Hypercalcaemia following the use of antibiotic-eluting absorbable calcium sulphate beads in revision arthroplasty for infection.
Periprosthetic joint infection (PJI) is a devastating complication for patients and results in greatly increased costs of care for both healthcare providers and patients. More than 15 500 revision hip and knee procedures were recorded in England, Wales and Northern Ireland in 2013, with infection accounting for 13% of revision hip and 23% of revision knee procedures. We report our experience of using antibiotic eluting absorbable calcium sulphate beads in 15 patients (eight men and seven women with a mean age of 64.8 years; 41 to 83) as part of a treatment protocol for PJI in revision arthroplasty. The mean follow-up was 16 months (12 to 22). We report the outcomes and complications, highlighting the risk of hypercalcaemia which occurred in three patients. We recommend that serum levels of calcium be routinely sought following the implantation of absorbable calcium sulphate beads in orthopaedic surgery.
St George's Hospital, Blackshaw Road, Tooting, London SW17 0QT, UK.
R
R
Kallala
University College London Hospitals, 235 Euston Road, London, NW1 2BU, UK.
F S
FS
Haddad
D020341:Absorbable Implants / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019644:Arthroplasty, Replacement, Hip / Q000379:methods; D019645:Arthroplasty, Replacement, Knee / Q000379:methods; D002133:Calcium Sulfate / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D006934:Hypercalcemia / Q000139:chemically induced*; D007595:Joint Prosthesis / Q000009:adverse effects*; D007720:Knee Prosthesis / Q000009:adverse effects; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000517:prevention & control*; D012086:Reoperation / Q000379:methods; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D002133:Calcium Sulfate
Antibiotics; Calcium sulphate; Drug delivery; Infection; Revision arthroplasty