Efficacy of Antibiotic-loaded Poly (Methyl Methacrylate) Beads in Orthopaedic Infections
Journal Title: Journal of Clinical and Diagnostic Research - Year 2018, Vol 12, Issue 9
Abstract
ABSTRACT Introduction: Bone infections are associated with morbidity and mortality. Infection control is achieved by surgical debridement and microbial-specific antibiotic administration. Antibiotic Loaded Bone Cement (ALBC) has been accepted as a mode of treatment since systemic antibiotics alone are associated with higher recurrence and reoperation rates. Aim: To assess the efficacy of ALBC in the treatment of orthopaedic infections. Materials and Methods: A retrospective case series of 59 patients, treated for chronic musculoskeletal infections between January 2007 to December 2013, were included. They were divided into five groups; 1) Open fractures (21 patients); 2) Closed fractures (5 patients); 3) Infected nonunion (26 patients); 4) Infected implants (6 patients); and 5) Chronic osteomyelitis (1 patient). Results: The median age at presentation was 34.8 years (range, 18.0-58.0). Five patients were lost to follow-up. In the 54 patients analysed, infection was controlled in all patients (100%) with debridement/implant exit and antibiotic beads. 31 patients (57%) united or were infection free with the primary procedure. This included all the patients in Group 4 and 5, six patients in Group 1 and 18 patients in Group 3. 23 patients (43%) underwent additional procedures to achieve bony union after the infection control. Gram-Negative Organisms (GNB) were isolated in 36% (21 cases), whereas Methicillin Resistant Staphylococcus Aureus (MRSA) was found in 12% (7 cases). The average healing time for GNB and MRSA infections was 19.4 months and eight months respectively. Conclusion: The ALBC is effective in controlling infection. Infections caused by gram-negative bacteria are becoming common and they resolve later than MRSA infections.
Authors and Affiliations
Kaushik Bhowmick, Chandrasekeran Gunasekaran, Viju Daniel Varghese, Abel Livingston, Thilak Samuel Jepegnanam, Alfred Job Daniel, Prjvc Boopalan
Keywords
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- EP ID EP524317
- DOI 10.7860/JCDR/2018/35222.11977
- Views 79
- Downloads 0
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