Abstract
Background
The aim of the study was to analyze effectiveness and safety of packing the medullary canal of the tibia and femur with Herafill (Heraeus Medical GmbH, Wehrheim, Germany), a void filler and antibiotic carrier, during second stage revision total knee arthroplasty(TKA) for periprosthetic joint infection (PJI). We used hybrid cementation technique for the fixation of TKA components with antibiotic-loaded bone cement for femoral and tibial component and cementless stem extensions.
Methods
Two groups of 27 consecutive patients each were matched for gender and age. The study group received Herafill, while the control group did not. Otherwise, the treatment protocol remained the same for both groups. The average follow-up was 48 months (minimum of 34 months).
Results
No reinfections were observed in the study group, while three were seen in the control group. No other differenceswere observed between the study and control groups, including clinical Knee Society Score (59.4 and 58.6 points, respectively) and functional Knee Society Score(63.5 and 60.6 points respectively). No side effects related to the use of Herafill beads were noted. Radiologically, all of the beads incorporated into the host bone.
Conclusions
Herafill packed into the tibial and femoral intramedullary canal during second stage of septic revision TKA seems to be a reliable bone substitute. It may reduce the infection recurrence rate. IT incorporates well into the host bone. Despite technical and surgical advances in the field of revision TKA, patients suffering from PJI should not expect good and very good results after second stage revision TKA.
