title: Fungal periprosthetic hip and knee joint infections clinical experience with a 2-stage treatment protocol.
abstract: Fungal periprosthetic joint infections are a rare entity in orthopedic surgery, and there exist no guidelines according to which these infections can be successfully managed. Between 2004 and 2009, 7 patients with fungal periprosthetic joint infections (4 total hip arthroplasties and 3 total knee arthroplasties) have been treated with a 2-stage protocol and implantation of antibiotic-loaded cement spacers. Most of the infection was caused by Candida species. Systemic antifungal agents were administered for 6 weeks in 6 cases and 6 months in 1 case. The mean spacer implantation time was 12 weeks. At a mean follow-up of 28 months (5-70 months), no persistence of infection or reinfection could be observed. A 2-stage treatment protocol with implantation of an antibiotic-loaded cement spacer is an efficient option in the treatment of fungal periprosthetic infections.
authors.affiliation: Klinik für Orthopädie und Orthopädische Chirurgie, Universitätskliniken des Saarlandes, Homburg/Saar, Germany.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Anagnostakos
authors.forename: Jens
authors.initials: J
authors.lastname: Kelm
authors.forename: Eduard
authors.initials: E
authors.lastname: Schmitt
authors.forename: Jochen
authors.initials: J
authors.lastname: Jung
mesh_terms: D000368:Aged; D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation; D001843:Bone Cements; D002175:Candida / Q000302:isolation & purification; D002177:Candidiasis / Q000628:therapy; D003131:Combined Modality Therapy; D003646:Debridement / Q000379:methods; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000187:drug effects / Q000382:microbiology / Q000601:surgery; D006622:Hip Prosthesis / Q000382:microbiology*; D006801:Humans; D007719:Knee Joint / Q000187:drug effects / Q000382:microbiology / Q000601:surgery; D007720:Knee Prosthesis / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000628:therapy*; D016459:Prosthesis-Related Infections / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D001843:Bone Cements