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Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_22 | Pages 44 - 44
1 Dec 2017
Sigmund IK Gamper J Weber C Holinka J Funovics P Windhager R
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Aim

Periprosthetic joint infections are a devastating complication after modular endoprosthetic reconstruction following resection of a musculoskeletal tumour. Due to long operating times, soft tissue dissection and immunosuppression, the infection rate after limb salvage is high and ranges between 8% and 15%. The aim of this retrospective single centre study was to assess the reinfection and re-reinfection rate after septic complications of megaprostheses.

Method

In this retrospective study, 627 patients with a primary replacement of a musculoskeletal tumour of the lower limb and reconstruction by a megaprosthesis were recorded from 1983 – 2016. 83 out of 621 patients available for follow-up experienced an infection (13.4%). Two patients were treated with debridement and removal of the mobile parts, 61 patients with a one-stage revision, 16 patients with a two-stage revision, and 4 patients with an amputation. The mean follow up was 133 months (range: 2 – 423 months).


Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_23 | Pages 6 - 6
1 Dec 2016
Sigmund IK Holinka J Gamper J Staats K Böhler C Kubista B Windhager R
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Aim

Quantitative assessment of alpha-Defensin offers a promising approach for diagnosing a periprosthetic joint infection (PJI) with sensitivities and specificities ranging from 97% to 100% and 95% to 100%, respectively. However, to the best of our knowledge and after due inquiry little information exists concerning qualitative measurements of alpha-Defensin. The aim of this study was to assess the diagnostic accuracy of the alpha-Defensin test, a lateral flow test for the qualitative detection of alpha-Defensin.

Method

In this study, 50 patient with indicated revision surgery met the inclusion criteria due to septic or aseptic loosening. In addition to clinical standard diagnostics of PJI, the alpha-Defensin test* for the assessment of the qualitative alpha-Defensin in the synovial fluid was performed. The results were compared with the sensitivity and specificity of currently available clinical tests, specifically C-reactive protein (CRP), frozen section, definitive histology, bacteriology and sonication.