Two-stage revision for infection of oncological megaprostheses : a multicentre EMSOS study.

IF 4.9 1区医学 Q1 ORTHOPEDICS Bone & Joint Journal Pub Date : 2025-02-01 DOI:10.1302/0301-620X.107B2.BJJ-2024-0562.R2

Andrea Sambri, Domenico A Campanacci, Elisa Pala, Maria A Smolle, Davide M Donati, Michiel A J van de Sande, Oleg Vyrva, Andreas Leithner, Lee Jeys, Pietro Ruggieri, Massimiliano De Paolis, Michele Fiore, Marta Bortoli, Alessandro Bruschi, Elisabetta Neri, Diogo Catelas, Vania Oliveira, Marko Bergovec, Korhan Özkan, Aykut Çelik, Erhan Okay, Luca Cevolani, Robert V der Wal, Richard Evenhuis, Minna Laitinen, Roman Malik, Andreas Krieg, Paul Jutte, Min W Joo, Tariq Azamgarhi, Craig Gerrand, Rob Pollock, Jasprit Kaur, Jonathan Stevenson, Hartej Sur, Guy Morris

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引用次数: 0

Abstract

Aims: The aim of this study was to assess the incidence of reinfection in patients after two-stage revision of an infected megaprosthesis (MPR) implanted after resection of a bone tumour.

Methods: A retrospective study was carried out of 186 patients from 16 bone sarcoma centres treated between January 2010 and December 2020. The median age at the time of tumour diagnosis was 26 years (IQR 17 to 33); 69 (37.1%) patients were female, and 117 (62.9%) were male.

Results: A total of 186 patients with chronic MPR infections were included. Median follow-up was 68 months (IQR 31 to 105). The most represented sites of MPR were distal femur in 93 cases (50.0%) and proximal tibia in 53 cases (28.5%). Polymicrobial infections were seen in 34 cases (18.3%). The most frequent isolated pathogens were staphylococci. Difficult-to-treat (DTT) pathogens were isolated in 50 cases (26.9%). The estimated infection recurrence (IR) rate was 39.1% at five years and 50.0% at ten years. A higher IR rate was found in DTT PJI compared to non-DTT infections (p = 0.019). Polymicrobial infections also showed a higher rate of infection recurrence (p = 0.046).

Conclusion: This study suggests that an infected MPR treated by two-stage revision and ultimately reimplantation with a MPR can be successful, but the surgeon must be aware of a high recurrence rate compared to those seen with infected conventional implants.

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来源期刊

Bone & Joint Journal ORTHOPEDICS-SURGERY

CiteScore

9.40

自引率

10.90%

发文量

318

期刊介绍： We welcome original articles from any part of the world. The papers are assessed by members of the Editorial Board and our international panel of expert reviewers, then either accepted for publication or rejected by the Editor. We receive over 2000 submissions each year and accept about 250 for publication, many after revisions recommended by the reviewers, editors or statistical advisers. A decision usually takes between six and eight weeks. Each paper is assessed by two reviewers with a special interest in the subject covered by the paper, and also by members of the editorial team. Controversial papers will be discussed at a full meeting of the Editorial Board. Publication is between four and six months after acceptance.