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A ceramic bone substitute containing gentamicin gives good outcome in trochanteric hip fractures treated with dynamic hip screw and in revision of total hip arthroplasty : A case series

Stravinskas, Mindaugas; Tarasevicius, Sarunas LU ; Laukaitis, Simonas; Nilsson, Malin; Raina, Deepak Bushan LU and Lidgren, Lars LU (2018) In BMC Musculoskeletal Disorders 19(1).
Abstract

Background: The primary objective was to investigate the clinical and radiological outcome in patients undergoing major hip surgery using a novel antibiotic containing bone substitute for local augmentation in trochanteric fracture fixation or revision of total hip arthroplasty (THA). Methods: We implanted a novel biphasic bone substitute CERAMENT™|G consisting of hydroxyapatite, calcium sulphate and gentamicin for bone regeneration and local antibiotic delivery in 20 patients treated surgically for trochanteric femoral fracture or uncemented hip revision. Preoperative, postoperative, 3 months and 1 year clinical and radiological assessment were performed including registration of any complications. In one trochanteric fracture patient,... (More)

Background: The primary objective was to investigate the clinical and radiological outcome in patients undergoing major hip surgery using a novel antibiotic containing bone substitute for local augmentation in trochanteric fracture fixation or revision of total hip arthroplasty (THA). Methods: We implanted a novel biphasic bone substitute CERAMENT™|G consisting of hydroxyapatite, calcium sulphate and gentamicin for bone regeneration and local antibiotic delivery in 20 patients treated surgically for trochanteric femoral fracture or uncemented hip revision. Preoperative, postoperative, 3 months and 1 year clinical and radiological assessment were performed including registration of any complications. In one trochanteric fracture patient, histological analyses were performed of bone biopsies taken at removal of hardware. Results: None of the trochanteric fractures or revision of THA showed any large migration. No local wound disturbances were seen and no infection was observed at one year follow-up. All trochanteric fractures healed at 3 months with a minimal sliding screw displacement on average 3 mm. Radiological analysis showed signs of bone remodeling and new bone formation in the substitute, illustrated also by histology in the biopsies taken from one trochanteric fracture at one year post-op. Conclusions: Local CERAMENT™|G was shown to be safe in a limited prospective major hip surgery study. Remodeling of the bone graft substitute was observed in all patients.

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author
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Antibiotics, Bone remodeling, Ceramic bone substitute, Gentamicin, Hip surgery, Infection
in
BMC Musculoskeletal Disorders
volume
19
issue
1
publisher
BioMed Central
external identifiers
  • scopus:85058074398
ISSN
1471-2474
DOI
10.1186/s12891-018-2360-8
language
English
LU publication?
no
id
13743c9e-8afc-4c5e-afdf-16c81e0360ad
date added to LUP
2018-12-18 14:24:01
date last changed
2019-01-06 14:20:33
@article{13743c9e-8afc-4c5e-afdf-16c81e0360ad,
  abstract     = {<p>Background: The primary objective was to investigate the clinical and radiological outcome in patients undergoing major hip surgery using a novel antibiotic containing bone substitute for local augmentation in trochanteric fracture fixation or revision of total hip arthroplasty (THA). Methods: We implanted a novel biphasic bone substitute CERAMENT™|G consisting of hydroxyapatite, calcium sulphate and gentamicin for bone regeneration and local antibiotic delivery in 20 patients treated surgically for trochanteric femoral fracture or uncemented hip revision. Preoperative, postoperative, 3 months and 1 year clinical and radiological assessment were performed including registration of any complications. In one trochanteric fracture patient, histological analyses were performed of bone biopsies taken at removal of hardware. Results: None of the trochanteric fractures or revision of THA showed any large migration. No local wound disturbances were seen and no infection was observed at one year follow-up. All trochanteric fractures healed at 3 months with a minimal sliding screw displacement on average 3 mm. Radiological analysis showed signs of bone remodeling and new bone formation in the substitute, illustrated also by histology in the biopsies taken from one trochanteric fracture at one year post-op. Conclusions: Local CERAMENT™|G was shown to be safe in a limited prospective major hip surgery study. Remodeling of the bone graft substitute was observed in all patients.</p>},
  articleno    = {438},
  author       = {Stravinskas, Mindaugas and Tarasevicius, Sarunas and Laukaitis, Simonas and Nilsson, Malin and Raina, Deepak Bushan and Lidgren, Lars},
  issn         = {1471-2474},
  keyword      = {Antibiotics,Bone remodeling,Ceramic bone substitute,Gentamicin,Hip surgery,Infection},
  language     = {eng},
  month        = {12},
  number       = {1},
  publisher    = {BioMed Central},
  series       = {BMC Musculoskeletal Disorders},
  title        = {A ceramic bone substitute containing gentamicin gives good outcome in trochanteric hip fractures treated with dynamic hip screw and in revision of total hip arthroplasty : A case series},
  url          = {http://dx.doi.org/10.1186/s12891-018-2360-8},
  volume       = {19},
  year         = {2018},
}