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One-stage revision surgery for infected megaprostheses
G Holzer1, R Windhager, R Kotz
1University Clinic for Orthopaedics, Vienna, Austria.
Abstract:
We have reviewed the results of one-stage revision surgery in 18 patients for infection of megaprostheses implanted after the resection of malignant bone and soft-tissue tumours. At a mean follow-up of 52.0 +/- 35.0 months (18 to 135) infection was eliminated in 14 of the 18 patients. The infection-free patients showed no abnormal tests for inflammation and had a mean Enneking score of 20.6 +/- 5.0 points (maximum 30 points). We suggest that one-stage revision without exchange of the anchorage parts is justified in patients with megaprostheses infected by antibiotic-sensitive micro-organisms.
Insights
One-stage revision surgery successfully eliminated infection in 14 of 18 patients with infected bone tumor megaprostheses. This approach is effective for megaprostheses infected by antibiotic-sensitive microorganisms.
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.