Infection in orthopaedic oncology: crucial problem in modern reconstructive techniques

Area of Science:

• Orthopaedic Oncology
• Infectious Disease
• Biomaterials Science

Background:

• Post-operative infections are a frequent and challenging complication in orthopaedic oncology surgery, with rates up to 47% after pelvic procedures.
• These infections can delay crucial cancer treatments, negatively impacting patient prognosis.
• Effective prevention and management strategies are critical concerns in this patient population.

Purpose of the Study:

• To review and analyze existing literature on strategies and novel materials for preventing infections in musculoskeletal oncology surgery.
• To assess the potential of new materials in reducing implant-related infections and biofilm formation.

Main Methods:

• Literature review focusing on studies investigating new materials for infection prevention in orthopaedic oncology.
• Analysis of data regarding the efficacy of iodine-coating, DAC-coating, and silver-coating technologies.

Main Results:

• Iodine-coating and silver-coating implants have shown efficacy against early post-operative infections, potentially reducing implant removal and amputation rates.
• DAC-coating shows initial promise in non-oncological patients, but its efficacy in orthopaedic oncology remains unstudied.
• Silver-coated prostheses are suggested as a viable option for revision surgery following infection.

Conclusions:

• New materials like iodine and silver coatings offer potential for reducing infection risk in orthopaedic oncology.
• While silver-coated prostheses are recommended for infected revision cases, current evidence does not definitively prove a drastic reduction in infection rates.
• Further extensive studies with long-term follow-up are necessary to establish the definitive efficacy of these advanced materials.