Abstract
Introduction
The aim of our study was to compare the effectiveness of high-pressure pulsatile lavage and low-pressure lavage in patients with an orthopaedic implant infection treated with open débridement followed by antibiotic treatment.
Patients and methods
Patients with an orthopaedic implant infection requiring open débridement from January 2008 to August 2009 were randomized prospectively to a low-pressure or a high-pressure pulsatile lavage arm. Relevant information about demographics, co-morbidity, type of implant, microbiology data, surgical treatment, and outcome were recorded. Comparison of proportions was made using χ2 test or Fisher exact test when necessary. The Kaplan–Meier survival method was used to estimate the cumulative probability of treatment failure from open débridement to the last visit.
Results
Seventy-nine patients were included. There were no differences between the main characteristics between both groups (p > 0.05). Mean (SD) age of the whole cohort was 70.2 (11.9) years. There were 46 infections on knee prosthesis, 17 on hip prosthesis, 7 on hip hemiarthroplasties and 9 on osteosynthesis devices. There were 69 acute post-surgical infections, 8 acute haematogenous infections and 2 chronic infections. The most common microorganisms isolated were coagulase-negative Staphylococci in 34 cases, Staphylococcus aureus in 26 and Escherichia coli in 19 cases. There were 30 polymicrobial infections. A total of 42 and 37 patients were randomized to a high-pressure pulsatile or a low-pressure lavage, respectively. There was no difference in the success rate between both arms (80.9 vs. 86.5%, p = 0.56).
Conclusion
The use of a high-pressure pulsatile lavage during open débridement of implant infections had a similar success rate as a low-pressure lavage.
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Conflict of interest
For the present study, the authors have received a grant of 4000€ from Stryker®. No financial arrangement entered between the sponsor of the covered study and the study staff or an immediate family member involved in the conduct of the covered study, whereby the value of the grant has not influenced in the outcome of the study. The authors declare that they have no affiliations that might affect the objective and scientific presentation of this research. All authors have full control of all primary data and they agree to allow the journal to review their data if requested.
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Muñoz-Mahamud, E., García, S., Bori, G. et al. Comparison of a low-pressure and a high-pressure pulsatile lavage during débridement for orthopaedic implant infection. Arch Orthop Trauma Surg 131, 1233–1238 (2011). https://doi.org/10.1007/s00402-011-1291-8
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DOI: https://doi.org/10.1007/s00402-011-1291-8