title: Treatment of infected retained implants.
abstract: We have prospectively studied the outcome of infections associated with implants which were retained and treated using a standardised antimicrobial protocol. Over a period of four years, we studied 24 consecutive patients who had symptoms of infection for less than one year, a stable implant, no sinus tract and a known pathogen which was susceptible to recommended antimicrobial agents. The infections involved hip prostheses (14), knee prostheses (5), an internal fixation device (4), and an ankle prosthesis (1). Twenty patients had a successful outcome at a median follow-up of 3.7 years (1.8 to 4.7); four had failure of the implant after a median follow-up of 1.2 years (0.3 to 2.5). The probability of survival without failure of treatment was 96% at one year (95% confidence interval (CI) 88 to 100), 92% at two years (95% CI 80 to 100) and 86% at three years (95% CI 72 to 100). Patients with a short-term infection but with a stable implant, no sinus tract and a known pathogen may be successfully treated by retention of the implant and the use of a standardised regimen of antimicrobial treatment.
authors.affiliation: Orthopaedic Hospital Valdoltra, Ankaran, Slovenia.
authors.forename: R
authors.initials: R
authors.lastname: Trebse
authors.forename: V
authors.initials: V
authors.lastname: Pisot
authors.forename: A
authors.initials: A
authors.lastname: Trampuz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000843:Ankle Joint; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000601:surgery; D003023:Cloxacillin / Q000627:therapeutic use; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects*; D007720:Knee Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000382:microbiology / Q000601:surgery; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D003023:Cloxacillin