Antibiotic-loaded calcium sulfate nails are ‘100% effective’ for infection prophylaxis
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Antibiotic, calcium sulfate-coated intramedullary nails are safe and “100% effective” for long bone infection prophylaxis and could be comparable to polymethylmethacrylate antibiotic-coated nails, according to a presenter.
In a study presented at the Limb Lengthening and Reconstruction Society Annual Scientific Meeting, Emilie-Ann Downey, MD, CM, FRCSC, and Austin T. Fragomen, MD, retrospectively reviewed data for 33 patients who underwent a limb salvage procedure for either infection prophylaxis (n = 24) or infection cure (n = 9) with antibiotic-loaded calcium sulfate intramedullary nails (ACS-IMN) from May 2017 to June 2020, and 28 patients who underwent a limb salvage procedure for infection cure with polymethylmethacrylate (PMMA) antibiotic-coated intramedullary nails (ACC-IMN) from January 2010 to August 2017.
“The use of a dissolving, local antibiotic delivery system has improved workflow, reduced operative time and controlled infection, revolutionizing orthopedic limb deformity and trauma surgery,” Fragomen told Healio Orthopedics.
Overall, the limb salvage rate for the nine patients treated with ACS-IMN to eradicate infection was 100% compared with 89% (n = 25) in the 28 patients treated with ACC-IMN. Infection was eradicated in 77.8% of patients (n = 7) in the ACS-IMN group vs. 80% of patients (n = 21) in the in ACC-IMN group. Additionally, researchers noted bone union or fusion was achieved in 88.9% of patients (n = 8) in the ACS-IMN group vs. 87.5% of patients (n = 21) in the ACC-IMN group.
“ACS-IMNs were found to be noninferior to ACC-IMNs for infection eradication in septic complex extremity reconstruction,” Downey told Healio Orthopedics. “ACS-IMNs are not only safe and easy to perform, but were also found to be 100% effective in our series for infection prophylaxis in high-risk cases where infection was suspected,” she concluded.
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Downey EA, et al. Antibiotic-loaded calcium sulfate coating vs antibiotic-loaded PMMA coating for intramedullary nails in septic complex extremity reconstruction. Presented at: Limb Lengthening and Reconstruction Society Annual Scientific Meeting; July 16-17, 2021; New York.
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