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Revista Portuguesa de Ortopedia e Traumatologia
Print version ISSN 1646-2122On-line version ISSN 1646-2939
Abstract
SOUSA, Ricardo et al. Tratamento de Infeções Protésicas com Desbridamento e Preservação do Implante: Resultados da Aplicação Prospetiva de um Protocolo Pré-estabelecido. Rev. Port. Ortop. Traum. [online]. 2017, vol.25, n.1, pp.16-27. ISSN 1646-2122.
Study Goal: Treating prosthetic joint infections is complex and the results of debridement with implant retention are often unpredictable. Our hypothesis is that it is possible to offer a good chance for success as long as simple patient selection and treatment guidelines are met. The goal of this paper is to present the results of prospectively applying these principles over the past few years in our institution. Material and Methods: This is a prospective clinical study including patients with prosthetic joint infection treated since January/2012 and a 12 months’ minimum follow-up after treatment discontinuation. Only patients with a stable prosthesis with no signs of loosening, good soft tissues and short duration of symptoms were candidates to debridement with implant retention. Surgery was performed by the same surgeon and it always included mobile parts exchange. Whenever possible, antibiotic therapy included agents effective against bacteria within the biofilm. Results: Twenty-four patients (15 knees and 9 hips) with a mean age of 65 years were included. One patient was excluded from the analysis of results as a result of unrelated death. There were three cases of treatment failure, resulting in an overall success rate of 87% (20/23) with an average 30 months’ follow-up after discontinuing antibiotic therapy. Conclusion: Following a predetermined treatment protocol allows for good results in the treatment of prosthetic joint infections even when choosing to preserve the implant.
Keywords : Hip Prosthesis; Knee Prosthesis; Prosthesis-Related Infections; Cohort Studies; Prospective Studies; Prosthesis Retention; Therapeutic Irrigation; Anti-Bacterial Agents; Treatment Outcome.
