Preventing and reducing periprosthetic joint infections

PERIPROSTHETIC JOINT INFECTION Rising numbers of revisions A higher life expectancy and surgery in younger patients is leading to an increasing number of revision procedures. These revisions are commonly caused by periprosthetic joint infections (PJI) as well as aseptic loosening. These are serious complications that affect the treatment algorithm, the patient and the healthcare system. (1– 3) CAUSES OF PROSTHETIC REVISIONS (1) 15.3 % The costs of a septic revision (hip & knee) exceed the refund at least two fold. (4 – 6) Due to increasing numbers of revisions, the cost issue will become increasingly...

COPAL® – SUCCESSFUL AGAINST INFECTION For patients at risk of infection & for revision surgery Choosing the right treatment algorithm is an essential factor for successfully preventing and reducing periprosthetic infections. For revisions – whether one-stage with good soft tissue conditions and known sensitive pathogens or two-stage with difficult soft tissue conditions and unknown resistant pathogens – the effectiveness of the therapy is increased by using antibiotic-loaded bone cement. (10) Heraeus provides support for therapy with COPAL® bone cement and COPAL® knee moulds to fabricate articulating...

INCREASED RISK OF INFECTION ALSO FOR PRIMARY PROCEDURES Comorbidity and traumatic incident The risk of infection after primary implantation of a hip or knee prosthesis is 1 % and 2 % respectively. (12) Comorbidities and attendant circumstances may increase the individual risk of infection. (13 –15) Excess weight Kidney disease Mortality and morbidity as a consequence of femoral neck fracture Older, frail patients are more commonly affected by femoral neck fractures. Every femoral neck fracture is associated with risk for patients. (16 –18) For patients with limited mobility and reduced general...

DUAL ANTIBIOTIC-LOADED BONE CEMENT REDUCES THE RATE OF INFECTIONS AFTER FEMORAL NECK FRACTURE The use of COPAL® G+C for femoral neck fractures significantly lowers the risk of infection in patients with cemented hip arthroplasty. This was the conclusion of INFECTION RATE DEEP SSI (IN %) a double-blind, two-arm, quasi-randomised study of 848 patients that recommended the use of high dose dual antibiotic-loaded bone cement. (19) ■ Low dose single antibiotic-loaded bone cement ■ High dose dual antibiotic-loaded bone cement 69 % lower rates of infection in patients with high dose dual antibioticloaded...

INFECTION – CAUSE AND POSSIBLE CONSEQUENCE OF THE REVISION Microbial diagnostics as the basis of treatment A common cause of revisions is septic loosening due to a periprosthetic infection. Correctly identifying the pathogen responsible is essential for choosing the appropriate antibiotic – both systemic and local. Depending on the spectrum of pathogens, COPAL® bone cements support the outcome of the treatment for septic revision. COPAL® bone cement combined with COPAL® knee moulds is an effective solution, particularly with the use of knee joint spacers. Coagulase-negative staphylococci Staphylococcus...

COPAL® SPECTRUM OF PATHOGENS * Gentamicin Coagulase-positive staphylococci (CoPS) (GRAM +) Staphylococcus aureus (MSSA) Staphylococcus aureus (MRSA) Coagulase-negative staphylococci (CoNS) (GRAM +) Staphylococcus epidermidis (MSSE) Staphylococcus epidermidis (MRSE) Streptococcus spp. (GRAM +) Streptococcus pneumoniae Streptococcus pyogenes Streptococcus agalactiae Enterococcus spp. (GRAM +) Enterococcus faecalis Enterococcus faecium Enterobacteriaceae spp. (GRAM –) Escherichia coli Proteus mirabilis Other (GRAM –) Pseudomonas aeruginosa Anaerobic bacteria (GRAM +) Clostridium difficile Clostridium...

High-viscosity, radiopaque bone cement with gentamicin and clindamycin High-viscosity, radiopaque bone cement with gentamicin and vancomycin COPAL® spacem High-viscosity, radiopaque special bone cement for the manufacture of spacers COPAL knee moulds Moulds for temporary knee spacers www.heraeus-medical.com Heraeus Medical GmbH Philipp-Reis-Str. 8/13 61273 Wehrheim Germany Simply order from Heraeu