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

作　　者：Diana Crego-Vita Daniel Aedo-Martín Rafael Garcia-Cañas Andrea Espigares-Correa Coral Sánchez-Pérez Christof Ernst Berberich 

机构地区：[1]Department of Orthopaedic and Trauma Surgery,Hospital Central de la Defensa Gómez Ulla,Madrid 28047,Spain [2]Department of Orthopaedic and Trauma Surgery,Hospital Universitario del Henares,Universidad Francisco de Vitoria,Coslada 28822,Madrid,Spain [3]Department of Orthopeadic and Trauma Surgery,Hospital Central de la Defensa Gómez Ulla,Madrid 28047,Spain [4]Department of Orthopeadic and Trauma Surgery,General University Hospital Gregorio Maranon,Madrid 28007,Spain [5]Department of Medical Training,Heraeus Medical GmbH,Wehrheim 612173,Hessen,Germany

出　　处：《World Journal of Orthopedics》2022年第2期150-159,共10页世界骨科杂志（英文版）

摘　　要：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 surgery.Therefore,priorities should lie in effective preventive strategies to mitigate this burden.AIM 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 cohort.METHODS 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 period.The 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 fixation.Patients 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 software.We 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 ALBC.RESULTS 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 study.There 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 patients.The statistical analysis showed an infection risk reduction of 55.3%(in p

关 键 词：prosthetic joint infection Femoral neck fracture patients HEMIARTHROPLASTY Antibiotic-loaded bone cement PROPHYLAXIS Cost-efficacy 

分 类 号：R687.3[医药卫生—骨科学]