Cement loaded with high-dose gentamicin and clindamycin does not reduce the risk of subsequent infection after aseptic total hip or knee revision arthroplasty: a preliminary study.

IF 3 2区医学 Q1 ORTHOPEDICS

Journal of Orthopaedics and Traumatology Pub Date : 2024-07-24 DOI:10.1186/s10195-024-00775-1

Ceyran Hamoudi, Marie Hamon, Aurélie Reiter-Schatz, Pierre-Antoine Debordes, Jeannot Gaudias, Cécile Rondé-Oustau, Jean-Yves Jenny

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引用次数: 0

Abstract

Purpose: The aim of this study was to quantify the prophylactic effect of high-dose gentamicin and clindamycin antibiotic-loaded bone cement (ALBC) during revision total hip (rTHA) or knee (rTKA) arthroplasty for aseptic reasons. The hypothesis was that the raw surgical site infection (SSI) rate is lower when this particular cement is used in comparison with cement loaded with standard-dose gentamicin during rTHA or rTKA for aseptic reasons.

Methods: This retrospective study included 290 consecutive patients undergoing aseptic rTHA or rTKA. Two consecutive cohorts were defined: the first (control group) involved 145 patients where ALBC with gentamicin only was used; the second (study group) involved 145 patients where ALBC with high-dose gentamicin and clindamycin was used. The primary endpoint was the raw SSI rate after 24 months.

Results: The raw SSI rate was 8/145 (6%) in the control group and 13/145 (9%) in the study group (odds ratio 0.62, p = 0.26). There was a significant impact of the presence of any risk factor on the SSI rate (15/100 versus 6/169, odds ratio = 4.25, p = 0.002), but no significant impact of any individual risk factor. No complication or side effect related to ALBC was observed in either group.

Conclusion: These results do not support the routine use of gentamicin and clindamycin ALBC for fixation of revision implants after rTHA and rTKA for aseptic reasons.

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无菌全髋关节或膝关节翻修关节置换术后，装入大剂量庆大霉素和林可霉素的水泥并不能降低后续感染的风险：一项初步研究。

目的：本研究旨在量化高剂量庆大霉素和克林霉素抗生素骨水泥（ALBC）在无菌原因的翻修全髋（rTHA）或膝（rTKA）关节成形术中的预防效果。假设在无菌原因的翻修全髋关节置换术（rTHA）或膝关节置换术（rTKA）中使用这种特殊骨水泥与使用标准剂量庆大霉素的骨水泥相比，手术部位感染（SSI）的发生率更低：这项回顾性研究包括290名连续接受无菌rTHA或rTKA的患者。确定了两个连续队列：第一个队列（对照组）包括145名仅使用庆大霉素的ALBC患者；第二个队列（研究组）包括145名使用大剂量庆大霉素和克林霉素的ALBC患者。主要终点是 24 个月后的原始 SSI 感染率：对照组的原始 SSI 感染率为 8/145（6%），研究组为 13/145（9%）（几率比 0.62，P = 0.26）。任何风险因素的存在都会对 SSI 感染率产生重大影响（15/100 对 6/169，几率比 = 4.25，p = 0.002），但任何单个风险因素都不会产生重大影响。两组患者均未观察到与ALBC相关的并发症或副作用：这些结果不支持常规使用庆大霉素和克林霉素ALBC固定rTHA和rTKA术后因无菌原因而翻修的植入物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Orthopaedics and Traumatology Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

审稿时长

13 weeks

期刊介绍： The Journal of Orthopaedics and Traumatology, the official open access peer-reviewed journal of the Italian Society of Orthopaedics and Traumatology, publishes original papers reporting basic or clinical research in the field of orthopaedic and traumatologic surgery, as well as systematic reviews, brief communications, case reports and letters to the Editor. Narrative instructional reviews and commentaries to original articles may be commissioned by Editors from eminent colleagues. The Journal of Orthopaedics and Traumatology aims to be an international forum for the communication and exchange of ideas concerning the various aspects of orthopaedics and musculoskeletal trauma.