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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). p.438-438
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... (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.

TRIAL REGISTRATION: EU-CTR2018-004414-18 Retrospectively registered on November 20, 2018.

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organization
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type
Contribution to journal
publication status
published
subject
keywords
Aged, Aged, 80 and over, Anti-Bacterial Agents/administration & dosage, Arthroplasty, Replacement, Hip/adverse effects, Bone Remodeling, Bone Screws, Bone Substitutes, Calcium Sulfate, Drug Combinations, Durapatite, Feasibility Studies, Female, Follow-Up Studies, Fracture Fixation, Internal/adverse effects, Gentamicins/administration & dosage, Hip/diagnostic imaging, Hip Fractures/diagnostic imaging, Humans, Male, Middle Aged, Osteogenesis, Postoperative Complications, Prospective Studies, Radiography, Reoperation/adverse effects, Treatment Outcome
in
BMC Musculoskeletal Disorders
volume
19
issue
1
article number
438
pages
438 - 438
publisher
BioMed Central (BMC)
external identifiers
  • pmid:30522476
  • scopus:85058074398
ISSN
1471-2474
DOI
10.1186/s12891-018-2360-8
language
English
LU publication?
yes
id
13743c9e-8afc-4c5e-afdf-16c81e0360ad
date added to LUP
2018-12-18 14:24:01
date last changed
2020-06-01 15:07:22
@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).</p><p>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.</p><p>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.</p><p>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><p>TRIAL REGISTRATION: EU-CTR2018-004414-18 Retrospectively registered on November 20, 2018.</p>},
  author       = {Stravinskas, Mindaugas and Tarasevicius, Sarunas and Laukaitis, Simonas and Nilsson, Malin and Raina, Deepak Bushan and Lidgren, Lars},
  issn         = {1471-2474},
  language     = {eng},
  month        = {12},
  number       = {1},
  pages        = {438--438},
  publisher    = {BioMed Central (BMC)},
  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},
  doi          = {10.1186/s12891-018-2360-8},
  volume       = {19},
  year         = {2018},
}