Abstract
INTRODUCTION
Post-operative infections following end-stage joint salvage reconstruction, tumor resection and megaprosthetic reconstruction is a major problem because of increasing infection rates in this patient cohort. The success of treatment and longevity is limited because current prosthetic composites do not decrease infection rates in these patients. Silver coating is an innovative development in the prevention of post-operative infection. Presented here is the current knowledge of the use of silver for this patient population including;
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The current knowledge of the use of silver coated prostheses for infection control,
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Concerns with ion release and toxicity,
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Present current published results and USA experience
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Discuss current regulatory issues both domestically (USA) and worldwide.
METHODS
We report the results of a comprehensive review of the technology of silver coating application to prostheses and the published clinical results of the success of decreasing the incidence of post-operative infection following tumor resection and limb salvage. The current regulatory status of silver use for orthopaedics will also be discussed.
DISCUSSION AND CONCLUSION
The potential for the use and success of silver coated megaprostheses following limb salvage and tumor resection is great importance and, based on our review shows significance in the decrease of post-operative infection without adverse issues of silver toxicity (Argyria). This option is an alternative to permanent fusion or the finality of amputation. While the majority of the regulatory world has allowed the routine use of silver coated megaprostheses for infection control, there still exists a few regulatory panels, including the US-FDA, that have yet to approve the routine use of silver coated megaprostheses for infection control following tumor resection and limb salvage.
