Ismat, Abdullah and Walter, Nike and Baertl, Susanne and Mika, Joerg and Lang, Siegmund and Kerschbaum, Maximilian and Alt, Volker and Rupp, Markus (2021) Antibiotic cement coating in orthopedic surgery: a systematic review of reported clinical techniques. JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY, 22 (1): 56. ISSN 1590-9921, 1590-9999
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Background Antibiotic-containing cement and bone graft substitute-coated orthopedic implants provide the advantages of simultaneous local antibiotic delivery and internal stable fixation, aiding in both infection eradication and osseous healing. Standardized protocols pertaining to implant coating techniques in various clinical and particularly intraoperative settings are scarce, and available literature is limited. This systematic review aims to provide a summary of the available current literature reporting on custom-made coating techniques of orthopedic implants, indications, outcomes, and associated complications in clinical use. Methods A systematic search of the literature in PubMed, Medline, Embase, and Cochrane Library databases was performed in accordance with PRISMA guidelines. Articles reporting specifically on custom-made coating techniques of orthopedic implants in a clinical setting were eligible. Results A total of 41 articles with a cumulative total number of 607 cases were included. Indications for treatment mostly involved intramedullary infections after previous plate osteosynthesis or nailing. A variety of implants ranging from intramedullary nails, plates, wires, and rods served as metal cores for coating. Polymethylmethacrylate (PMMA) bone cement was most commonly used, with vancomycin as the most frequently added antibiotic additive. Chest tubes and silicone tubes were most often used to mold. Common complications are cement debonding and breakage of the metallic implant. Conclusion Adequate coating techniques can reduce the burden of treatment and be associated with favorable outcomes. Lack of general consensus and heterogeneity in the reported literature indicate that the perfect all-in-one implant coating method is yet to be found. Further efforts to improve implant coating techniques are warranted.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | IMPREGNATED CEMENT; INFECTED NONUNION; BONE-CEMENT; INTRAMEDULLARY INFECTIONS; CHRONIC OSTEOMYELITIS; COATED NAILS; LONG BONES; GENTAMICIN; ELUTION; SPACER; Bone cement coating; Implant coating; Osteosynthesis; Osteomyelitis |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Unfallchirurgie |
| Depositing User: | Petra Gürster |
| Date Deposited: | 10 Jan 2023 11:05 |
| Last Modified: | 10 Jan 2023 11:05 |
| URI: | https://pred.uni-regensburg.de/id/eprint/46684 |
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