Treatment for Staphylococcus aureus infection following open wedge high tibial osteotomy using antibiotic-impregnated calcium phosphate cement

Seki, Kazushige; Sakka, Akihito; Tokushige, Atsunori; Imagama, Takashi; Mutou, Masanori; Taguchi, Toshihiko

doi:10.1007/s00167-013-2460-9

Cited by 13 publications

(12 citation statements)

References 17 publications

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“…The management of deep SSI after MOWHTO reported in the past literature included the removal of internal fixation devices, debridement, and intravenous antibiotic injection. Some authors have proposed antibiotic-impregnated calcium phosphate cement insertion [8,32,33]. However, hardware removal can be problematic before bony union.…”

Section: Discussionmentioning

confidence: 99%

“…[7] Postoperative deep SSI has been regarded as one of the most detrimental complications, which may lead to multiple revision surgeries, loss of correction degree, and nonunion. [8] However, few past reports have focused on this issue. The existing papers on the topic differ based on study design, patient collectives, implant selection, surgical technique, and investigation parameters.…”

Section: Introductionmentioning

confidence: 99%

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Risk Factor Analysis for Infection after Medial Open Wedge High Tibial Osteotomy

Liu

Chiu

Chen

et al. 2021

JCM

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Background: Medial open wedge high tibial osteotomy (MOWHTO) is a well-established treatment for osteoarthritis of the medial tibiofemoral compartment. Surgical site infection (SSI) after MOWHTO is a devastating complication that may require further surgery. In this study, we aimed to identify the risk factors for infection after MOWHTO over 1 to 4 years of follow-up. Methods: Fifty-nine patients who underwent MOWHTO combined with knee arthroscopic surgery were included in this prospective study. Artificial bone grafts were used in all cases. Possible risk factors, including sex, age, body mass index (BMI), underlying disease, hospitalization length, correction angle, and surgery time, were recorded. Both univariate and multivariate analysis were used. Results: A total of 59 patients who underwent 61 operations were included. Eleven patients (18.0%) were reported to have SSI. Univariate analysis showed that smoking and diabetes mellitus were positively associated with SSI. Multivariate analysis showed that smoking and age were positively associated with SSI. Three patients (4.9%) were reported to suffer from deep SSI, requiring surgical debridement, all of whom were male smokers. Conclusion: Smoking, diabetes mellitus, and old age were identified to be possible risk factors of SSI after MOWHTO. These findings are common risk factors of SSI after orthopedic surgery according to the literature. Patient selection should be performed cautiously, and postoperative prognosis for MOWHTO should be carefully explained to patients who smoke.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk Factor Analysis for Infection after Medial Open Wedge High Tibial Osteotomy

Liu

Chiu

Chen

et al. 2021

JCM

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“…Another possible property inherent to MPCs which is desired, and often added to CPCs, is antibacterial activity. Although CPCs have antibiotics such as vancomycin added to the cement formulation, some MPCs may be naturally antibiotic. , Mestres et al observed cements of MgO + MNaHP salt or MNaHP/MAHP salt mixture exhibited bactericidal effects on S. sanguinis bacteria, whereas cements reacted with only MAHP salt exhibited growth inhibition but no bactericidal effects . The bactericidal effects were attributed to a combination of pH increase (up to 9.91) while the growth inhibition was attributed to acidic conditions and the release of Mg 2+ ions and reactive oxygen species from the remaining MgO.…”

Section: In Vitro Propertiesmentioning

confidence: 99%

Magnesium Phosphate Cement Systems for Hard Tissue Applications: A Review

Ostrowski

Roy

Kumta

2016

ACS Biomater. Sci. Eng.

160

154

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In the search for more ideal bone graft materials for clinical application, the investigation into ceramic bone cements or bone void filler is ongoing. Calcium phosphate-based materials have been widely explored and implemented for medical use in bone defect repair. Such materials are an excellent choice because the implant mimics the natural chemistry of mineralized bone matrix and in injectable cement form, can be implemented with relative ease. However, of the available calcium phosphate cements, none fully meet the ideal standard, displaying low strengths and acidic setting reactions or slow setting times, and are often very slow to resorb in vivo. The study of magnesium phosphates for bone cements is a relatively new field compared to traditional calcium phosphate bone cements. Although reports are more limited, preliminary studies have shown that magnesium phosphate cements (MPC) may be a strong alternative to calcium phosphates for certain applications. The goal of the present publication is to review the history and achievements of magnesium phosphate-based cements or bone void fillers to date, assess how these cements compare with calcium phosphate competitors and to analyze the future directions and outlook for the research, development, and clinical implementation of these cements.

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“…Seki et al [ 7 ] successfully treated one case with hardware removal and filling of the osteotomy defect with vancomycin-impregnated, calcium phosphate cement associated with external fixation for 12 months and concomitant antibiotics for 3 months.…”

Section: Discussionmentioning

confidence: 99%

Management of an Infected Nonunion of an Opening-Wedge High Tibial Osteotomy with 2-Stage Implantation of Rotating Hinge Knee Prosthesis

Mariaux

Borens

2018

Case Reports in Orthopedics

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Introduction High tibial osteotomy (HTO) is a frequent and effective treatment for unicompartmental gonarthritis. Only a few articles are focused on the treatment of infected nonunion. Patient and Method A 50-year-old obese patient was operated on by medial opening-wedge HTO. She developed a painful nonunion treated by hardware removal, allograft, and plate fixation. However, the nonunion persisted. 2 years later, cellulitis appeared with an abscess adjacent to the HTO plate. Despite surgical debridement and antibiotics, septic knee arthritis occurred. In a situation of infected nonunion and septic arthritis with chondrolysis, she was scheduled for a 2-stage total knee replacement (TKR). The infected tibial articular block was first resected and replaced by a cement spacer. After a short interval, the TKR was implanted. After 2 years, the patient walked pain-free with good knee function. Discussion In the literature, different efficient treatments exist for infected nonunion after HTO, but comprehensive studies are missing for a consensus treatment. Current data are mostly based on case reports, since this pathology is quite rare. Conclusion In a difficult situation of infected nonunion with septic knee arthritis, we performed a 2-stage knee prosthesis implantation. This led to an early mobilization and fast recovery.

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Treatment for Staphylococcus aureus infection following open wedge high tibial osteotomy using antibiotic-impregnated calcium phosphate cement

Abstract: V.

Cited by 13 publications

References 17 publications

Risk Factor Analysis for Infection after Medial Open Wedge High Tibial Osteotomy

Risk Factor Analysis for Infection after Medial Open Wedge High Tibial Osteotomy

Magnesium Phosphate Cement Systems for Hard Tissue Applications: A Review

Management of an Infected Nonunion of an Opening-Wedge High Tibial Osteotomy with 2-Stage Implantation of Rotating Hinge Knee Prosthesis

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