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Periprosthetic joint infections in femoral neck fracture patients treated with hemiarthroplasty–should we use antibiotic-loaded bone cement?

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World Journal of Orthopedics 2022年第2期13卷 150-159页

作者： Diana Crego-Vita Daniel Aedo-Martín Rafael Garcia-Cañas Andrea Espigares-Correa Coral Sánchez-Pérez Christof Ernst Berberich Department of Orthopaedic and Trauma Surgery Hospital Central de la Defensa Gómez UllaMadrid 28047Spain Department of Orthopaedic and Trauma Surgery Hospital Universitario del HenaresUniversidad Francisco de VitoriaCoslada 28822MadridSpain Department of Orthopeadic and Trauma Surgery Hospital Central de la Defensa Gómez UllaMadrid 28047Spain Department of Orthopeadic and Trauma Surgery General University Hospital Gregorio MaranonMadrid 28007Spain Department of Medical Training Heraeus Medical GmbHWehrheim 612173HessenGermany

BACKGROUND Hemiarthroplasty is the most common treatment in elderly patients with displaced intra-capsular femoral neck fracture(FNF).Prosthetic joint infection(PJI)is one of the most feared and frequent complications post-surgery because of the frail health status of these patients and the need for fast track ***,priorities should lie in effective preventive strategies to mitigate this *** To determine how much the implementation of the routine use of antibioticloaded bone cement(ALBC)as a relatively easy-to-apply amendment to the surgical practice reduces the infection rate in our hemiarthroplasty *** We retrospectively assessed all demographic,health status and treatment-related data of our FNF patients undergoing cemented hemiarthroplasty in the period from 2011 to 2017;241 patients were further analyzed after exclusion of patients with cancer-related sequelae and those who died before the end of the 1-year observation *** PJI rate as diagnosed on basis of the Musculoskeletal Infection Society(MSIS)criteria 2011 was determined for each included patient and compared in function of the bone cement used for hip stem *** were split into a group receiving a plain bone cement in the period from January 2011 to June 2013(non-ALBC group)and into a group receiving an ALBC in the period July 2013 to December 2017(ALBC group).Data analysis was performed with statistical *** further calculated the cost-efficacy of the implementation of routine use of ALBC in the second group balancing the inhospital infection related treatment costs with the extra costs of use of *** In total 241 FNF patients who received cemented hemiarthroplasty in the period from January 2011 to January 2017 were eligible for inclusion in this retrospective *** were 8 PJI cases identified in the ALBC group among n=94 patients,whereas 28 PJI cases were observed in the non-ALBC group among n=147 *** statistical analysis

关键词： prosthetic joint infection Femoral neck fracture patients Hemiarthroplasty Antibiotic-loaded bone cement Prophylaxis cost-efficacy

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