EVALUATION OF DEBRIDEMENT EFFECTIVENESS FOR THE TREATMENT OF PERIPROSTHETIC JOINT INFECTIONS OF THE HIP

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Abstract

Purpose - evaluation of the effectiveness of debridement in the treatment of periprosthetic infection and detection of possible factors affecting the outcome. Material and methods: Analysis of the effectiveness of treatment in 125 patients with periprosthetic infection operated at Vreden Russian Research Institute of Traumatology and Orthopedics in 2008-2012 was carried out. All patients underwent endoprosthesis-saving sanitation surgery at different times. The effectiveness of surgery was evaluated using clinical, X-ray, laboratory, and statistical methods. To estimate a subjective component, Harris and visual analog scales were used. Results: Recurrent infections after sanitation surgery were detected in 20 (15.7%) patients (Group 1). 105 (84%) patients in the follow-up of above 12 months demonstrated remission of infectious process (Group 2). Cardiovascular pathology and obesity were significantly more common in Group 1 patients (р<0.01). In 63% patients of Group 2 sanitation operation was performed within a month after primary arthroplasty, whereas in patients with relapses this figure was only 25% (р<0.01).Gram-positive bacteria dominated in the spectrum of pathogens of periprosthetic infection in both study groups, however, S. epidermidis was somewhat more common in the group with relapses. Conclusion: The time of sanitation surgery, cardiovascular diseases and bacterial species are the main risk factors leading to recurrent infections.

About the authors

B. Lyu

Vreden Russian Research Institute of Traumatology and Orthopedics

Author for correspondence.
Email: info@rniito.ru
Russian Federation

R. M. Tikhilov

Vreden Russian Research Institute of Traumatology and Orthopedics; Mechnikov Northwestern State Medical University

Email: info@rniito.org
Russian Federation

I. I. Shubnyakov

Vreden Russian Research Institute of Traumatology and Orthopedics

Email: shubnyakov@mail.ru
Russian Federation

S. A. Bozhkova

Vreden Russian Research Institute of Traumatology and Orthopedics

Email: clinpharm-rniito@yandex.ru
Russian Federation

V. A. Artyukh

Vreden Russian Research Institute of Traumatology and Orthopedics

Email: artyukhva@mail.ru
Russian Federation

A. O. Denisov

Vreden Russian Research Institute of Traumatology and Orthopedics

Email: med-03@yandex.ru
Russian Federation

References

  1. Божкова С.А., Тихилов Р.М., Разоренов В.Л., Чуприс В.Г., Петрова Т.М. Микробиологические аспекты антибактериальной терапии парапротезной инфекции, вызванной грамположительными возбудителями. Инфекции в хирургии. 2011.9(3):31-36
  2. Божкова С.А., Тихилов Р.М., Краснова М.В., Рукина А.Н. Ортопедическая имплантат-ассоциированная инфекция: ведущие возбудители, локальная резистентность и рекомендации по антибактериальной терапии. Травматология и ортопедия России. 2013; (4):5-15
  3. Материалы международной согласительной конференции по перипротезной инфекции [Proceeding of the International Consensus Conference on periprosthetic infection]. Джавад Парвизи, Торстен Герке. Перевод с англ. под ред. д.м.н., профессора Р.М. Тихилова. СПб.: РНИИТО им. Р.Р. Вредена, 2014. 355 с
  4. Преображенский П.М., Каземирский А.В., Накопия B.Б. Особенности ревизионного эндопротезирования коленного сустава после установки неартикулирующих спейсеров у пациентов с хронической глубокой параэндопротезной инфекцией. Травматология и ортопедия России. 2013; (2):159
  5. Сергиенко В.И., Бондарева И.Б. Математическая статистика в клинических исследованиях. М.: ГЭОТАР-Медицина; 2000. 256 с
  6. Тихилов Р.М., Шаповалов В.М. (ред.) Руководство по эндопротезированию тазобедренного сустава. СПб.: РНИИТО им. Р.Р. Вредена, 2008. 324 с
  7. Barberan J. Management of infections of osteoarticular prosthesis. Clin. Microbiol. Infect. 2006; 12(suppl. 3): 93-101.
  8. Berdal J.E., Skramm I., Mowinckel P., Gulbrandsen P., Bjornholt J.V. Use of rifampicin and ciprofloxacin combination therapy after surgical debridement in the treatment of early manifestation prosthetic joint infections. Clin. Microbiol. Infect. 2005; 11:843-845.
  9. Blom A.W., Brown J., Taylor A.H., Pattison G., Whitehouse S., Bannister G.C. Infection after total knee arthroplasty. J. Bone Joint Surg. Br. 2004; 86:688-691.
  10. Byren I., Bejon P., Atkins B.L. et al. One hundred and twelve infected arthroplasties treated with 'DAIR' (debridement, antibiotics and implant retention): antibiotic duration and outcome. J. Antimicrob. Chemother. 2009; 63:1264-1271.
  11. Haaker R., Senge A., Kramer J. et al. Osteomyelitis after endoprostheses. Orthopäde. 2004;33(4):P.431-438.
  12. Kurtz S., Ong K., Lau E., Mowat F., Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J. Bone Joint Surg. Am. 2007; 89:780-785.
  13. Lentino J. R. Infections associated with prosthetic knee and prosthetic hip. Curr. Infect. Dis. Rep. 2004; 6(5):388-392.
  14. Lichstein P., Gehrke T., Lombardi A. et al. One-stage vs two-stage exchange. J. Arthroplasty. 2014;29 (2 Suppl):108-111.
  15. Lidgren L., Knutson K., Stefansdottir A. Infection and arthritis. Infection of prosthetic joints. Best Pract. Res. Clin. Rheumatol. 2003; 17:209-218.
  16. Lie S.A., Havelin L.I., Furnes O.N., Engesaeter L.B., Vollset S.E. Failure rates for 4762 revision total hip arthroplasties in the Norwegian Arthroplasty Register. J. Bone Joint Surg. Br. 2004;86(4):504-509.
  17. Meehan A.M., Osmon D.R., Duffy M.C., Hanssen A.D., Keating M.R. Outcome of penicillin-susceptible streptococcal prosthetic joint infection treated with debridement and retention of the prosthesis. Clin. Infect. Dis. 2003; 36:845-849.
  18. Ong K.L., Kurtz S.M., Lau E., Bozic K.J., Berry D.J., Parvizi J. Prosthetic joint infection risk after total hip arthroplasty in the Medicare population. J. Arthroplasty. 2009;24 (6 Suppl.):105-109.
  19. Raja A.F., Furqan A., Inshad A. Kh. et al. Antistaphylococcal and biofilm inhibitory activities of acetyl-11-keto-β-boswellic acid from Boswellia serrata. BMC Microbiology. 2011; 11:1-9.
  20. Rao R.S., Karthika R.U., Singh S.P., Shashikala P., Kanungo R., Jayachandran S., Prashanth K. Correlation between biofilm production and multiple drug resistance in imipenem resistant clinical isolates of Acinetobacter baumannii. Ind. J. Med. Microbiol. 2008;26(4):333-337.
  21. Tsukayama D.T., Estrada R., Gustilo R.B. Infection after total hip arthroplasty. A study of the treatment of one hundred and six infections. J. Bone Joint Surg. Am. 1996; 78: 512-523.
  22. U.K. Health Protection Agency, 2008. Surgical Site Infection - National aggregated data on Surgical Site Infections for hospitals that have participated in Surgical Site Infection Surveillance Scheme (SSISS) between October 1997 and December 2005. http:// www.hpa.org.uk/HPA/Topics/ InfectiousDiseases/ InfectionsAZ/1202115536296/.
  23. Zimmerli W., Trampuz A., Ochsner P. Prosthetic-joint infections. N. Engl. J. Med. 2004; 351:1645-1654.
  24. Zimmerli W., Trampuz A., Biomaterials-associated infection: a perspective from the clinic. In: Biomaterials associated infection: immunological aspects and antimicrobial strategies. Moriarty T.F., Zaat S.A.J., Busscher H. (eds.). NY, Heidelberg Dordrecht, London: Springer; 2013. p. 3-24.

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