Two-stage cementless hip revision for peri-prosthetic infection with an antibacterial hydrogel coating: results of a comparative series.

Abstract

The aim of this study was to investigate the hypothesis that a two-stage exchange procedure, performed with an antibiotic-loaded, fast-resorbable hydrogel coating, may provide better infection cure rate than a two-stage procedure without the coating, in patients affected by peri-prosthetic hip infection. In this case-control study, 27 patients, treated with a two-stage procedure, using cementless implants coated with an antibiotic-loaded hydrogel (DAC®, "Defensive Antibacterial Coating"), were compared with 27 matched controls, treated with a two-stage cementless revision procedure, without the coating. At a mean follow-up of 2.7 (minimum 2.1-maximum 3.5) years, no evidence of infection, implant loosening, or adverse events were observed in the DAC-treated group, compared to four cases of infection recurrence in the control group. Although in a relatively limited series of patients our data show that cementless two-stage hip revision, performed with an antibacterial hydrogel coating, may provide better infection control than two-stage without the coating, with reduced hospitalization time, these findings warrant further studies in the possible applications of antibacterial coating technologies to treat implant-related infections.