Infection and Local Treatment in Orthopedic Surgery

Abstract

Introduction: The social and economical impact of orthopedic infections. Orthopedic device-related infections: Epidemiology and classification of device-related orthopedic infection.- Diagnostic challenges: early and differential diagnosis.- Bacterial strategies of implant colonization and resistance.- Pathologic findings of septic loosening.- Antibiotic prophylaxis in orthopedic surgery.- The limits of systemic antibiotics in device-related infections.- Antibiotic bone cement as a prophylactic means.- The limits of the local antibiotic therapy.- The role of suppressive therapy. Basic research and local antibiotic therapy: PMMA as drug delivery system and in vivo release from spacers.- Problems and pitfalls of antibiotic spacers.- The preformed spacers: from the idea to the realization of an industrial device.- Fatigue and wear characterization of the preformed hip spacer.- Fatigue characterization of the preformed knee spacer.- Surface analysis of the spacer before and after the clinical use.- Bone loss: does the use of the spacer affects it?- Antibiotic impregnated bone grafts - what do we know?- Antibiotic-loaded bone grafts: personal experience.- Bi-physical bone loss and permanent replacement.- Antibiotic loaded cement: from research to clinical evidence. Clinical applications: Hip: The management of infection in THA: an historical excursus.- Girdlestone arthroplasty after hip prosthesis infection - a two stage revision.- One stage cemented revision of septic hip prosthesis.- One stage non-cemented revision of septic hip prosthesis using antibiotic loaded bone graft.- One-stage or two-stage revision: the reason of a choice.-Block spacer vs preformed spacer in two-stage revision.- Two-stage revision with pre-formed hip spacers.-Two stage revision of septic hip prosthesis with uncemented implants.- Long-stem pre-formed spacers followed by uncemented implants: a solution for wide femoral opening or bone loss intwo-stage revision.- Two-stage cemented revision of septic hip implants.- Analysis of the gait in patients with hip spacers. Clinical applications: Knee: Septic knee prosthesis revision: a challenging surgery.- One stage cemented revision of septic knee prosthesis.- Static vs articulating spacers.- Antibiotic-loaded cement spacers for the 2-stage revision of TKR.- Key points in two-stage revision: bone loss, quality of life between stages and surgical approach at second stage.- Two-stage revision with pre-formed knee spacers and modular knee prosthesis.- Arthrodesis for the treatment of severe knee disease.- Arthrodesis and amputation.- Salvage procedures in exposed septic knee prosthesis. Novel applications and perspectives: The management of the shoulder prosthesis infection.- The shoulder spacer as a definitive solution?- The genta-vanco preformed spacer: pharmacological study.- Rationale of nail antibiotic clothing and 'in vivo' animal study.- The use of cemented antibiotic-loaded spacers in post-traumatic bone infections.- The use of antibiotic-impregnated cement in infected reconstructions after resection for bone tumors.- Antibiotic coatings: a new approach to infection prevention in orthopedics.- Local antibiotic therapy: present and future.