqkMGl8C97u_RgSPlr1H_cJr_Cth94O1kl_wNs46cMZemVkH-Dt432Kvn89_7a-zDY3F1fr1SZTnJCYacKXirdcs7ao6rY2wAxURJaNJhJUW1aqlkRXBaPNslGK16w16XDNWSWNKU7RhyM3OUsxQxSDDQr6XjoYpyBYWTNG2bLkScqOUpVCBA9G7L0dkmNBiZjbEzsxtyfm9gRpRGovLb1_5E_tAPrfylNdSfD5KICU8pcFL4Ky4BRo69P_CD3a5_h_AQSKr3Q</recordid><startdate>202112</startdate><enddate>202112</enddate><creator>Jenny, Jean-Yves</creator><creator>Hamon, Marie</creator><creator>Klein, Stéphane</creator><creator>Reiter-Schatz, Aurélie</creator><creator>Rondé-Oustau, Cécile</creator><creator>Boéri, Cyril</creator><creator>Wisniewski, Sandra</creator><creator>Gaudias, Jeannot</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202112</creationdate><title>Cement Loaded With High-Dose Gentamicin and Clindamycin Reduces the Risk of Subsequent Infection After One-Stage Hip or Knee Arthroplasty Exchange for Periprosthetic Infection: A Preliminary Study</title><author>Jenny, Jean-Yves ; Hamon, Marie ; Klein, Stéphane ; Reiter-Schatz, Aurélie ; Rondé-Oustau, Cécile ; Boéri, Cyril ; Wisniewski, Sandra ; Gaudias, Jeannot</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-d049c4b4d2b367b7fe2fe60a58d0aecb56c7a0d6321898cc472bffff4d426aff3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>antibiotic-loaded cement</topic><topic>Arthroplasty, Replacement, Hip - adverse effects</topic><topic>Arthroplasty, Replacement, Knee - adverse effects</topic><topic>Bone Cements</topic><topic>clindamycin</topic><topic>Clindamycin - therapeutic use</topic><topic>gentamicin</topic><topic>Gentamicins</topic><topic>Humans</topic><topic>one stage exchange</topic><topic>periprosthetic infection</topic><topic>Prosthesis-Related Infections - drug therapy</topic><topic>Prosthesis-Related Infections - epidemiology</topic><topic>Prosthesis-Related Infections - prevention & control</topic><topic>Reoperation</topic><topic>Retrospective Studies</topic><topic>total joint arthroplasty</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jenny, Jean-Yves</creatorcontrib><creatorcontrib>Hamon, Marie</creatorcontrib><creatorcontrib>Klein, Stéphane</creatorcontrib><creatorcontrib>Reiter-Schatz, Aurélie</creatorcontrib><creatorcontrib>Rondé-Oustau, Cécile</creatorcontrib><creatorcontrib>Boéri, Cyril</creatorcontrib><creatorcontrib>Wisniewski, Sandra</creatorcontrib><creatorcontrib>Gaudias, Jeannot</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of arthroplasty</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jenny, Jean-Yves</au><au>Hamon, Marie</au><au>Klein, Stéphane</au><au>Reiter-Schatz, Aurélie</au><au>Rondé-Oustau, Cécile</au><au>Boéri, Cyril</au><au>Wisniewski, Sandra</au><au>Gaudias, Jeannot</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cement Loaded With High-Dose Gentamicin and Clindamycin Reduces the Risk of Subsequent Infection After One-Stage Hip or Knee Arthroplasty Exchange for Periprosthetic Infection: A Preliminary Study</atitle><jtitle>The Journal of arthroplasty</jtitle><addtitle>J Arthroplasty</addtitle><date>2021-12</date><risdate>2021</risdate><volume>36</volume><issue>12</issue><spage>3973</spage><epage>3978</epage><pages>3973-3978</pages><issn>0883-5403</issn><eissn>1532-8406</eissn><abstract>The use of antibiotic-loaded acrylic cement for treating periprosthetic joint infections remains controversial. We hypothesized that the raw rate of surgical site infection (SSI) is lower after using cement loaded with high-dose gentamicin and clindamycin than after using cement loaded with standard-dose gentamicin for implant fixation during 1-stage hip and knee revision arthroplasty for infection.
One hundred seventy-one continuous patients operated by 2 experienced surgeons during a 2-year period were included in the study. All patients were followed for 24 months. The primary endpoint was the raw rate of SSI after 2 years of follow-up time.
The raw rate of SSI after 2 years of follow-up time was significantly lower in the study group (13%) than in the control group (26%) (P = .03) with an odds ratio of 0.42 (P = .03). These SSIs were new infections rather than a recurrence/persistence of the initial infection.
The cement used in the study group significantly reduced the risk of SSI relative to the cement used in the control group. Routine use of this high-dose dual antibiotic-loaded cement can be considered during 1-stage knee or hip revision arthroplasty for infection.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>34511281</pmid><doi>10.1016/j.arth.2021.08.014</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Anti-Bacterial Agents - therapeutic use antibiotic-loaded cement Arthroplasty, Replacement, Hip - adverse effects Arthroplasty, Replacement, Knee - adverse effects Bone Cements clindamycin Clindamycin - therapeutic use gentamicin Gentamicins Humans one stage exchange periprosthetic infection Prosthesis-Related Infections - drug therapy Prosthesis-Related Infections - epidemiology Prosthesis-Related Infections - prevention & control Reoperation Retrospective Studies total joint arthroplasty |
| title | Cement Loaded With High-Dose Gentamicin and Clindamycin Reduces the Risk of Subsequent Infection After One-Stage Hip or Knee Arthroplasty Exchange for Periprosthetic Infection: A Preliminary Study |
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