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Antibacterial hydrogel coating in joint mega-prosthesis: results of a comparative series

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

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.

Funding

This research received no external funding.

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Authors and Affiliations

  1. Oncological Orthopedics Department, IFO - Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy

    Carmine Zoccali & Roberto Biagini

  2. Department of Orthopaedic Oncology and Reconstructive Surgery, University of Florence, Azienda Ospedaliera Universitaria Careggi, Largo Brambilla, 3, 50134, Florence, Italy

    Guido Scoccianti & Domenico Andrea Campanacci

  3. Oncologic Surgery Centre, Gaetano Pini Orthopedic Institute, Via Quadronno, 25, 20122, Milan, Italy

    Primo Andrea Daolio & Fabio Luca Giardina

Authors
  1. Carmine Zoccali
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  2. Guido Scoccianti
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  3. Roberto Biagini
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  4. Primo Andrea Daolio
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  5. Fabio Luca Giardina
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  6. Domenico Andrea Campanacci
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Contributions

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.

Corresponding author

Correspondence to Carmine Zoccali.

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The authors declare that they have no conflict of interest.

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RS1229/19 (Regina Elena National Cancer Institute Experimental Registry Number).

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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

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