The primary endpoint of this study is to characterize the progression of bone defects at the femoral and tibial side in patients who sustained PJI of the knee that underwent two-stage revision with spacer implantation. In addition, we want to analyze the differences between functional moulded and hand-made spacers. A retrospective analysis of patients that underwent two-stage revision due to PJI of the knee between January 2014 and December 2021 at our institution. Diagnosis of infection was based on the criteria of the Muscoloskeletal Infection Society. The bone defect evaluation was performed intraoperatively based on the Aim
Methods
The aim of this study is to evaluate if the gentamycin elution from bone cement is influenced by the timing of application of the antibiotic powder. This was an experimental in vitro study that compared the elution properties of different formulation of gentamycin from a commercially available hip, knee and shoulder cement spacers. Four different experimental models were prepared. Five different spacers were prepared for each experimental mode and for each joint. We compared four different formulation of cement spacers: spacer #1, in which the spacer was prepared with a premixed bone-cement antibiotic mixture; spacer #2, in which the spacer was prepared by adding antibiotic powder to the bone cement at the time of spacer preparation; spacer #3, in which the spacer was prepared as spacer #2 but was stored for two months before starting the experiment; spacer #4, in addition to the gentamycin, other two antibiotics (tobramycin and vancomycin) were added to the bone cement. Gentamycin concentration was documented at seven intervals of time: T0 = 0h, T1 = 1h, T2 = 24h, T3 = 1W, T4 = 2W, T5 = 1M, T6 = 3M and T7 = 6M. The gentamycin elution at each interval of time was evaluated by using a T-student test.Aim
Method
Periprosthetic joint infections (PJI) are a severe complications after hip arthroplasty. The infections rate ranges from 0.7 to 1.3 depending on different reports. The aim of the present study is to evaluate the radiological and clinical outcome of patients that underwent two-stage revision for the treatment of periprosthetic joint infection of the hip when an extended trochanteric osteotomy (ETO) was necessary to remove the femoral stem. We retrospectively analyzed data from 84 patients that underwent two-stage revision of the hip between January 2006 and December 2010 at our institution. In forty-nine patients (Group A, 58.3%), the femoral stem was removed without an ETO, while in the remaining thirty-five patients (Group B, 41.7%) an ETO was necessary. In each case a metallic cerclage was used to closure of the flap. The average age for patients in group A was 64.3 years, while the average age in patients in group B was 66.4 years. The mean follow-up was respectively 117 months in group A and 122 months in group B. Eight patients died before the last follow-up, and data from six patients were incomplete. Complications, radiological and clinical outcome were. Mann Whitney U Test and Chi Square Test were used respectively to analyze continues and categorical variables. Cumulative survival of the implants was calculated for reinfection and mechanical complications with Kaplan-Meyer curves.Aim
Methods
