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Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_17 | Pages 77 - 77
1 Dec 2018
Pesch S Kirchhoff C van Griensven M Biberthaler P Hanschen M Huber-Wagner S
Full Access

Aim

The current treatment concepts of acute and chronic osteomyelitis are associated with unsolved challenges and problems, underlining the need for ongoing medical research. The invention and prevalence of an absorbable, gentamicin-loaded ceramic bone graft, that is well injectable for orthopedic trauma and bone infections, enlarges the treatment scope regarding the rise of posttraumatic deep bony infections. This substance can be used either for infection, dead-space, or reconstruction management. The bone cement, eluting antibiotics continuously to the surrounding tissue, outperforms the intravenous antibiotic therapy and enhances the local concentration levels efficiently. This study aims to evaluate the power and practicability of bone cement in several locations of bony infections.

Method

The occurrence of posttraumatic infections with acute or chronic osteomyelitis increases in trauma surgery along with progression of high impact injuries and consecutively high incidence of e.g. open fractures. We present a case-series of 33 patients (18w/15m; 56,8±19,4 years) with posttraumatic osteomyelitis at different anatomic sites, who were treated in our level I trauma center. All of these patients received antibiotic eluting bone cement (Cerement® G) for infection and reconstruction management.


Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_22 | Pages 79 - 79
1 Dec 2017
Huber-Wagner S Pesch S Kirchhoff C Griensven M Biberthaler P Hanschen M
Full Access

Aim

The current treatment concepts of acute and chronic osteitis are associated with unsolved challenges and problems, underlining the need for ongoing medical research. The invention and prevalence of an absorbable, gentamicin-loaded ceramic bone graft, that is well injectable for orthopedic trauma and bone infections, enlarges the treatment scope regarding the rise of posttraumatic deep bone infections. This substance can be used either for infection, dead-space, or reconstruction management. The bone cement, eluting antibiotics continuously to the surrounding tissue, outperforms the intravenous antibiotic therapy and enhances the local concentration levels efficiently. This study aims to evaluate the power and practicability of bone cement in several locations of bone infections.

Method

The occurrence of posttraumatic infections with acute or chronic osteitis increases in trauma surgery along with progression of high impact injuries and consecutively high incidence of e.g. open fractures. We present a case-series of 10 patients with posttraumatic osteitis at different anatomic sites, who were treated in our level I trauma center. All of these patients received antibiotic eluting bone cement* for infection and reconstruction management.


Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_II | Pages 315 - 315
1 May 2010
Mayer W Wagner S Linke R Maegerlein S Jansson V Mueller P
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Introduction: Arthroplasty plays a growing role in our society today. Due to scientific and medical progress there are an increasing number of viable candidates and the improvement of quality of life thereafter speaks for itself.

Even though the operations are largely successful, complications after joint replacement surgery occur frequently. Approximately 10% of lower limb arthroplasties need surgical revision, of which 70% are due to loosening. The purpose of this study was to assess the feasibility of 18-fluorodeoxyglucose positron emission tomography (18FFDG–PET) in detecting septic and aseptic endoprosthetic loosening of hip and knee endoprostheses.

Materials and Methods: Thirty-three patients (age range: 45–90y) with lower limb arthroplasty complaints (74 prostheses) were studied preoperatively with 18F-FDG-PET. All patients underwent surgery at a later stage with microbiological culturing to differentiate aseptic and septic loosening and to confirm the final diagnosis. Prostheses were tested intraoperatively for stability and microbiology.

Results: The sensitivity/specificity of 18F-FDG-PET towards implant loosening in the hip was 80%/87%, in the knee 56%/82%.

The sensitivity/specificity for infectious loosening in hip replacement arthroplasties was 67%/83%, in the knee 14%/89%.

Discussion: 18F-FDG-PET seems an excellent method for detecting hip endoprosthetic loosening and a moderate tool to diagnose hip implant infection. It should not be seen as the method of choice to diagnose knee endoprosthetic loosening and infection.


Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_I | Pages 176 - 176
1 Mar 2009
Mayer W Wagner S Linke R Maegerlein S Jansson V Müller P
Full Access

Introduction: Arthroplasty plays a growing role in our society today. Due to scientific and medical progress there are an increasing number of viable candidates and the improvement of quality of life thereafter speaks for itself.

Even though the operations are largely successful, complications after joint replacement surgery occur frequently. Approximately 10% of lower limb arthroplasties need surgical revision, of which 70% are due to loosening. The purpose of this study was to assess the feasibility of 18-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) in detecting septic and aseptic endoprosthetic loosening of hip and knee endoprostheses.

Materials and Methods: Thirty-three patients (age range: 45 – 90y) with lower limb arthroplasty complaints (74 prostheses) were studied preoperatively with 18F-FDG-PET. All patients underwent surgery at a later stage with microbiological culturing to differentiate aseptic and septic loosening and to confirm the final diagnosis. Prostheses were tested intraoperatively for stability and microbiology.

Results: The sensitivity/specificity of 18F-FDG-PET towards implant loosening in the hip was 80%/87%, in the knee 56%/82%.

The sensitivity/specificity for infectious loosening in hip replacement arthroplasties was 67%/83%, in the knee 14%/89%.

Discussion: 18F-FDG-PET seems an excellent method for detecting hip endoprosthetic loosening and a moderate tool to diagnose hip implant infection. It should not be seen as the method of choice to diagnose knee endoprosthetic loosening and infection.