Osteomyelitis nach Endoprothesen

Haaker, Rolf; Senge, A.; Krämer, Jürgen; Rubenthaler, F.

doi:10.1007/s00132-003-0624-x

Cited by 26 publications

(13 citation statements)

References 15 publications

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“…The 1 -2% of the cases, and this rate may increase after revision surgery [41,42]. This means that between 1000 and 2500 patients annually undergo this type of complication in Germany alone [43]. Implant surfaces should not only enhance cell growth, but also show initial antimicrobial properties, to prevent bacterial infections that may occur after surgery and could lead to dramatic consequences for the patient resulting in unnecessary medical costs [20].…”

Section: Discussionmentioning

confidence: 99%

Antibacterial burst-release from minimal Ag-containing plasma polymer coatings

Lischer

Körner

Balazs

et al. 2011

J. R. Soc. Interface.

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Biomaterials releasing silver (Ag) are of interest because of their ability to inhibit pathogenic bacteria including antibiotic-resistant strains. In order to investigate the potential of nanometre-thick Ag polymer (Ag/amino-hydrocarbon) nanocomposite plasma coatings, we studied a comprehensive range of factors such as the plasma deposition process and Ag cation release as well as the antibacterial and cytocompatible properties. The nanocomposite coatings released most bound Ag within the first day of immersion in water yielding an antibacterial burst. The release kinetics correlated with the inhibitory effects on the pathogens Pseudomonas aeruginosa or Staphylococcus aureus and on animal cells that were in contact with these coatings. We identified a unique range of Ag content that provided an effective antibacterial peak release, followed by cytocompatible conditions soon thereafter. The control of the in situ growth conditions for Ag nanoparticles in the polymer matrix offers the possibility to produce customized coatings that initially release sufficient quantities of Ag ions to produce a strong adjacent antibacterial effect, and at the same time exhibit a rapidly decaying Ag content to provide surface cytocompatibility within hours/days. This approach seems to be favourable with respect to implant surfaces and possible Ag-resistance/tolerance built-up.

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Section: Discussionmentioning

confidence: 99%

Antibacterial burst-release from minimal Ag-containing plasma polymer coatings

Lischer

Körner

Balazs

et al. 2011

J. R. Soc. Interface.

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“…Die Infektionsrate elektiver Gelenkersatz operationen wird je nach Kollektiv und Erfassungszeitraum in Größenordnungen von 0,5-1,5% angegeben [8,9,10,16,17,37,39,60,77]. Bei Vorerkrankungen und Re visionseingriffen steigen die Angaben bis 5%, bei Reimplantationen nach peripro thetischer Infektion bis in die Größen ordnung von 15 …”

Section: Risikofaktorenunclassified

“…Neben der Antibiotikaresistenz spielt das Verhalten der Keime auf der anorga nischen Oberfläche der Prothetik die ent scheidende Rolle bezüglich Therapiean satz und Prognose der periprothetischen Infektion. Vorzugsweise Staphylokokken sind in der Lage, über spezifische Rezep toren an vorhandenen Proteinoberflächen anzuheften [13, 16,33,37,56,57,75,87].…”

Section: Klassifikationunclassified

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Replacement of infected knee and hip endoprostheses

Militz

Bühren

2010

Chirurg

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Infections occur in 0.5-5% of cases after implantation of an endoprosthesis and represent one of the most severe complications of artificial joint replacements. Approximately 300,000 primary implantations for hip and knee prostheses are carried out in Germany annually with a corresponding number of early and late infections. This means that approximately 4,000-6,000 cases are to be expected annually. Periprosthetic infections normally lead to a significant loss of function and quality of life for patients and the complex remediation is costly. Therefore, preventive measures, such as perioperative prophylaxis with antibiotics, maintaining highly sterile conditions during operations and an expedient selection of patients are of substantial importance. The basic principles of an adequate restoration include identification of the pathogen, local eradication of the infection mostly after removal of the prosthesis, pathogen-oriented systemic and local antibiotic therapy and finally re-implantation of the revision prosthesis under infection-free conditions. The standard procedure for revision surgery is a two-phase replacement with maintenance of an infection-free interval before renewal of the prosthesis. The use of single-phase or multi-phase strategies, as well as the selection of cemented or cement-free revision, varies between centers as a definitive evaluation is not yet available.The most important parameters for successful treatment of periprosthetic infections have been identified as the earliest possible diagnosis, radical surgical cleansing with an adequate antibiotic therapy and successful restoration has been reported in approximately 80% of cases. Because of the complex therapy regime, treatment in specialized centers is generally recommended especially under the aspect of a demanding patient monitoring.

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“…Hochberg und Mitarbeiter definieren einen alleinigen positiven Wundabstrich ebenfalls als Kontamination [27], während andere Autoren von Infektion berichten [1,20]. Weiterhin wird zwischen "früher" und "später" sowie "oberflächlicher" und "tiefer" Infektion unterschieden: Die Grenze zwischen "früher" und "später" Infektion wird in der Regel bei 3-4 Wochen festgelegt [14,23,25,38,41,43,52]. "Oberflächliche" Infektionen sind Infekte ohne sichtbares Metall.…”

Section: Infektionunclassified

Weichteildefekt und exponiertes Osteosynthesematerial — Metallerhalt oder Entfernung?

Baumeister

Levin

Erdmann

2006

Chirurg

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Hardware used in spine surgery is commonly left in situ until bony consolidation has been achieved. The indications for hardware removal depend on length of exposure or infection, implant failure, and location. Osteosynthetic devices in the extremities may be removed and replaced by external fixators or immobilisation. Removal of prostheses requires complex second-stage reimplantation or arthrodesis. A treatment algorithm is suggested that might ease the decision whether exposed hardware can remain or requires removal before reconstruction of soft-tissue defects.

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Osteomyelitis nach Endoprothesen

Cited by 26 publications

References 15 publications

Antibacterial burst-release from minimal Ag-containing plasma polymer coatings

Antibacterial burst-release from minimal Ag-containing plasma polymer coatings

Replacement of infected knee and hip endoprostheses

Weichteildefekt und exponiertes Osteosynthesematerial — Metallerhalt oder Entfernung?

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