Iontophoresed segmental allografts in revision arthroplasty for infection
Revision arthroplasty after infection can often be complicated by both extensive bone loss and a relatively high rate of re-infection. Using allograft to address the bone loss in such patients is controversial because of the perceived risk of bacterial infection from the use of avascular graft mater...
Gespeichert in:
| Veröffentlicht in: | Journal of bone and joint surgery. British volume 2006-11, Vol.88 (11), p.1430-1437 |
|---|---|
| Hauptverfasser: | , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1437 |
|---|---|
| container_issue | 11 |
| container_start_page | 1430 |
| container_title | Journal of bone and joint surgery. British volume |
| container_volume | 88 |
| creator | MICHALAK, K. A KHOO, P. P. C YATES, P. J DAY, R. E WOOD, D. J |
| description | Revision arthroplasty after infection can often be complicated by both extensive bone loss and a relatively high rate of re-infection. Using allograft to address the bone loss in such patients is controversial because of the perceived risk of bacterial infection from the use of avascular graft material. We describe 12 two-stage revisions for infection in which segmental allografts were loaded with antibiotics using iontophoresis, a technique using an electrical potential to drive ionised antibiotics into cortical bone. Iontophoresis produced high levels of antibiotic in the allograft, which eluted into the surrounding tissues. We postulate that this offers protection from infection in the high-risk peri-operative period. None of the 12 patients who had two-stage revision with iontophoresed allografts had further infection after a mean period of 47 months (14 to 78). |
| doi_str_mv | 10.1302/0301-620X.88B11.18335 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_69014441</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1173933341</sourcerecordid><originalsourceid>FETCH-LOGICAL-c411t-486eb3dd63a32a6c2075c15e80890264f83242de05ad6643624d678e35eed1bd3</originalsourceid><addsrcrecordid>eNpdkEtLw0AUhQdRbK3-BCUIukudd6ZLLT4KBTcK7oZp5qZNSTJ1JhH67522wYKruzjfOVw-hK4JHhOG6QNmmKSS4q-xUk-EjIliTJygIcWcp4Jl2Ska_jEDdBHCGmPMhWDnaEAynAmsxBDNZq5p3WblPASwSYBlDU1rqsRUlVt6U7QhKZvEw08ZStckxrcr7zaVCe02KZyPYQF5G6NLdFaYKsBVf0fo8-X5Y_qWzt9fZ9PHeZpzQtqUKwkLZq1khlEjcxo_yYkAhdUEU8kLxSinFrAwVkrOJOVWZgqYALBkYdkI3R92N959dxBaXZchh6oyDbguaDnBhHNOInj7D1y7zjfxN03pJFMZFzxC4gDl3oXgodAbX9bGbzXBeida7yTqnUS9F633omPvph_vFjXYY6s3G4G7HjAhN1XhTZOX4cgpmkVMsl-CjYWo</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>229787454</pqid></control><display><type>article</type><title>Iontophoresed segmental allografts in revision arthroplasty for infection</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>MICHALAK, K. A ; KHOO, P. P. C ; YATES, P. J ; DAY, R. E ; WOOD, D. J</creator><creatorcontrib>MICHALAK, K. A ; KHOO, P. P. C ; YATES, P. J ; DAY, R. E ; WOOD, D. J</creatorcontrib><description>Revision arthroplasty after infection can often be complicated by both extensive bone loss and a relatively high rate of re-infection. Using allograft to address the bone loss in such patients is controversial because of the perceived risk of bacterial infection from the use of avascular graft material. We describe 12 two-stage revisions for infection in which segmental allografts were loaded with antibiotics using iontophoresis, a technique using an electrical potential to drive ionised antibiotics into cortical bone. Iontophoresis produced high levels of antibiotic in the allograft, which eluted into the surrounding tissues. We postulate that this offers protection from infection in the high-risk peri-operative period. None of the 12 patients who had two-stage revision with iontophoresed allografts had further infection after a mean period of 47 months (14 to 78).</description><edition>British volume</edition><identifier>ISSN: 0301-620X</identifier><identifier>ISSN: 2049-4394</identifier><identifier>EISSN: 2044-5377</identifier><identifier>EISSN: 2049-4408</identifier><identifier>DOI: 10.1302/0301-620X.88B11.18335</identifier><identifier>PMID: 17075085</identifier><identifier>CODEN: JBSUAK</identifier><language>eng</language><publisher>London: British Editorial Society of Bone and Joint Surgery</publisher><subject>Aged ; Aged, 80 and over ; Anti-Infective Agents - administration & dosage ; Anti-Infective Agents - analysis ; Arthroplasty, Replacement ; Arthroplasty, Replacement, Hip ; Arthroplasty, Replacement, Knee ; Biological and medical sciences ; Female ; Humans ; Iontophoresis - methods ; Male ; Medical sciences ; Middle Aged ; Orthopedic surgery ; Osteoarthritis, Hip - surgery ; Osteoarthritis, Knee - surgery ; Postoperative Complications ; Recurrence ; Reoperation ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgical Wound Infection - drug therapy ; Treatment Outcome</subject><ispartof>Journal of bone and joint surgery. British volume, 2006-11, Vol.88 (11), p.1430-1437</ispartof><rights>2007 INIST-CNRS</rights><rights>Copyright British Editorial Society of Bone & Joint Surgery Nov 2006</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-486eb3dd63a32a6c2075c15e80890264f83242de05ad6643624d678e35eed1bd3</citedby><cites>FETCH-LOGICAL-c411t-486eb3dd63a32a6c2075c15e80890264f83242de05ad6643624d678e35eed1bd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18270856$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17075085$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>MICHALAK, K. A</creatorcontrib><creatorcontrib>KHOO, P. P. C</creatorcontrib><creatorcontrib>YATES, P. J</creatorcontrib><creatorcontrib>DAY, R. E</creatorcontrib><creatorcontrib>WOOD, D. J</creatorcontrib><title>Iontophoresed segmental allografts in revision arthroplasty for infection</title><title>Journal of bone and joint surgery. British volume</title><addtitle>J Bone Joint Surg Br</addtitle><description>Revision arthroplasty after infection can often be complicated by both extensive bone loss and a relatively high rate of re-infection. Using allograft to address the bone loss in such patients is controversial because of the perceived risk of bacterial infection from the use of avascular graft material. We describe 12 two-stage revisions for infection in which segmental allografts were loaded with antibiotics using iontophoresis, a technique using an electrical potential to drive ionised antibiotics into cortical bone. Iontophoresis produced high levels of antibiotic in the allograft, which eluted into the surrounding tissues. We postulate that this offers protection from infection in the high-risk peri-operative period. None of the 12 patients who had two-stage revision with iontophoresed allografts had further infection after a mean period of 47 months (14 to 78).</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anti-Infective Agents - administration & dosage</subject><subject>Anti-Infective Agents - analysis</subject><subject>Arthroplasty, Replacement</subject><subject>Arthroplasty, Replacement, Hip</subject><subject>Arthroplasty, Replacement, Knee</subject><subject>Biological and medical sciences</subject><subject>Female</subject><subject>Humans</subject><subject>Iontophoresis - methods</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Orthopedic surgery</subject><subject>Osteoarthritis, Hip - surgery</subject><subject>Osteoarthritis, Knee - surgery</subject><subject>Postoperative Complications</subject><subject>Recurrence</subject><subject>Reoperation</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgical Wound Infection - drug therapy</subject><subject>Treatment Outcome</subject><issn>0301-620X</issn><issn>2049-4394</issn><issn>2044-5377</issn><issn>2049-4408</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkEtLw0AUhQdRbK3-BCUIukudd6ZLLT4KBTcK7oZp5qZNSTJ1JhH67522wYKruzjfOVw-hK4JHhOG6QNmmKSS4q-xUk-EjIliTJygIcWcp4Jl2Ska_jEDdBHCGmPMhWDnaEAynAmsxBDNZq5p3WblPASwSYBlDU1rqsRUlVt6U7QhKZvEw08ZStckxrcr7zaVCe02KZyPYQF5G6NLdFaYKsBVf0fo8-X5Y_qWzt9fZ9PHeZpzQtqUKwkLZq1khlEjcxo_yYkAhdUEU8kLxSinFrAwVkrOJOVWZgqYALBkYdkI3R92N959dxBaXZchh6oyDbguaDnBhHNOInj7D1y7zjfxN03pJFMZFzxC4gDl3oXgodAbX9bGbzXBeida7yTqnUS9F633omPvph_vFjXYY6s3G4G7HjAhN1XhTZOX4cgpmkVMsl-CjYWo</recordid><startdate>20061101</startdate><enddate>20061101</enddate><creator>MICHALAK, K. A</creator><creator>KHOO, P. P. C</creator><creator>YATES, P. J</creator><creator>DAY, R. E</creator><creator>WOOD, D. J</creator><general>British Editorial Society of Bone and Joint Surgery</general><general>British Editorial Society of Bone & Joint Surgery</general><scope>IQODW</scope><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>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20061101</creationdate><title>Iontophoresed segmental allografts in revision arthroplasty for infection</title><author>MICHALAK, K. A ; KHOO, P. P. C ; YATES, P. J ; DAY, R. E ; WOOD, D. J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-486eb3dd63a32a6c2075c15e80890264f83242de05ad6643624d678e35eed1bd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anti-Infective Agents - administration & dosage</topic><topic>Anti-Infective Agents - analysis</topic><topic>Arthroplasty, Replacement</topic><topic>Arthroplasty, Replacement, Hip</topic><topic>Arthroplasty, Replacement, Knee</topic><topic>Biological and medical sciences</topic><topic>Female</topic><topic>Humans</topic><topic>Iontophoresis - methods</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Orthopedic surgery</topic><topic>Osteoarthritis, Hip - surgery</topic><topic>Osteoarthritis, Knee - surgery</topic><topic>Postoperative Complications</topic><topic>Recurrence</topic><topic>Reoperation</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgical Wound Infection - drug therapy</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>MICHALAK, K. A</creatorcontrib><creatorcontrib>KHOO, P. P. C</creatorcontrib><creatorcontrib>YATES, P. J</creatorcontrib><creatorcontrib>DAY, R. E</creatorcontrib><creatorcontrib>WOOD, D. J</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of bone and joint surgery. British volume</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>MICHALAK, K. A</au><au>KHOO, P. P. C</au><au>YATES, P. J</au><au>DAY, R. E</au><au>WOOD, D. J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Iontophoresed segmental allografts in revision arthroplasty for infection</atitle><jtitle>Journal of bone and joint surgery. British volume</jtitle><addtitle>J Bone Joint Surg Br</addtitle><date>2006-11-01</date><risdate>2006</risdate><volume>88</volume><issue>11</issue><spage>1430</spage><epage>1437</epage><pages>1430-1437</pages><issn>0301-620X</issn><issn>2049-4394</issn><eissn>2044-5377</eissn><eissn>2049-4408</eissn><coden>JBSUAK</coden><abstract>Revision arthroplasty after infection can often be complicated by both extensive bone loss and a relatively high rate of re-infection. Using allograft to address the bone loss in such patients is controversial because of the perceived risk of bacterial infection from the use of avascular graft material. We describe 12 two-stage revisions for infection in which segmental allografts were loaded with antibiotics using iontophoresis, a technique using an electrical potential to drive ionised antibiotics into cortical bone. Iontophoresis produced high levels of antibiotic in the allograft, which eluted into the surrounding tissues. We postulate that this offers protection from infection in the high-risk peri-operative period. None of the 12 patients who had two-stage revision with iontophoresed allografts had further infection after a mean period of 47 months (14 to 78).</abstract><cop>London</cop><pub>British Editorial Society of Bone and Joint Surgery</pub><pmid>17075085</pmid><doi>10.1302/0301-620X.88B11.18335</doi><tpages>8</tpages><edition>British volume</edition><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0301-620X |
| ispartof | Journal of bone and joint surgery. British volume, 2006-11, Vol.88 (11), p.1430-1437 |
| issn | 0301-620X 2049-4394 2044-5377 2049-4408 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_69014441 |
| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Aged Aged, 80 and over Anti-Infective Agents - administration & dosage Anti-Infective Agents - analysis Arthroplasty, Replacement Arthroplasty, Replacement, Hip Arthroplasty, Replacement, Knee Biological and medical sciences Female Humans Iontophoresis - methods Male Medical sciences Middle Aged Orthopedic surgery Osteoarthritis, Hip - surgery Osteoarthritis, Knee - surgery Postoperative Complications Recurrence Reoperation Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgical Wound Infection - drug therapy Treatment Outcome |
| title | Iontophoresed segmental allografts in revision arthroplasty for infection |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-01T05%3A36%3A57IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Iontophoresed%20segmental%20allografts%20in%20revision%20arthroplasty%20for%20infection&rft.jtitle=Journal%20of%20bone%20and%20joint%20surgery.%20British%20volume&rft.au=MICHALAK,%20K.%20A&rft.date=2006-11-01&rft.volume=88&rft.issue=11&rft.spage=1430&rft.epage=1437&rft.pages=1430-1437&rft.issn=0301-620X&rft.eissn=2044-5377&rft.coden=JBSUAK&rft_id=info:doi/10.1302/0301-620X.88B11.18335&rft_dat=%3Cproquest_cross%3E1173933341%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=229787454&rft_id=info:pmid/17075085&rfr_iscdi=true |