PJI TREATMENT WITH IMPLANT REPLACEMENT AND LOCAL CALCIUM PHOSPHATE + HA ANTIBIOTIC CARRIER: SHORT TERM RESULTS FROM A SINGLE CENTER

Brioschi D¹, Moretti F, Larghi M, Manzotti A¹

¹Ospedale L Sacco, Milano, , Italy

Aim: PJI treatment still represents a high challenge in orthopedic surgery. Many efforts are still tried to increase the chances of success in revision surgery. We tried to apply the concepts of local device antibiotic carriers and bone growth induction materials even in a small case series of PJI.

 

Method: We present short term results of the use of a Calcium Sulphate + Hydroxyapatite carrier added with antibiotic used over revision implants and ORIF plates in PJI revision surgery. Patients treated were 5 (2 M 3 F), mean age 67.4. Surgery treatments were 2 THA revisions, 3 TKR revisions (1 associated with periprosthetic fracture ORIF). Clinical and local follow up was performed at 12 months.

 

Results: At 12 months follow up we registered no failure among all the implants with no signs of early loosening at X rays. 1 patient was submitted to local revision and DAIR with removal of only 1 TTA screw for intolerance (intraoperative cultures negative). Patients were all satisfied with full regain of ADL. Follow up is still ongoing.

 

Conclusions: The treatment of PJI is still difficult due to PJI recurrency, especially in complex or repeatedly operated patients. This one of the major challenges in joint arthroplasty and the use of a local device improving both asepsis and bone ingrowth could be a valid aid and a promising technology for these patients. Longer and larger follow-up are required regarding advantages or limits even in terms of cost.