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Orthopaedic Proceedings
Vol. 106-B, Issue SUPP_19 | Pages 14 - 14
22 Nov 2024
Gómez MM Guembe M Díaz-Navarro M Peinado LP Matas-Díaz J Ruiz PS
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Aim

Chemical debridement is a fundamental step during Periprosthetic joint infection (PJI) surgery. Antiseptic solutions are commonly used, but evidence on the optimal antiseptic, concentration, and irrigation time is lacking. The aim of this study is to analyze and compare the anti-biofilm capacity of povidone iodine, H202, acetic acid and Bactisure™ after different exposure times, as well as their combinations.

Method

Surgical steel discs inoculated with methicillin susceptible (MSSA) and resistant S. aureus (MRSA), P. aeruginosa, and S. epidermidis were exposed to the following antiseptic solutions: 0.3% (PI0.3) and 10% povidone iodine (PI10), H202, 3% Acetic acid (AA3) and Bactisure™. Combinations included AA3, H202, and PI10 in various orders. Exposure time for the antiseptics solutions was 1, 3 and 5 minutes, while combinations had a 9-minute total exposure, 3 minutes per antiseptic sequentially. All experiments were performed in triplicate and with a sterile saline control. nThe reduction in colony-forming units (CFU) was measured after sonication, and biofilm structure was analyzed via scanning electron microscopy.


Orthopaedic Proceedings
Vol. 105-B, Issue SUPP_17 | Pages 7 - 7
24 Nov 2023
Martos MS Boadas L Trebse R Marais L Ruiz PS Vaznaisiene D Grenho A Ferrari MC Soriano A
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Aim

Two-stage replacement is a frequent procedure in patients with chronic PJI. However, results in the literature after this procedure differ, ranging from 54% to 100% of infection eradication. Positive cultures at reimplantation, when performing the second stage, are perceived as a risk factor for reinfection. This study aims to determine the impact of positive cultures during the second stage on the outcome of patients undergoing a 2-stage septic replacement and the impact of antibiotic holidays between the first and the second stage.

Method

We systematically searched four databases from inception to May 31, 2022. We combined terms related to PJI, joint replacement and culture results. We analysed the risk of failure when positive cultures at second stage and performed a subgroup analysis by antibiotic holiday period.


Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_14 | Pages 76 - 76
1 Dec 2019
Torres IL Ruiz PS Matas-Díaz J Fraguas A Navarro-García F Vaquero J
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Aim

The demonstration of the in vivo bactericidal efficacy of a new bone cement with rifampicin contained in microcapsules and its intra-articular release profile.

Method

Fifteen New Zealand White rabbits were employed to reproduce periprosthetic infection by intra-articular inoculation of 105 CFU/mL of Staphylococcus aureus ATCC® 29213 using as a target implant a 3D printed stainless steel tibial insert. 7 days after inoculation, the first stage of the two stage exchange was carried out and at this time the animals were divided into two study groups: group C (7 rabbits) that received a spacer with gentamicin and group R (8 rabbits) that received a spacer with gentamicin and rifampicin microcapsules. Response to infection was monitored by clinical (weight and temperature), hematological (leukocyte, lymphocyte and platelet counts) and biochemical (erythrocyte sedimentation rate) analyses at the time of inoculation, at the first stage of exchange, 4 days after first stage and weekly until the fourth week when animals were euthanized. Microbiological counts were performed at the first stage of exchange and at the end of the study.