Silver-Coated Megaprosthesis of the Proximal Tibia in Patients With Sarcoma.
Proximal tibia arthroplasty is associated with high rates of infection. This study is the largest one that has compared the infection rates with titanium vs silver-coated megaprostheses in patients treated for sarcomas.



The infection rate in 98 patients with sarcoma or giant-cell tumor in the proximal tibia who underwent placement of a titanium (n = 42) or silver-coated (n = 56) megaprosthesis (MUTARS) was assessed, along with the treatments administered for any infection.



As the primary end point of the study, the rates of infection were 16.7% in the titanium group and 8.9% in the silver group, resulting in 5-year prosthesis survival rates of 90% in the silver and 84% in the titanium group. Whereas in the titanium group 37.5% of patients ultimately had to undergo amputation in the present study, these mutilating surgical procedures were only necessary in the silver group in one patient (14.3%).



The use of silver-coated prosthesis reduced the infection rate in a relatively large and homogeneous group of patients. In addition, less-aggressive treatment of infection was possible in the group with silver-coated prosthesis.
Department of Orthopaedics and Tumour Orthopaedics, Münster University Hospital, Münster, Germany.
Jendrik
J
Hardes
Department of Orthopaedics and Tumour Orthopaedics, Münster University Hospital, Münster, Germany.
Marcel P
MP
Henrichs
Department of Orthopaedics and Tumour Orthopaedics, Münster University Hospital, Münster, Germany.
Gregor
G
Hauschild
Department of Orthopaedics and Tumour Orthopaedics, Münster University Hospital, Münster, Germany.
Markus
M
Nottrott
Department of Orthopaedics and Tumour Orthopaedics, Münster University Hospital, Münster, Germany.
Wiebke
W
Guder
Department of Orthopaedics and Tumour Orthopaedics, Münster University Hospital, Münster, Germany.
Arne
A
Streitbuerger
D000293:Adolescent; D000328:Adult; D000368:Aged; D001178:Arthroplasty; D001859:Bone Neoplasms / Q000601:surgery; D002648:Child; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D019736:Prostheses and Implants / Q000009:adverse effects* / Q000706:statistics & numerical data; D019919:Prosthesis Implantation; D016459:Prosthesis-Related Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000601:surgery; D012509:Sarcoma / Q000601:surgery; D012834:Silver / Q000627:therapeutic use*; D013977:Tibia / Q000601:surgery*; D014025:Titanium; D055815:Young Adult
D012834:Silver; D014025:Titanium
bone neoplasms; implantation; prosthesis-related infections; proximal tibia; sarcoma; silver