One-stage revision surgery for infected megaprostheses

Area of Science:

• Orthopedic Surgery
• Oncology
• Infectious Diseases

Background:

• Infection of megaprostheses following bone and soft-tissue tumor resection poses a significant clinical challenge.
• Traditional management often involves complex, multi-stage revision surgeries.
• Evaluating less invasive, effective treatment options is crucial for improving patient outcomes.

Purpose of the Study:

• To assess the efficacy of one-stage revision surgery in managing infected megaprostheses.
• To determine the infection elimination rate and functional outcomes after this surgical approach.
• To identify patient subgroups who may benefit from one-stage revision without prosthesis component exchange.

Main Methods:

• Retrospective review of 18 patients who underwent one-stage revision surgery for infected megaprostheses.
• Data collection included infection status, inflammatory markers, and functional scores (Enneking score).
• Mean follow-up duration was 52.0 months.

Main Results:

• Infection was successfully eliminated in 14 out of 18 patients (77.8%).
• Infection-free patients demonstrated normal inflammatory tests and achieved a mean Enneking score of 20.6/30.
• No abnormal inflammatory markers were observed in patients with successful infection eradication.

Conclusions:

• One-stage revision surgery is a viable and effective strategy for treating infected bone tumor megaprostheses.
• This approach is particularly justified in cases involving antibiotic-sensitive microorganisms.
• Preserving the anchorage parts during one-stage revision can lead to favorable functional outcomes and infection control.