Abstract
Purpose
Joint mega-prosthesis after bone tumors, severe trauma or infection is associated with high rates of post-surgical septic complications. A fast-resorbable antibacterial hydrogel coating (DAC®, Defensive Antibacterial Coating) has previously been shown to be able to significantly reduce surgical site infection in various clinical settings. Aim of the present study was to evaluate the safety and efficacy of the DAC hydrogel coating to prevent early periprosthetic joint infection after joint mega-prosthesis.
Methods
In this three-centers, case–control study, 43 patients, treated with an antibacterial hydrogel coated mega-prosthesis for oncological (N = 39) or non-oncological conditions (N = 4), were retrospectively compared with 43 matched controls, treated with mega-implants without the coating. Clinical, laboratory and radiographic examinations were performed to evaluate the occurrence of post-surgical infection, complications and adverse events.
Results
At a mean follow-up of 2 years, no evidence of infection or adverse events were observed in the DAC-treated group, compared to six cases of post-surgical infection in the control group.
Conclusion
This matched case–control study shows that a fast-resorbable, antibiotic-loaded coating can be safely used to protect joint mega-prosthesis, providing a reduction of early surgical site infections with no side effects. Larger prospective trials with longer follow-ups are warranted to confirm this report.
Trial registration
RS1229/19 (Regina Elena National Cancer Institute Experimental Registry Number)
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Availability of data and materials
All data are available hospital archives on request.
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Acknowledgements
We would like to acknowledge Dr. Carlo L. Romanò for his technical assistance and bibliographic search.
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C.Z., G.S. and F.L.G. contributed to conceptualization; C.Z., G.S., R.B., P.A.D., F.L.G. and D.A.C. were involved in surgeries and methodology ; C.Z. contributed to writing—original draft preparation; R.B., P.A.D. and D.A.C. were involved in supervision and writing—review and editing.
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Zoccali, C., Scoccianti, G., Biagini, R. et al. Antibacterial hydrogel coating in joint mega-prosthesis: results of a comparative series. Eur J Orthop Surg Traumatol 31, 1647–1655 (2021). https://doi.org/10.1007/s00590-021-02884-7
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DOI: https://doi.org/10.1007/s00590-021-02884-7