Infection and Local Treatment in Orthopedic Surgery PDF
Preview Infection and Local Treatment in Orthopedic Surgery
E.Meani·C.Romano`·L.Crosby·G.Hofmann(Eds.) InfectionandLocalTreatmentinOrthopedicSurgery E.Meani · C.Romano` · L.Crosby · G.Hofmann (Eds.) EditorialCoordinator:G.Calonego Infection and Local Treatment in Orthopedic Surgery With173Figuresin317Partsand49Tables Editors: EnzoMeani,MD LynnCrosby,MD IstitutoOrtopedicoG.Pini DepartmentofOrthopaedicSurgery CentroperilTrattamentodelleComplicanze 30EastAppleStreet OrtopedicheSettiche(COS) Dayton,Ohio45409,UnitedStates PiazzaCardinalFerrari1 GuntherHofmann,MD 20122Milano,Italy BG-KlinikumBergmannstrostHalle CarloRomano`,MD DepartmentofTraumatology IstitutoOrtopedicoG.Pini MerseburgerStraße165 CentroperilTrattamentodelleComplicanze 06112Hallea.d.Saale,Germany OrtopedicheSettiche(COS) PiazzaCardinalFerrari1 20122Milano,Italy EditorialCoordinator: GiovanniCalonego ScientificCoordinator TecresS.p.A. ViaA.Doria,6 37066Sommacampagna/VR,Italy ISBN978-3-540-47998-7 Springer-VerlagBerlinHeidelbergNewYork LibraryofCongressControlNumber:2006939134 Thisworkissubjecttocopyright.Allrightsarereserved,whetherthewholeorpartofthe materialisconcerned,specificallytherightsoftranslation,reprinting,reuseofillustrations, recitation,broadcasting,reproductiononmicrofilmorinanyotherway,andstorageindata banks.Duplicationofthispublicationorpartsthereofispermittedonlyundertheprovisions oftheGermanCopyrightLawofSeptember9,1965,initscurrentversion,andpermissionfor usemustalwaysbeobtainedfromSpringer-Verlag.Violationsareliableforprosecutionunder theGermanCopyrightLaw. SpringerisapartofSpringerScience+BusinessMedia http://www.springer.com ©Springer-VerlagBerlinHeidelberg2007 PrintedinGermany Theuseofgeneraldescriptivenames,registerednames,trademarks,etc.inthispublication doesnotimply,evenintheabsenceofaspecificstatement,thatsuchnamesareexemptfrom therelevantprotectivelawsandregulationsandthereforefreeforgeneraluse. Productliability:Thepublisherscannotguaranteetheaccuracyofanyinformationaboutthe applicationofoperativetechniquesandmedicationscontainedinthisbook.Ineveryindividual casetheusermustchecksuchinformationbyconsultingtherelevantliterature. Editor:GabrieleSchröder DeskEditor:IrmelaBohn Copy-editing:WSEditorialLtd,Shrewsbury,UK ProductionEditor:JoachimW.Schmidt Coverdesign:eStudioCalamar,Spain Typesetting:FotoSatzPfeiferGmbH,D-82166Gräfelfing Printedonacid-freepaper–24/3151–543210 Preface Boneinfectionsinvolveenormoussocial,economicandhumanimpact. Despiteimprovementsinsurgicaltechniques,asepsisandprevention,theincreas- inguseofsurgeryinorthopaedicsandtraumameansthattheabsolutenumberof boneinfectionsisprogressivelyincreasinginwesterncountries. Theworkoforthopaedicsurgeonsisincreasinglyassistedbyindustrialinnovation designedtomeetnewrequirementsandachievewhatclinicalandscientificevidence indicatesintermsofpreventionandtreatmentofboneandjointinfections. Inparticular,newtechnologiesinrecentyears,suchasthoseallowinglocaltreat- mentwithantibiotic-loadedcementsandpreformedspacers,havemadeitpossibleto improvesubstantiallytheeffectivenessofinfectiontreatmentinorthopaedics. ThisbookcollectsthescientificcontributionsofeminentEuropeanandInterna- tionalscientists,whichwerepresentedduringtheInternationalCongressorganized byTecresSpa(Verona,Italy)andheldinVeronaatthe“PalazzodellaGranGuardia” (7–9September2006). Specialistsofsurgeryandmedicine(orthopaedic,traumaandinfectionsurgeons, microbiologistsandpharmacologists)fromallovertheworldmettoexchangethe latest information. This is a collection of their personal clinical experience in the treatmentoforthopaedicimplantinfections. Withthehopethatthisbookmayrepresentausefultoolforupdatingthosewho dedicatethemselvestothedifficultartoftreatingosteo-articularinfections,wewish agoodreading! EnzoMeani CarloRomano` LynnCrosby GuntherHofmann Table of Contents Introduction TheSocio-economicBurdenofMusculoskeletalInfections K.N.Malizos,L.A.Poultsides,P.A.Lazaros ............................ 1 OrthopaedicDevice-relatedInfections 1 EpidemiologyandClassificationofSepticTotalHipReplacement G.Sessa,V.Pavone,L.Costarella .................................. 13 2 EarlyRadiologicalDiagnosisandDifferentialDiagnosisofInfectionin OrthopaedicSurgery M.B.Gallazzi,R.Chiapparino,P.G.Garbagna ...................... 21 3 BacterialStrategiesofImplantColonizationandResistance C.vonEiff,C.Heilmann,G.Peters................................. 33 4 PathologicalFindingsofSepticLoosening G.Gasparini,S.Cerciello,M.Vasso,C.Fabbriciani ................. 39 5 AntimicrobialProphylaxisinOrthopaedicSurgery A.Soriano,S.Garc´ıa-Ramiro,J.Mensa............................. 49 6 TheLimitsofSystemicAntibioticsinDevice-relatedInfections P.Baiocchi,P.Martino............................................ 58 7 AntibioticBoneCementasaProphylacticMeansinJointReplacementSurgery A.Lundberg,H.Hedlund.......................................... 62 8 TheLimitsoftheLocalAntibioticTherapy E.Witsø.......................................................... 67 9 TheRoleofSuppressiveSurgery E.Concia,A.Tedesco ............................................. 73 VIII TableofContents BasicResearchandLocalAntibioticTherapy 10 PMMAasDrugDeliverySystemandinvivoReleasefromSpacers E.Bertazzoni-Minelli,A.Benini.................................. 79 11 AntibioticCementSpacersinTotalHipandTotalKneeArthroplasty: Problems,Pitfalls,andAvoidingComplication R.S.J.Burnett,J.C.Clohisy,R.L.Barrack .......................... 92 12 ThePreformedSpacers:FromtheIdeatotheRealizationofanIndustrial Device R.Soffiatti ..................................................... 112 13 FatigueandWearCharacterizationofthePreformedHipSpacer M.Baleani,S.Affatato,F.Fraina,A.Toni ......................... 121 14 FatigueCharacterizationofthePreformedKneeSpacer T.Villa,D.Carnelli,R.Pietrabissa .............................. 128 15 SurfaceAnalysisoftheSpacerBeforeandAftertheClinicalUse A.Cigada,F.Brunella ........................................... 136 16 BoneLoss:DoesUseoftheSpacerAffectit? H.FerrerEscobar,R.TorresRoman˜a,A.MatamalaPe´rez, J.AsuncionMa´rquez............................................. 148 17 AntibioticImpregnatedBoneGrafts–WhatDoWeKnow? E.Witsø......................................................... 154 18 Antibiotic-loadedBoneAllograft:PersonalExperience G.Gualdrini,L.Amendola,R.BenAyad,A.Giunti ................. 160 19 AntibioticLoadedCement:FromResearchtoClinicalEvidence G.H.I.M.Walenkamp ............................................. 170 ClinicalApplications:Hip 20 TheManagementofInfectioninTHA:AHistoricalPerspective W.Petty ........................................................ 179 21 GirdlestoneArthroplastyafterHipProsthesisInfection–ATwo-stageRevision S.Tohtz ......................................................... 189 22 One-stageNon-cementedRevisionofSepticHipProsthesisUsing Antibiotic-loadedBoneGraft H.Winkler,A.Stoiber ........................................... 194 23 Two-stageRevisionofInfectedTotalHipArthroplasty.ComparisonBetweena Custom-madeandaPreformedSpacer F.A.Grassi,G.Zatti,F.D’Angelo,P.Cherubino .................... 201 24 Two-stageRevisionofInfectedTotalHipReplacementUsingaPreformed, Antibiotic-loadedAcrylicCementSpacer B.Magnan,D.Regis,A.Costa,P.Bartolozzi ....................... 205 TableofContents IX 25 Two-stageRevisionofSepticHipProsthesiswithUncementedImplants X.FloresSa´nchez,E.GuerraFarfan,J.NardiVilardaga .......... 214 26 Long-stemPreformedSpacersFollowedbyUncementedImplants:ASolution forWideFemoralOpeningorBoneLossinTwo-stageRevision C.Romano`,E.Meani ............................................. 231 27 Two-stageRevisionSurgeryinSepticTotalHipArthroplasty C.H.Lohmann,M.Fuerst,O.Niggemeier,W.Ruether .............. 243 28 One-stage,Two-stageorMulti-stageRevision:TheReasonofaChoice M.Diefenbeck,A.Tiemann,G.O.Hofmann......................... 248 29 AnalysisoftheGaitinPatientswithHipSpacers C.Romano`,M.Ferrarin,M.Rabbuffetti,M.Recalcati,E.Meani ... 258 ClinicalApplications:Knee 30 SepticKneeProsthesisRevision:AChallengingSurgery E.Valenti ...................................................... 267 31 ManagementofTKAInfection–One-stageExchange T.Gehrke,S.JBreusch............................................ 272 32 Antibiotic-loadedBoneCementSpacersfortheTwo-stageRevisioninTotal KneeReplacement R.P.Pitto........................................................ 286 33 KeyPointsinTwo-stageRevisionforInfectedKneeArthroplasty:Bone Loss,QualityofLifeBetweenStagesandSurgicalApproachatSecondStage C.C.Castelli,R.Ferrari ......................................... 294 34 Two-stageRevisionwithPreformedKneeSpacersandModularKnee Prosthesis E.Meani,C.L.Romano` ............................................ 302 35 ArthrodesisfortheTreatmentofSevereKneeDisease C.Sandrone,G.Moraca,G.CasalinoFinocchio ................... 309 36 ArthrodesisandAmputationinKneeJointInfections R.A.Laun........................................................ 320 37 SalvageProceduresinExposedSepticKneeProsthesis L.Vaienti,A.O.Menozzi,J.Lonigro,A.DiMatteo,D.Zilio.......... 328 NovelApplicationsandPerspectives 38 TheManagementoftheShoulderProsthesisInfection L.A.Crosby...................................................... 339 39 ShoulderSpacerasaDefinitiveSolution? A.Giraldi,A.Pellegrini,C.Romano`,E.Meani..................... 344 X TableofContents 40 TheGentamicin-VancomycinSpacer:APharmacologicalStudy E.BertazzoniMinelli,A.Benini.................................. 352 41 RationaleofNailAntibioticClothingand“invivo”AnimalStudy R.Giardino,M.Fini,G.Giavaresi,V.Sambri,C.Romano`,E.Meani, R.Soffiatti ..................................................... 359 42 TheUseofAntibiotic-loadedSpacersinPost-traumaticBoneInfection F.Baldo,G.Zappala`,M.Ronga ................................... 367 43 TheUseofAntibiotic-impregnatedCementinInfectedReconstructions afterResectionforBoneTumors M.Mercuri,D.Donati,C.Errani,N.Fabbri,M.dePaolis ........... 377 44 LocalAntibioticTherapy:PresentandFuture E.Meani,C.L.Romano` ............................................ 385 Corresponding Authors Dr.JordiAsuncionMa´rquez Prof.ClaudioCarloCastelli DepartmentofOrthopaedics DepartmentofOrthopaedicsand HospitalMutuadeTerrassa Traumatology PlazaDr.Robert5 OspedaliRiunitiofBergamo 08221Terrassa,Spain LargoBarozzi1 Eng.MassimilianoBaleani 24100Bergamo,Italy MedicalTechnologyLaboratory Prof.AlbertoCigada RizzoliOrthopaedicInstitutes DepartmentofAppliedPhysical ViadiBarbiano1/10 Chemistry 40136Bologna,Italy PolitecnicodiMilano Prof.ElisaBertazzoniMinelli ViaMancinelli7 DepartmentofMedicine 20131Milan,Italy andPublicHealth Prof.ErcoleConcia PharmacologySection DepartmentofInfectiousDisease Policlinico“G.B.Rossi” UniversityofVerona P.leL.A.Scuro,10 Policlinico“G.B.Rossi” 37134Verona,Italy P.leL.A.Scuro,10 Dr.PiaBaiocchi 37134Verona,Italy DepartmentofClinicalMedicine Prof.LynnA.Crosby PoliclinicoUmbertoI DepartmentofOrthopaedicSurgery University“LaSapienza” WrightStateUniversityBoonshoft VialedelPoliclinico155 SchoolofMedicine 00161Roma,Italy 30E.AppleStreet,Suite5250 Ass.Prof.R.StephenJ.Burnett Dayton,Ohio,USA DepartmentofOrthopaedicSurgery Dr.MichaelDiefenbeck WashingtonUniversitySchoolofMedicine BerufsgenossenschaftlicheKliniken Barnes-JewishHospital Bergmannstrost Barnes-Jewish,Barnes-JewishWestCount KlinikfürUnfall-und &St.LuisVAMedicalCenterHospitals Wiederherstellungschirurgie OneBarnes-JewishHospitalPlaza Merseburgerstr.165 Suite11300 06112Halle/Saale SaintLouis,MO63110,USA
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