Commercially available antibiotic-laden PMMA-covered locking nails for the treatment of fracture-related infections - A retrospective case analysis of 10 cases

Jorge-Mora, Alberto; Amhaz-Escanlar, Samer; Fernandez-Pose, Sabela; García-Iglesias, Adrián; Mandia-Mancebo, Fermín; Franco-Trepat, Eloi; Guillán-Fresco, María; Pino-Minguez, Jesús

doi:https://doi.org/10.7150/jbji.34072

Articles | Volume 4, issue 4

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Articles | Volume 4, issue 4

https://doi.org/10.7150/jbji.34072

Articles | Volume 4, issue 4

Article
Metrics
Related articles

Original full-length article

05 Jul 2019

Original full-length article |

| 05 Jul 2019

Commercially available antibiotic-laden PMMA-covered locking nails for the treatment of fracture-related infections - A retrospective case analysis of 10 cases

Alberto Jorge-Mora, Samer Amhaz-Escanlar, Sabela Fernandez-Pose, Adrián García-Iglesias, Fermín Mandia-Mancebo, Eloi Franco-Trepat, María Guillán-Fresco, and Jesús Pino-Minguez

Alberto Jorge-Mora

Division of Traumatology, Santiago University Clinical Hospital, Santiago de Compostela, Spain

Faculty of Medicine, University of Santiago de Compostela, Spain

Musculoskeletal Pathology Group, Laboratory 18, Institute IDIS, Servicio Galego de Saúde, Santiago de Compostela, Spain

Samer Amhaz-Escanlar

Division of Traumatology, Santiago University Clinical Hospital, Santiago de Compostela, Spain

Faculty of Medicine, University of Santiago de Compostela, Spain

Sabela Fernandez-Pose

Division of Traumatology, Santiago University Clinical Hospital, Santiago de Compostela, Spain

Adrián García-Iglesias

Division of Traumatology, Santiago University Clinical Hospital, Santiago de Compostela, Spain

Fermín Mandia-Mancebo

Division of Traumatology, Santiago University Clinical Hospital, Santiago de Compostela, Spain

Faculty of Medicine, University of Santiago de Compostela, Spain

Eloi Franco-Trepat

Musculoskeletal Pathology Group, Laboratory 18, Institute IDIS, Servicio Galego de Saúde, Santiago de Compostela, Spain

María Guillán-Fresco

Musculoskeletal Pathology Group, Laboratory 18, Institute IDIS, Servicio Galego de Saúde, Santiago de Compostela, Spain

Jesús Pino-Minguez

Division of Traumatology, Santiago University Clinical Hospital, Santiago de Compostela, Spain

Faculty of Medicine, University of Santiago de Compostela, Spain

Cited articles

Court-Brownd CM, Clement ND, Duckworth AD, Biant LC, McQueen MM. The changing epidemiology of fall-related fractures in adults. Injury. 2017;48:819–24.

Court-Brown CM, McQueen MM. Global Forum: Fractures in the Elderly. J Bone Joint Surg Am. 2016;98:e36.

Doshi P, Gopalan H, Sprague S, Pradhan C, Kulkarni S, Bhandari M. Incidence of infection following internal fixation of open and closed tibia fractures in India (INFINITI): a multi-centre observational cohort study. BMC Musculoskelet Disord. 2017;18:156. [PMC free article]

Harwood PJ, Giannoudis PV, Probst C, Krettek C, Pape HC. The risk of local infective complications after damage control procedures for femoral shaft fracture. J Orthop Trauma. 2006;20:181–9.

Backes M, Dingemans SA, Dijkgraaf MGW, van den Berg HR, van Dijkman B, Hoogendoorn JM. et al. Effect of Antibiotic Prophylaxis on Surgical Site Infections Following Removal of Orthopedic Implants Used for Treatment of Foot, Ankle, and Lower Leg Fractures: A Randomized Clinical Trial. JAMA. 2017;318:2438–45. [PMC free article]

Metsemakers WJ, Kortram K, Morgenstern M, Moriarty TF, Meex I, Kuehl R. et al. Definition of infection after fracture fixation: A systematic review of randomized controlled trials to evaluate current practice. Injury. 2018;49:497–504.

Metsemakers WJ, Morgenstern M, McNally MA, Moriarty TF, McFadyen I, Scarborough M. et al. Fracture-related infection: A consensus on definition from an international expert group. Injury. 2018;49:505–10.

Ali AM, McMaster JM, Noyes D, Brent AJ, Cogswell LK. Experience of managing open fractures of the lower limb at a major trauma centre. Ann R Coll Surg Engl. 2015;97:287–90. [PMC free article]

Bose D, Kugan R, Stubbs D, McNally M. Management of infected nonunion of the long bones by a multidisciplinary team. Bone Joint J; 2015. p. 97. -B: 814-7.

Bonnevialle P. Operative treatment of early infection after internal fixation of limb fractures (exclusive of severe open fractures) Orthop Traumatol Surg Res. 2017;103:S67–S73.

Tosounidis TH, Calori GM, Giannoudis PV. The use of Reamer-irrigator-aspirator in the management of long bone osteomyelitis: an update. Eur J Trauma Emerg Surg. 2016;42:417–23. [PMC free article]

Wasko MK, Borens O. Antibiotic cement nail for the treatment of posttraumatic intramedullary infections of the tibia: midterm results in 10 cases. Injury. 2013;44:1057–60.

Conway J, Mansour J, Kotze K, Specht S, Shabtai L. Antibiotic cement-coated rods: an effective treatment for infected long bones and prosthetic joint nonunions. Bone Joint J; 2014. p. 96. -B: 1349-54.

Conway JD, Hlad LM, Bark SE. Antibiotic cement-coated plates for management of infected fractures. Am J Orthop (Belle Mead NJ) 2015;44:E49–53.

Paley D, Herzenberg JE. Intramedullary infections treated with antibiotic cement rods: preliminary results in nine cases. J Orthop Trauma. 2002;16:723–9.

Metsemakers WJ, Reul M, Nijs S. The use of gentamicin-coated nails in complex open tibia fracture and revision cases: A retrospective analysis of a single centre case series and review of the literature. Injury. 2015;46:2433–7.

Antoci V, Phillips MJ, Antoci V Jr, Krackow KA. Using an antibiotic-impregnated cement rod-spacer in the treatment of infected total knee arthroplasty. Am J Orthop (Belle Mead NJ) 2009;38:31–3.

Chou DT, Pullinger M, Davis B. A method of fabricating an antibiotic cement spacer using an elastic nail for the treatment of intramedullary osteomyelitis. Ann R Coll Surg Engl. 2015;97:157–8. [PMC free article]

Noh JH, Koh SJ, Lee KH. Treatment of Proximal Femur Osteomyelitis Occurred after Proximal Femoral Nail Antirotation Fixation, with Antibiotic Cement-coated Tibia Intramedullary Nail: A Case Report. Hip Pelvis. 2018;30:45–52. [PMC free article]

Pradhan C, Patil A, Puram C, Attarde D, Sancheti P, Shyam A. Can antibiotic impregnated cement nail achieve both infection control and bony union in infected diaphyseal femoral non-unions? Injury. 2017;48(Suppl 2):S66–S71.

Qiang Z, Jun PZ, Jie XJ, Hang L, Bing LJ, Cai LF. Use of antibiotic cement rod to treat intramedullary infection after nailing: preliminary study in 19 patients. Arch Orthop Trauma Surg. 2007;127:945–51.

Riel RU, Gladden PB. A simple method for fashioning an antibiotic cement-coated interlocking intramedullary nail. Am J Orthop (Belle Mead NJ) 2010;39:18–21.

Wasko MK, Kaminski R. Custom-Made Antibiotic Cement Nails in Orthopaedic Trauma: Review of Outcomes, New Approaches, and Perspectives. Biomed Res Int. 2015;2015:387186. [PMC free article]

Alt V. Antimicrobial coated implants in trauma and orthopaedics-A clinical review and risk-benefit analysis. Injury. 2017;48:599–607.

Schmidmaier G, Kerstan M, Schwabe P, Sudkamp N, Raschke M. Clinical experiences in the use of a gentamicin-coated titanium nail in tibia fractures. Injury. 2017;48:2235–41.

Liporace FA, Yoon RS, Frank MA, Gaines RJ, Maurer JP, Polishchuk DL. et al. Use of an "antibiotic plate" for infected periprosthetic fracture in total hip arthroplasty. J Orthop Trauma. 2012;26:e18–23.

Kühn K. Antibiotic loaded bone cements-antibiotic release and influence on mechanical properties. Local Antibiotics in Arthroplasty: Thieme; 2007. [Google Scholar]

Moghaddam A, Graeser V, Westhauser F, Dapunt U, Kamradt T, Woerner SM. et al. Patients' safety: is there a systemic release of gentamicin by gentamicin-coated tibia nails in clinical use? Ther Clin Risk Manag. 2016;12:1387–93. [PMC free article]

Frommelt L. Antibiotic choices in bone surgery-local therapy using antibiotic loaded bone cement. Local Antibiotics in Arthroplasty: Thieme; 2007. p. 59. [Google Scholar]

Karek MR, Jackson NM, Flynn JC, Vaidya R, Markel DC. Elution Profiles of Two Methods of Antibiotic Tibial Nail Preparations. Orthopedics. 2017;40:e436–e42.

Koury KL, Hwang JS, Sirkin M. The Antibiotic Nail in the Treatment of Long Bone Infection: Technique and Results. Orthop Clin North Am. 2017;48:155–65.

Selhi HS, Mahindra P, Yamin M, Jain D, De Long WG Jr, Singh J. Outcome in patients with an infected nonunion of the long bones treated with a reinforced antibiotic bone cement rod. J Orthop Trauma. 2012;26:184–8.

Kanakaris N, Gudipati S, Tosounidis T, Harwood P, Britten S, Giannoudis PV. The treatment of intramedullary osteomyelitis of the femur and tibia using the Reamer-Irrigator-Aspirator system and antibiotic cement rods. Bone Joint J; 2014. p. 96. -B: 783-8.

Klaue K, Knothe U, Masquelet A. Effet biologique des membranes à corps étranger induites in situ sur la consolidation des greffes d'os spongieux. Rev Chir Orthop Suppl. 1995;70:109–10. [Google Scholar]

Sheehy SH, Atkins BA, Bejon P, Byren I, Wyllie D, Athanasou NA. et al. The microbiology of chronic osteomyelitis: prevalence of resistance to common empirical anti-microbial regimens. J Infect. 2010;60:338–43.

Thakore RV, Greenberg SE, Shi H, Foxx AM, Francois EL, Prablek MA. et al. Surgical site infection in orthopedic trauma: A case-control study evaluating risk factors and cost. J Clin Orthop Trauma. 2015;6:220–6. [PMC free article]

Morgenstern M, Moriarty TF, Kuehl R, Richards RG, McNally MA, Verhofstad MHJ. et al. International survey among orthopaedic trauma surgeons: Lack of a definition of fracture-related infection. Injury. 2018;49:491–6.

Metsemakers WJ, Kuehl R, Moriarty TF, Richards RG, Verhofstad MHJ, Borens O. et al. Infection after fracture fixation: Current surgical and microbiological concepts. Injury. 2018;49:511–22.

Rand BC, Penn-Barwell JG, Wenke JC. Combined local and systemic antibiotic delivery improves eradication of wound contamination: An animal experimental model of contaminated fracture. Bone Joint J; 2015. p. 97. -B: 1423-7.

Dudareva M, Ferguson J, Riley N, Stubbs D, Atkins B, McNally M. Osteomyelitis of the Pelvic Bones: A Multidisciplinary Approach to Treatment. J Bone Jt Infect. 2017;2:184–93. [PMC free article]

Metsemakers WJ, Onsea J, Neutjens E, Steffens E, Schuermans A, McNally M. et al. Prevention of fracture-related infection: a multidisciplinary care package. Int Orthop. 2017;41:2457–69.

Toro-Ibarguen A, Moreno-Beamud JA, Porras-Moreno MA, Aroca-Peinado M, Leon-Baltasar JL, Jorge-Mora AA. The number of locking screws predicts the risk of nonunion and reintervention in periprosthetic total knee arthroplasty fractures treated with a nail. Eur J Orthop Surg Traumatol. 2015;25:661–4.

Thonse R, Conway J. Antibiotic cement-coated interlocking nail for the treatment of infected nonunions and segmental bone defects. J Orthop Trauma. 2007;21:258–68.

Olesen UK, Pedersen NJ, Eckardt H, Lykke-Meyer L, Bonde CT, Singh UM. et al. The cost of infection in severe open tibial fractures treated with a free flap. Int Orthop. 2017;41:1049–55.

Corona PS, Barro V, Mendez M, Caceres E, Flores X. Industrially prefabricated cement spacers: do vancomycin- and gentamicin-impregnated spacers offer any advantage? Clin Orthop Relat Res. 2014;472:923–32. [PMC free article]

Pino-Minguez J, Jorge-Mora A, Couceiro-Otero R, Garcia-Santiago C. Study of the viability and adhesion of osteoblast cells to bone cements mixed with hydroxyapatite at different concentrations to use in vertebral augmentation techniques. Rev Esp Cir Ortop Traumatol. 2015;59:122–8.