Megaprosthesis have become a standard option in limb preserving surgery after bone resection in musculoskeletal tumors. Recently they have also been used in complex revision arthroplasty in cases with massive bone loss. The aim of this study was to analyze the incidence of periprosthetic joint infection (PJI) both in primary oncology cases and aseptic revision cases and analyze which are the significant risk factors for PJI with a special interest on the use of prophylactic antibiotic loaded calcium sulfate beads All patients undergoing surgery with the use of megaprosthesis in our institution between January/2012 and December/2022 were retrospectively reviewed. Data was collected from electronic medical records. We identified 108 procedures involving megaprosthesis in 90 patients with an average follow-up of 37 months. Indications were 79 primary musculoskeletal tumors and 29 aseptic complex revision arthroplasty.Aim
Method
Debridement, antibiotics and implant retention (DAIR) is recommended for acute postoperative and late acute prosthetic joint infection (PJI). There are two recommend scores to predict its outcome, KLIC and CRIME 80 scores respectively. They have not been widely adopted for decision making. We aim to evaluate them in predicting DAIR failure in our cohort. All patients submitted to DAIR after total hip or knee PJI, between 2010 and 2021, with a minimum one-year follow-up, were retrospectively evaluated. We excluded tumoral total joint replacements. KLIC score was applied to acute PJIs and CRIME 80 to late acute (LA) PJI. LA PJI was defined as the development of acute symptoms occurring ≥ 3 months after implantation. Repeat DAIR was performed as needed. Failure was defined as the need for implant removal, amputation, infection related death and suppressive antibiotic therapy.Aim
Method
