title: Infective complications following tumour endoprosthesis surgery for bone and soft tissue tumours.
abstract: OBJECTIVE
  This study aims to describe the incidence of infective complications, including tumour endoprosthesis infection, in a cohort of patients undergoing tumour endoprosthesis surgery in Victoria, Australia.
  
  
  METHODS
  This retrospective cohort study was performed over 15 years (January 1996-December 2010).
  
  
  RESULTS
  121 patients underwent tumour endoprosthesis surgery during the study period. Patients were followed for a median of 34 months (interquartile range [IQR] 17, 80). Overall, 34 patients (28%) experienced infective complications including: bacteraemia in 19 patients (16%) and tumour endoprosthesis infection in 17 (14%). The majority of patients with early and late acute infections (haematogenous) were managed with debridement and retention of the prosthesis in addition to biofilm-active antibiotics. Late chronic infections were predominantly managed by exchange of the prosthesis. The overall success rate of treatment was 71%. The success rate for debridement and retention was 75% compared with 67% for exchange procedures.
  
  
  CONCLUSIONS
  There is a significant rate of infective complications following tumour endoprosthesis surgery including 14% of patients experiencing infection involving the tumour endoprosthesis. This study is the first to report on outcomes from debridement and retention of the prosthesis; which had comparable success rates to other treatment modalities.
authors.affiliation: Department of Surgery, St Vincent's Hospital, University of Melbourne, Regent Street, Fitzroy, VIC 3065, Australia; Department of Infectious Diseases, St Vincent's Hospital Melbourne, Victoria Parade, Fitzroy, VIC 3065, Australia; Department of Orthopaedics, St Vincent's Hospital Melbourne, Victoria Parade, Fitzroy, VIC 3065, Australia. Electronic address: tnpeel@student.unimelb.edu.au.
authors.forename: T
authors.initials: T
authors.lastname: Peel
authors.affiliation: Department of Orthopaedics, St Vincent's Hospital Melbourne, Victoria Parade, Fitzroy, VIC 3065, Australia.
authors.forename: D
authors.initials: D
authors.lastname: May
authors.affiliation: Department of Infectious Diseases, St Vincent's Hospital Melbourne, Victoria Parade, Fitzroy, VIC 3065, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Buising
authors.affiliation: Department of Infectious Diseases, Peter MacCallum Cancer Centre, Lansdowne St, East Melbourne, VIC 3002, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Thursky
authors.affiliation: Department of Infectious Diseases, Peter MacCallum Cancer Centre, Lansdowne St, East Melbourne, VIC 3002, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Slavin
authors.affiliation: Department of Surgery, St Vincent's Hospital, University of Melbourne, Regent Street, Fitzroy, VIC 3065, Australia; Department of Orthopaedics, St Vincent's Hospital Melbourne, Victoria Parade, Fitzroy, VIC 3065, Australia.
authors.forename: P
authors.initials: P
authors.lastname: Choong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D001859:Bone Neoplasms / Q000601:surgery*; D002813:Chondrosarcoma / Q000601:surgery; D015331:Cohort Studies; D060085:Coinfection / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D005266:Femoral Neoplasms / Q000601:surgery; D018212:Giant Cell Tumor of Bone / Q000601:surgery; D051677:Histiocytoma, Malignant Fibrous / Q000601:surgery; D006801:Humans; D006811:Humerus / Q000601:surgery; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D008875:Middle Aged; D018204:Neoplasms, Connective and Soft Tissue / Q000601:surgery*; D061646:Operative Time; D012516:Osteosarcoma / Q000601:surgery; D010384:Pelvic Bones / Q000601:surgery; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D016459:Prosthesis-Related Infections / Q000453:epidemiology* / Q000382:microbiology; D012189:Retrospective Studies; D012307:Risk Factors; D012512:Sarcoma, Ewing / Q000601:surgery; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013977:Tibia / Q000601:surgery; D014739:Victoria / Q000453:epidemiology; D055815:Young Adult
keywords: Bone and soft tissue tumour; Epidemiology; Infection; Outcome; Treatment; Tumour endoprosthesis infection; Tumour endoprosthesis surgery