Abstract
From 1992 on 2008, 615/515 patients underwent primary or revisional endoprosthetic replacement of major joints. In 51 patients (31 men & 20 women) modular system MUTARS (Implantcast, Germany) has been used. The median age was 23.3 years (15 to 52 years).
MUTARS modular endoprosthesis has been used in 10 patients with deep infection of endoprosthetic bed as a revisional endoprosthetic replacement: 1 Total endoprosthetic replacement of femur, 5 Total knee joint replacement (2 for distal femoral defect and 3 for proximal tibial defect). In 3(27%) patients, we used newly patented silver ion coated MUTARS either after two stage treatment for infection of endoprosthetic bed or as a prophylaxis of endoprosthetic infection.
In 1 patient (23 yrs), with 12cm limb length shortening, we used extensible MUTARS as a revisional endoprosthetic replacement.
The following complications we observed: Instability of endoprosthesis – 3/51 (5.9%), deep endoprosthetic bed infection – 4/51 (7.8%).
In comparison group, when using custom-made endoprosthesis, the frequency of infectious complications have made 60/574 (10.5 %), and instability of implants was observed in 79/574 (13.8 %) cases.
Transition of using modular systems for primary and revisional endoprosthesis allows to reduce the level of instability from 13.8 % to 5.9 %. The quantity of infectious complications is also not great as in comparison with control group. For revisional endoprosthetic replacement, we think, the given modular system is optimal, for correcting limb length deficiency and restoration of basic function at patients. Use of silver ion coated modular implants is a promising method for treating deep endoprosthetic bed infection.
Correspondence should be addressed to Professor Stefan Bielack, Olgahospital, Klinikum Stuttgart, Bismarkstrasse 8, D-70176 Stuttgart, Germany. Email: s.bielack@klinikum_stuttgart.de
