Background
Methods
Patients and inclusion criteria
Clinical and functional follow-up
End points and definitions
Surgical treatment
Antibiotic combination | Patients (N) |
---|---|
Gentamicin | 8 |
Gentamicin/vancomycin | 5 |
Gentamicin/vancomycin/clindamycin | 23 |
Gentamicin/clindamycin | 8 |
Gentamicin/clindamycin/vancomycin/voriconazole | 1 |
Gentamicin/clindamycin/vancomycin/meropenem | 1 |
Gentamicin/clindamycin/daptomycin | 1 |
None | 2 |
Acetabular reconstruction | Patients (N) |
---|---|
Dual mobility cup | 22 |
Bipolar head | 4 |
Constrained cup | 5 |
Standard cup | 4 |
Cage + dual mobility cup | 13 |
Cage + constrained cup | 1 |
Statistical analysis
Results
Diagnosis of periprosthetic infections and microorganisms
Microorganism | Patients (N) |
---|---|
Acinetobacter baumannii complex | 1 |
Candida albicans
| 1 |
Corynebacteria | 2 |
Enterobacter cloacae
| 2 |
Enterococcus faecalis
| 8 (1 VRE) |
Enterococcus faecium
| 1 |
Escherichia coli
| 4 |
Peptococcus species | 1 |
Propionibacteria | 1 |
Proteus mirabilis
| 2 |
Pseudomonas aeruginosa
| 3 |
Pseudomonas fluorescens
| 1 |
Salmonella species | 1 |
Serratia marcescens
| 1 |
Staphylococcus aureus
| 10 (5 MRSA) |
Staphylococcus capitis
| 1 |
Staphylococcus epidermidis
| 18 |
Staphylococcus haemolyticus
| 2 |
Staphylococcus hominis
| 1 |
Sterile | 5 |
Streptococcus agalactiae
| 1 |
Patients with two species | 8 |
Patients with three species | 3 |
Patients with four species | 1 |
Infection therapy
Complications
Comorbidities and previous operations
Patient no., sex, age | History | Comorbidities | Bacterium | Spacer interval (days) | Complications | Time of reinfection (months) |
---|---|---|---|---|---|---|
1, F, 75 | Arthroplasty in case of avascular necrosis of the femur head | – |
S. epidermidis
| 34 | 21 | |
2, F, 69 | Periprosthetic hip fracture and stem revision | Diabetes mellitus, anticoagulation, obesity |
S. epidermidis
| 78 | 29 | |
3, F, 65 | Osteosynthesis after neck fracture; secondary arthroplasty; stem exchange after loosening | Obesity, anticoagulation |
Propionibacterium avium
| 84 | 23 | |
4, F, 68 | Cup exchange after loosening of primary arthroplasty | Chronic venous insufficiency |
S. epidermidis
| 139 | 37 |
Comorbidity | Patients (N) |
---|---|
Anticoagulation | 12 |
Obesity (body mass index > 30) | 12 |
Renal insufficiency | 6 |
Type 2 diabetes mellitus | 4 |
Cancer | 4 |
Cardiac insufficiency | 3 |
Cirrhosis of the liver | 1 |
Hepatitis B/C | 2 |
Multiple sclerosis | 1 |
Amyotrophic lateral sclerosis | 1 |
Rheumatoid arthritis | 1 |
Bacterial inflammation | 6 |
Chronic venous insufficiency | |
Patients with more than one comorbidity | 13 |
Functional results
Results | Patients (N) |
---|---|
Excellent (90–100) | 3 |
Good (80–89) | 6 |
Fair (70–79) | 7 |
Poor (60–69) | 19 |
Poor (< 60) | 5 |