title: The use of calcium carbonate beads containing gentamicin in the second stage septic revision of total knee arthroplasty reduces reinfection rate.
abstract: BACKGROUND
  The aim of the study was to analyze effectiveness and safety of packing the medullary canal of the tibia and femur with Herafill (Heraeus Medical GmbH, Wehrheim, Germany), a void filler and antibiotic carrier, during second stage revision total knee arthroplasty (TKA) for periprosthetic joint infection (PJI).
  
  
  METHODS
  Two groups were formed of 28 consecutive patients during second stage revision TKA, comparable for gender and age. The study group received Herafill, while the control group did not. The average follow-up was 52 months (minimum 36 months).
  
  
  RESULTS
  No reinfections were observed in the study group, while five were seen in the control group. No other differences were observed between the study and control groups, including mean clinical KSS (Knee Society score) (67.4 and 68.4 points, respectively) and functional score (72.5 and 70.5 points respectively). No side effects related to the use of Herafill beads were noted.
  
  
  CONCLUSIONS
  Herafill packed into the tibial and femoral intramedullary canal during second stage of septic revision TKA is a reliable bone substitute, may reduce recurrence of infection and incorporates well with host bone. However, results after PJI treatment are less than optimal measured by KSSs as compared to patients who do not require revision.
authors.affiliation: Postgraduated Medical Education Center Orthopaedic Dept. Otwock, Poland.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Marczak
authors.affiliation: Clinic of Orthopaedics and Paediatric Orthopaedics Medical University of Lodz, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Synder
authors.affiliation: Clinic of Orthopaedics and Paediatric Orthopaedics Medical University of Lodz, Poland. Electronic address: sibinek@poczta.onet.pl.
authors.forename: Marcin
authors.initials: M
authors.lastname: Sibiński
authors.affiliation: Postgraduated Medical Education Center Orthopaedic Dept. Otwock, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Okoń
authors.affiliation: Postgraduated Medical Education Center Orthopaedic Dept. Otwock, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Kowalczewski
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D002119:Calcium Carbonate; D004337:Drug Carriers; D005260:Female; D005500:Follow-Up Studies; D005839:Gentamicins / Q000008:administration & dosage*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000453:epidemiology; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents; D004337:Drug Carriers; D005839:Gentamicins; D002119:Calcium Carbonate
keywords: Bone substitutes; Infection; Results; Septic arthritis; Treatment