International Orthopaedics

, Volume 43, Issue 1, pp 111–115 | Cite as

Two-stage cementless hip revision for peri-prosthetic infection with an antibacterial hydrogel coating: results of a comparative series

  • Luigi ZagraEmail author
  • Enrico Gallazzi
  • Delia Romanò
  • Sara Scarponi
  • Carlo Romanò
Original Paper



The aim of this study was to investigate the hypothesis that a two-stage exchange procedure, performed with an antibiotic-loaded, fast-resorbable hydrogel coating, may provide better infection cure rate than a two-stage procedure without the coating, in patients affected by peri-prosthetic hip infection.


In this case-control study, 27 patients, treated with a two-stage procedure, using cementless implants coated with an antibiotic-loaded hydrogel (DAC®, “Defensive Antibacterial Coating”), were compared with 27 matched controls, treated with a two-stage cementless revision procedure, without the coating.


At a mean follow-up of 2.7 (minimum 2.1–maximum 3.5) years, no evidence of infection, implant loosening, or adverse events were observed in the DAC-treated group, compared to four cases of infection recurrence in the control group.


Although in a relatively limited series of patients our data show that cementless two-stage hip revision, performed with an antibacterial hydrogel coating, may provide better infection control than two-stage without the coating, with reduced hospitalization time, these findings warrant further studies in the possible applications of antibacterial coating technologies to treat implant-related infections.


Antibacterial coatings DAC Peri-prosthetic joint infection Revision surgery Total hip replacement 


Compliance with ethical standards

The present study was conducted in accordance with the Helsinki declaration and was approved by the local Ethical Committee (protocol IDAC-2013-THA/TKA—IRCCS San Raffaele Hospital, Milan, Italy).

Conflict of interests

LZ, EG, DR, SS have nothing to disclose related to this paper. CLR received consultant fees from Novagenit Srl.


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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  1. 1.Hip DepartmentIRCCS Istituto Ortopedico GaleazziMilanItaly
  2. 2.Department of Reconstructive Surgery of Osteo-articular InfectionsIRCCS Istituto Ortopedico GaleazziMilanItaly
  3. 3.Centro MedicoMilanItaly

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