Long-Term Outcomes of Permanent Cement Spacers in the Infected Foot

Elmarsafi, Tammer; Oliver, Noah G.; Steinberg, John S.; Evans, Karen K.; Attinger, Christopher E.; Kim, Paul J.

doi:10.1053/j.jfas.2016.10.022

Cited by 20 publications

(12 citation statements)

References 22 publications

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“…The clinical utility of bone cements in the lower extremity relies on its biocompatibility and mechanical properties [16] . There is however a paucity of studies relating to permanent application of PMMA spacers in the foot, with an even lesser degree related to the pathologic diabetic foot [17] . A study by Elmarsafi et al published in 2017 report the salvage rates of permanent PMMA spacers in the infected foot as 66.7% in 30 high risk patients including 9 with CN.…”

Section: Discussionmentioning

confidence: 99%

“…A study by Elmarsafi et al published in 2017 report the salvage rates of permanent PMMA spacers in the infected foot as 66.7% in 30 high risk patients including 9 with CN. Furthermore, they report the mean time to spacer failures as 20.9 months, mean follow up 52 (12–111) months, longest retained spacer 76 months, and longest exchanged spacer was 111 months [17] . PMMA is a dense monolithic minimally porous material.…”

Section: Discussionmentioning

confidence: 99%

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Viability of permanent PMMA spacer with combined free fasciocutaneous tissue transfer for failed charcot reconstruction: A 38 month prospective case report

Elmarsafi

Steinberg

Kim

et al. 2017

International Journal of Surgery Case Reports

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HighlightsThis case report demonstrates the long term viability and utility of the use of permanent cement spacers when combined with free tissue transfer for closure of complex diabetic foot wounds.Charcot Neuroarthropathy often requires osseous reconstruction, which can be complicated with osteomyelitis and hardware infection.This case is an example of a multidisciplinary team approach to limb salvage with successful long term outcome; a plantigrade stable functional foot in an ambulatory highly active patient.Follow up time since initial intervention was 38 months.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Viability of permanent PMMA spacer with combined free fasciocutaneous tissue transfer for failed charcot reconstruction: A 38 month prospective case report

Elmarsafi

Steinberg

Kim

et al. 2017

International Journal of Surgery Case Reports

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“…There are some literatures concerning the treatment using antibiotic cement spacer in foot and ankle infection [1][2][3][4][5][6]. But there are only few literatures with respect to the appropriate time of removing the cement spacer and complications that occur without its removal.…”

Section: Introductionmentioning

confidence: 99%

“…Infection, Foot and ankle, Antibiotic cement spacer acute or chronic osteomyelitis [4]. With respect to the foot and ankle infection, an antibiotic cement spacer plays an important role of alleviating infections by prevention soft tissue contracture or bone shortening and avoiding amputation [1,2,4,5].…”

Section: Introductionmentioning

confidence: 99%

Treatment of Foot and Ankle Infection with Antibiotic Cement Spacer

Soo¹,

Jin²,

Woo³

2021

Int J Foot Ankle

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“…The main disadvantage of the use of cement is the need for a second surgery for its removal since the reduction in antibiotic concentration over time could favor local bacterial proliferation and biofilm formation 1 – 3 , 7 . However, some authors have described patients with spacer retention for up to 76 months without significant clinical repercussions 8 . At present, there is no consensus on the safety and effectiveness of retention of cement spacers for prolonged periods.…”

Section: Introductionmentioning

confidence: 99%

Clinical Evaluation of Patients With Vancomycin Spacer Retained for More Than 12 Months

et al. 2019

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Objective:There is no consensus in the literature regarding the time taken to remove antibiotic spacers in the treatment of bone infections. The aim of this study is to evaluate the clinical results of patients with prolonged retention of the same.Methods:Patients selected were diagnosed with post-osteosynthesis infection and/or osteomyelitis and were submitted to treatment using an orthopedic cement spacer (polymethylmethacrylate) with vancomycin, retaining it for a period of more than 12 months. They were clinically evaluated to determine the presence of local or systemic infectious signs via hemogram, investigations of inflammatory markers, liver, renal and, with radiographic control.Results:Eighteen patients were included in the study. The mean retention time of the spacer was 30.4 months (15 – 61 months). No patient had clinical signs of local or systemic infectious relapse at the time of evaluation. Seven patients (39%) presented non-disabling pain in the operated limb. Seventeen patients (94%) presented a reduction in C-reactive protein values compared to the preoperative period. Radiographically, no migration, no spacer failure, or bone sequestration occurred.Conclusion:In this retrospective case series, cement spacer retention with vancomycin for more than 12 months was associated with good clinical results, without relapse of the infectious condition. Nível de Evidência IV. Estudos Terapêuticos - Investigação dos Resultados do Tratamento.

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Long-Term Outcomes of Permanent Cement Spacers in the Infected Foot

Cited by 20 publications

References 22 publications

Viability of permanent PMMA spacer with combined free fasciocutaneous tissue transfer for failed charcot reconstruction: A 38 month prospective case report

Viability of permanent PMMA spacer with combined free fasciocutaneous tissue transfer for failed charcot reconstruction: A 38 month prospective case report

Treatment of Foot and Ankle Infection with Antibiotic Cement Spacer

Clinical Evaluation of Patients With Vancomycin Spacer Retained for More Than 12 Months

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