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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 3, 314-319.
doi: 10.1302/0301-620X.87B3.14788  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Vancomycin-supplemented impacted bone allografts in infected hip arthroplasty

TWO-STAGE REVISION RESULTS

M. A. Buttaro, MD, Orthopaedic Surgeon; R. Pusso, MD, Consultant Orthopaedic Surgeon; and F. Piccaluga, MD, Hip Surgery Unit Chief, Orthopaedic Surgeon

The Hip Surgery Unit, Institute of Orthopaedics "Carlos E. Ottolenghi" Italian Hospital, Potosi 4215 (C1199ACK), Buenos Aires, Argentina.

Correspondence should be sent to Dr M. A. Buttaro; e-mail: cadera{at}hospitalitaliano.org.ar

Bone allografts can store and release high levels of vancomycin. We present our results of a two-stage treatment for infected hip arthroplasty with acetabular and femoral impaction grafting using vancomycin-loaded allografts. We treated 29 patients (30 hips) by removal of the implants, meticulous debridement, parenteral antibiotic therapy and second-stage reconstruction using vancomycin-supplemented impacted bone allografts and a standard cemented Charnley femoral component. The mean follow-up was 32.4 months (24 to 60). Infection control was obtained in 29 cases (re-infection rate of 3.3%; 95% confidence interval 0.08 to 17) without evidence of progressive radiolucent lines, demarcation or graft resorption. One patient had a further infection ten months after revision caused by a different pathogen. Associated post-operative complications were one traumatic periprosthetic fracture at 14 months, a single dislocation in two hips and four displacements of the greater trochanter. Vancomycin-supplemented allografts restored bone stock and provided sound fixation with a low incidence of further infection.




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(c) British Editorial Society of Bone and Joint Surgery All Rights Reserved
Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General