gms | German Medical Science

54. Jahrestagung der Norddeutschen Orthopädenvereinigung e. V.

Norddeutsche Orthopädenvereinigung

16.06. bis 18.06.2005, Hamburg

The ENDO-Concept of the One Stage Exchange Procedure for Periprosthetic Infection

Meeting Abstract

Suche in Medline nach

  • corresponding author J. Wodtke - ENDO-Klinik Hamburg GmbH, Hamburg
  • L. Frommelt
  • F.-J. Löhr

Norddeutsche Orthopädenvereinigung. 54. Jahrestagung der Norddeutschen Orthopädenvereinigung e.V.. Hamburg, 16.-18.06.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05novP17

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/nov2005/05nov068.shtml

Veröffentlicht: 13. Juni 2005

© 2005 Wodtke et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Problem

Successful treatment of periprosthetic infections is still a challenge for the surgon. Special and effective defense mechanisms of the pathogen in presence of the foreign body (FB) require an adequate concept and due diligence other than in soft tissue infection.

Method

In 1969 BUCHOLZ developed the concept of antibiotic augmented bone cement that was effective in creating a high concentration of antibiotic directly around the FB through elution. With individual cement preparations according to the individual antibiogram the one stage exchange of the prosthesis could successfully be done. Prerequisites for this method are: an identified pathogen with susceptibility for the possible antibiotic combinations.

A complete and radical surgical debridement including bone and soft tissue and all foreign bodies (prostheseses, screws, wires, cement etc.)

The reimplantation using the individual augmented cement and postoperatively application of i.v. antibiotics for approximately 10 days

A close and permanent cooperation between surgeon an microbiologist is mandatory.

Results

Our last evaluation (2003) of 105 consecutive one stage exchange procedures of the hip replacement showed a success rate of 87,5% (5-7 years f.u.). This is well comparable to studies of other centers and the also advocated concept of the „two stage revision".

Conclusion

It is a save and established method of treatment of periprosthetic infections with clear advantages for the patient, the surgeon and the economy also in comparison to the other treatment options.