Document Detail


Vancomycin-supplemented impacted bone allografts in infected hip arthroplasty. Two-stage revision results.
MedLine Citation:
PMID:  15773637     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Bone allografts can store and release high levels of vancomycin. We present our results of a two-stage treatment for infected hip arthroplasty with acetabular and femoral impaction grafting using vancomycin-loaded allografts. We treated 29 patients (30 hips) by removal of the implants, meticulous debridement, parenteral antibiotic therapy and second-stage reconstruction using vancomycin-supplemented impacted bone allografts and a standard, cemented Charnley femoral component. The mean follow-up was 32.4 months (24 to 60). Infection control was obtained in 29 cases (re-infection rate of 3.3%; 95% confidence interval 0.08 to 17) without evidence of progressive radiolucent lines, demarcation or graft resorption. One patient had a further infection ten months after revision caused by a different pathogen. Associated post-operative complications were one traumatic periprosthetic fracture at 14 months, a single dislocation in two hips and four displacements of the greater trochanter. Vancomycin-supplemented allografts restored bone stock and provided sound fixation with a low incidence of further infection.
Authors:
M A Buttaro; R Pusso; F Piccaluga
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of bone and joint surgery. British volume     Volume:  87     ISSN:  0301-620X     ISO Abbreviation:  J Bone Joint Surg Br     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-03-18     Completed Date:  2005-03-29     Revised Date:  2010-11-10    
Medline Journal Info:
Nlm Unique ID:  0375355     Medline TA:  J Bone Joint Surg Br     Country:  England    
Other Details:
Languages:  eng     Pagination:  314-9     Citation Subset:  AIM; IM    
Affiliation:
The Hip Surgery Unit, Institute of Orthopaedics Carlos E. Ottolenghi Italian Hospital, Buenos Aires, Argentina. cadera@hospitalitaliano.org.ar
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anti-Bacterial Agents / administration & dosage*
Arthritis / surgery
Arthroplasty, Replacement, Hip / methods*
Bone Transplantation / methods*
Female
Follow-Up Studies
Graft Survival
Hip Injuries / surgery
Humans
Male
Middle Aged
Osteonecrosis / surgery
Osteosarcoma / surgery
Prosthesis-Related Infections / prevention & control*,  radiography
Retrospective Studies
Transplantation, Homologous
Vancomycin / administration & dosage*
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 1404-90-6/Vancomycin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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