The use of an antibacterial implant in the treatment of periprosthetic infection in an HIV-positive patient

Abstract

Background: The frequency of occurrence of infectious complications after hip arthroplasty in HIV-infected patients is extremely high. Revision arthroplasty for periprosthetic infection is the leader (64%) among the causes of early revision interventions. The search for ways to increase the efficiency of the sanitizing stage of treatment due to antibacterial coatings of the endoprosthesis components continues.Objective: Demonstration of a clinical case of treatment of periprosthetic infection in an HIV-positive patient using a spacer and a femoral component of a hip joint endoprosthesis coated with linear Sp1 carbon chains and silver. 123 months after hip arthroplasty for stage 3 dysplastic coxarthrosis in HIV-positive patient of 42 years old developed an instability of the acetabular component with the growth of Staphylococcus aureus in punctates. A revision was performed with the removal of the endoprosthesis and the installation of an articulating spacer with the addition of antibiotics. 12 weeks later, a recurrence of periprosthetic infection occurred, and Enterococcus faecalis was detected in punctates. During re-endoprosthetics, there was an installation of an articulating spacer covered with a two-dimensionally ordered linear-chain carbon doped with silver, based on the Zimmer CPT femoral component and bone cement with antibiotics addition. After 3 months, the second stage of revision arthroplasty was performed with implantation of an individual acetabular component and a femoral component coated with two-dimensionally ordered linear-chain carbon doped with silver.Conclusion: 4 months after the operation the patient returned to work, 12 months later the functional results were satisfactory. The use of components coated with two-dimensionally ordered linear-chain carbon doped with silver in an HIV-positive patient with recurrent periprosthetic infection made it possible to stop the infectious process, improve limb function and the quality of life.