Antibiotic calcium sulfate beads may not reduce recurrent prosthetic joint infections
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Results showed use of antibiotic-loaded calcium sulfate beads during debridement, antibiotics and implant retention did not reduce the incidence of recurrent prosthetic joint infection at 2 years or 90 days postoperatively.
Based on Charlson Comorbidity Index, T. David Tarity, MD, and colleagues matched patients who either did (n=20) or did not (n=20) receive adjunctive, dissolvable antibiotic-loaded calcium sulfate beads during debridement, antibiotics and implant retention (DAIR) for acute or acute hematogenous prosthetic joint infection between 2013 and 2018.
“All patients were defined as acute, occurring within 6 weeks of the index procedure, or acute hematogenous, defined as infectious presenting with no more than 6 weeks of symptoms in a previously well-functioning prosthesis, as per the 2018 International Consensus Meeting on Periprosthetic Joint Infection,” Tarity said in his presentation at the Musculoskeletal Infection Society Annual Meeting.
Tarity noted the two groups had no significant differences related to patient demographics, including age, BMI and sex, as well as no significant differences in overall microbiology distribution of resistant antibiotic organisms. He added the two groups also had no significant differences in the use of intraoperative lavage adjuncts. Patients who did and those who did not receive adjunctive, dissolvable antibiotic-loaded calcium sulfate beads had no statistically significant differences in infection related failure at 2-years or 90-days postoperatively, according to Tarity.
“In total, 16 patients did not receive a modular component exchange due to their DAIR based on intraoperative considerations,” Tarity said. “This was evenly distributed between groups, with eight patients found in both the cases and the controls.”
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Xiang W, et al. Paper 729. Presented at: Musculoskeletal Infection Society Annual Meeting; Aug. 6-7, 2021; Fort Lauderdale, Florida (hybrid meeting).
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