Abstract:
BACKGROUND:There is a concern regarding the use of a closed-suction drain (CSD) in two-stage exchange arthroplasty for periprosthetic joint infection as it may decrease the antibiotic concentrations in the joint fluids. The purpose of this study was to identify whether the use of a CSD could reduce local antibiotic concentrations following spacer implantation. METHODS:A prospective, randomized, controlled trial was conducted at our institution between January 2018 and November 2018. We enrolled 32 patients undergoing two-stage exchange arthroplasty for periprosthetic hip infection with an interim cement spacer containing 4-g vancomycin and 2-g meropenem per 40-g methyl-methacrylate cement polymer. Patients were randomized and evenly divided into the study group (non-CSD) and control group (CSD group) by sealed envelopes. Drainage samples of joint fluids (n = 160) were collected every 24 h for the first five days following spacer implantation. The antibiotic concentrations of drainage samples were measured by high-performance liquid chromatography, and the bioactivities of the drainage samples against methicillin-sensitive and methicillin-resistant Staphylococcus aureus (MSSA and MRSA) and E. coli were assessed. RESULTS:There was no significant difference in the decrease of vancomycin (study group vs. control group: 163.20 ± 77.05 vs. 162.39 ± 36.31; p = 0.917) and meropenem concentration (123.78 ± 21.04 vs. 117.27 ± 19.38; P = 0.548) between the two groups during the first five days following spacer implantation. All joint drainage samples in each group exhibited antibacterial activity against MSSA, MRSA and E. coli. CONCLUSIONS:The use of CSD following the implantation of an antibiotic-loaded cement spacer does not reduce the effectiveness of such a spacer in two-stage exchange arthroplasty. (Chinese Clinical Trial Registry, ChiCTR-INR-17014162. Registered 26 December 2017.).
journal_name
BMC Musculoskelet Disordjournal_title
BMC musculoskeletal disordersauthors
Xu C,Jia CQ,Kuo FC,Chai W,Zhang MH,Chen JYdoi
10.1186/s12891-019-2974-5subject
Has Abstractpub_date
2019-12-04 00:00:00pages
583issue
1issn
1471-2474pii
10.1186/s12891-019-2974-5journal_volume
20pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Vertebral fractures, the most common type of osteoporotic fractures, are associated with increased risk of subsequent fracture, morbidity, and mortality. The aim of this study was to examine the contribution of important risk factors to the variability in vertebral fracture risk. METHODS:Vertebral fracture ...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/1471-2474-13-163
更新日期:2012-08-31 00:00:00
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journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章,多中心研究,随机对照试验
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pub_type: 杂志文章,随机对照试验
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