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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="other" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Traumatology and Orthopedics of Russia</journal-id><journal-title-group><journal-title xml:lang="en">Traumatology and Orthopedics of Russia</journal-title><trans-title-group xml:lang="ru"><trans-title>Травматология и ортопедия России</trans-title></trans-title-group></journal-title-group><issn publication-format="print">2311-2905</issn><issn publication-format="electronic">2542-0933</issn><publisher><publisher-name xml:lang="en">Vreden National Medical Research Center of Traumatology and Orthopedics</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">1322</article-id><article-id pub-id-type="doi">10.21823/2311-2905-2019-25-4-64-74</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Reviews</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Обзоры</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="zh"><subject>Reviews</subject></subj-group><subj-group subj-group-type="article-type"><subject></subject></subj-group></article-categories><title-group><article-title xml:lang="en">Local Antibacterial Implant Protection in Orthopedics and Trauma: What’s New?</article-title><trans-title-group xml:lang="ru"><trans-title>Применение имплантатов с антибактериальным покрытием в ортопедии и травматологии: современное состояние проблемы</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Romanò</surname><given-names>C. L.</given-names></name><name xml:lang="ru"><surname>Романо</surname><given-names>К. Л.</given-names></name></name-alternatives><address><country country="IT">Italy</country></address><bio xml:lang="en"><p>Carlo Luca Romanò — MD, Orthopaedic Consultant</p><p>Milan</p><p>Director </p><p>Tirane, Albania</p></bio><bio xml:lang="ru"><p>MD, Orthopaedic Consultant</p><p>Milan, Italy;</p><p>Director</p><p>Tirane, Albania</p></bio><email>carlo.romano@unimi.it</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Bozhkova</surname><given-names>S. A.</given-names></name><name xml:lang="ru"><surname>Божкова</surname><given-names>С. А.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Svelana Bozhkova — Dr. Sci. (Med.), Head of the Research Department of Prevention and Treatment of Wound Infection and Department of Clinical Pharmacology</p><p>St. Petersburg</p></bio><bio xml:lang="ru"><p>Dr. Sci. (Med.), Head of the Research Department of Prevention and Treatment of Wound Infection and Department of Clinical Pharmacology</p><p>St. Petersburg</p></bio><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Artyukh</surname><given-names>V.</given-names></name><name xml:lang="ru"><surname>Артюх</surname><given-names>В.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Vasilii Artyukh — Cand. Sci. (Med.), Head of Department</p><p>St. Petersburg</p></bio><bio xml:lang="ru"><p>Cand. Sci. (Med.), Head of Department</p><p>St. Petersburg</p></bio><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Romanò</surname><given-names>D.</given-names></name><name xml:lang="ru"><surname>Романо</surname><given-names>Д.</given-names></name></name-alternatives><address><country country="IT">Italy</country></address><bio xml:lang="en"><p>Delia Romanò — MD, Consultant</p><p>Milan</p></bio><bio xml:lang="ru"><p>MD, Consultant</p><p>Milan</p></bio><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Tsuchiya</surname><given-names>H.</given-names></name><name xml:lang="ru"><surname>Цучия</surname><given-names>Х.</given-names></name></name-alternatives><address><country country="JP">Japan</country></address><bio xml:lang="en"><p>Hiroyuki Tsuchiya — MD, PhD, Professor and Chairman, Department of Orthopaedic Surgery</p><p>Kanazawa</p></bio><bio xml:lang="ru"><p>MD, PhD, Professor and Chairman, Department of Orthopaedic Surgery</p><p>Канадзава</p></bio><xref ref-type="aff" rid="aff4"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Drago</surname><given-names>L.</given-names></name><name xml:lang="ru"><surname>Драго</surname><given-names>Л.</given-names></name></name-alternatives><address><country country="IT">Italy</country></address><bio xml:lang="en"><p>Lorenzo Drago — PhD, Professor, Clinical Microbiology Department of Biomedical Sciences for Health</p><p>Milan</p></bio><bio xml:lang="ru"><p>Факультет клинической микробиологии </p><p>PhD, Professor, Clinical Microbiology Department of Biomedical Sciences for Health</p><p>Milan</p></bio><xref ref-type="aff" rid="aff5"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Studio Medico Associato Cecca-Romanò,&#13;
Romano Institute</institution></aff><aff><institution xml:lang="ru">Медицинская клиника Cecca-Romanò&#13;
Медицинская клиника Romano Institute</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Vreden Russian Research Institute of Traumatology and Orthopedics</institution></aff><aff><institution xml:lang="ru">ФГБУ «Российский научно-исследовательский институт травматологии и ортопедии им. Р.Р. Вредена» Минздрава России</institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="en">Studio Medico Associato Cecca-Romanò</institution></aff><aff><institution xml:lang="ru">Медицинская клиника Cecca-Romanò</institution></aff></aff-alternatives><aff-alternatives id="aff4"><aff><institution xml:lang="en">Graduate School of Medical Sciences, Kanazawa University</institution></aff><aff><institution xml:lang="ru">Высшая школа медицины, Университет Канадзавы</institution></aff></aff-alternatives><aff-alternatives id="aff5"><aff><institution xml:lang="en">University of Milan</institution></aff><aff><institution xml:lang="ru">Миланский университет</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2019-12-23" publication-format="electronic"><day>23</day><month>12</month><year>2019</year></pub-date><volume>25</volume><issue>4</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>64</fpage><lpage>74</lpage><history><date date-type="received" iso-8601-date="2019-11-06"><day>06</day><month>11</month><year>2019</year></date><date date-type="accepted" iso-8601-date="2019-11-06"><day>06</day><month>11</month><year>2019</year></date></history><permissions><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/></permissions><self-uri xlink:href="https://journal.rniito.org/jour/article/view/1322">https://journal.rniito.org/jour/article/view/1322</self-uri><abstract xml:lang="en"><p>Current prophylactic and hygienic measures notwithstanding, implant-related infection remains among leading reasons for failure in orthopaedics and trauma surgery, resulting in extremely high social and economic costs. Various antibacterial coating technologies have been proven safe and effective both in preclinical and in clinical settings and able to reduce post-surgical infections up to 90%, depending on the type of the coating and on the experimental setup. In spite of this findings, the widespread use of these technologies is still limited by several factors. After reviewing the latest evidence on currently available antibacterial coatings, an algorithm is proposed to calculate the impact of the delayed introduction of these technologies in the clinical practice. When applied to joint arthroplasties, our calculator shows that each year of delay to implement an antibacterial coating, able to reduce post-surgical infection by 80% at a final user’s cost price of €600, causes an estimated 35 200 new cases of periprosthetic joint infection in Europe and additional annual hospital costs of approximately €440 million. Faster and more affordable regulatory pathways for antibacterial coating technologies and an adequate reimbursement policy for their clinical use appear a feasible solution to mitigate the impact of implant-related infections and may benefit patients, healthcare systems, and related research.</p><p>All patients provided written informed consent.</p><p>Competing interests: the authors declare that there are no competing interests.</p></abstract><trans-abstract xml:lang="ru"><p>Несмотря на современные достижения профилактики и гигиены, имплант-ассоциированная инфекция остается одной из основных причин несостоятельных результатов ортопедических и травматологических вмешательств, что приводит к чрезвычайно высоким социальным и экономическим издержкам. Различные технологии антибактериального покрытия имплантатов зарекомендовали себя как безопасное и эффективное решение проблемы инфицирования в процессе как доклинических исследований, так и в клинической практике, что способствует снижению частоты послеоперационной инфекции до 90% в зависимости от типа покрытия и условий использования. Несмотря на такие выводы, широкое внедрение подобных технологий по-прежнему ограничено несколькими факторами. Изучив наиболее актуальные данные по доступным антибактериальным покрытиям, авторы предлагают алгоритм для расчета влияния несвоевременного внедрения таких технологий в клиническую практику. Применение предлагаемого калькулятора к операциям по эндопротезированию суставов демонстрирует, что каждый год отсрочки внедрения антибактериальных покрытий, который позволил бы снизить частоту послеоперационной инфекции на 80% при стоимости для конечного пользователя в размере 600 евро, приведет примерно к 35 200 новых случаев возникновения перипротезной инфекции в странах Европы и к дополнительным ежегодным госпитальным расходам в размере около 440 млн евро. Ускоренные и более доступные с точки зрения затрат процессы нормативного регулирования в отношении технологий антибактериального покрытия имплантатов, а также адекватная политика возмещения расходов по клиническому использованию таких технологий представляются возможным решением для снижения частоты имплант-ассоциированной инфекции, улучшения качества лечения пациентов, снижения нагрузки на систему здравоохранения и для стимулирования научных изысканий.</p></trans-abstract><kwd-group xml:lang="en"><kwd>infection</kwd><kwd>prosthesis</kwd><kwd>implant coating</kwd><kwd>periprosthetic joint infection</kwd><kwd>PJI</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>эндопротезирование</kwd><kwd>имплантаты</kwd><kwd>антибактериальное покрытие</kwd><kwd>перипротезная инфекция</kwd><kwd>расходы на лечение</kwd></kwd-group><funding-group><funding-statement xml:lang="en">no funding or sponsorship was received for this study or publication of this article.</funding-statement></funding-group></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>1. 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