Continuous Local Antibiotic Perfusion for Periprosthetic Joint Infection After Tumor Endoprosthetic Reconstruction

Area of Science:

• Orthopedic Surgery
• Oncology
• Infectious Diseases

Background:

• Periprosthetic joint infection (PJI) after tumor reconstruction has high complication rates.
• Implant removal leads to significant morbidity, functional impairment, and potential amputation.
• Implant-preserving strategies are crucial for limb salvage and oncologic therapy continuation.

Purpose of the Study:

• To evaluate the efficacy of Continuous Local Antibiotic Perfusion (CLAP) in managing PJI after tumor endoprosthetic reconstruction.
• To assess the potential of CLAP as an implant-preserving treatment for PJI in this patient population.

Main Methods:

• Retrospective case series of three patients with PJI post-tumor reconstruction treated with CLAP.
• Surgical debridement followed by CLAP and systemic antibiotics.
• Evaluation of clinical characteristics, treatment, complications, and outcomes.

Main Results:

• All three patients completed CLAP and achieved infection control without implant removal.
• No major CLAP-related complications were observed during follow-up (2-22 months).
• One patient required two CLAP courses; transient gentamicin elevation occurred but normalized.

Conclusions:

• CLAP demonstrated success in controlling PJI with implant retention in this case series.
• CLAP may be a promising implant-preserving option for challenging PJI cases after tumor reconstruction.
• This approach supports limb preservation and ongoing oncologic treatment.