The use of calcium carbonate beads containing gentamicin in the second stage septic revision of total knee arthroplasty reduces reinfection rate

• Published in: The knee 2016-03, Vol.23 (2), p.322-326
• Main Authors: Marczak, Dariusz, Synder, Marek, Sibiński, Marcin, Okoń, Tomasz, Kowalczewski, Jacek
• Format: Article
• Language: English
• Subjects: Aged; Anti-Bacterial Agents - administration & dosage; Antibiotics; Arthroplasty, Replacement, Knee - adverse effects; Bacteria; Bacterial infections; Bone substitutes; Calcium; Calcium Carbonate; Canals; Cement; Drug Carriers; Female; Follow-Up Studies; Gentamicins - administration & dosage; Heraeus; Humans; Incidence; Infection; Joint surgery; Male; Middle Aged; Orthopedics; Poland - epidemiology; Postoperative period; Prosthesis-Related Infections - drug therapy; Prosthesis-Related Infections - epidemiology; Recurrence; Reoperation; Results; Retrospective Studies; Septic arthritis; Staphylococcus infections; Time Factors; Transplants & implants; Treatment
• ISSN: 0968-0160; 1873-5800
• DOI: 10.1016/j.knee.2015.12.001

Abstract Background The aim of the study was to analyze effectiveness and safety of packing the medullary canal of the tibia and femur with Herafill (Heraeus Medical GmbH, Wehrheim, Germany), a void filler and antibiotic carrier, during second stage revision total knee arthroplasty (TKA) for periprosthetic joint infection (PJI). Methods Two groups were formed of 28 consecutive patients during second stage revision TKA, comparable for gender and age. The study group received Herafill, while the control group did not. The average follow-up was 52 months (minimum 36 months). Results No reinfections were observed in the study group, while five were seen in the control group. No other differences were observed between the study and control groups, including mean clinical KSS (Knee Society score) (67.4 and 68.4 points, respectively) and functional score (72.5 and 70.5 points respectively). No side effects related to the use of Herafill beads were noted. Conclusions Herafill packed into the tibial and femoral intramedullary canal during second stage of septic revision TKA is a reliable bone substitute, may reduce recurrence of infection and incorporates well with host bone. However, results after PJI treatment are less than optimal measured by KSSs as compared to patients who do not require revision.