The use of silver-coated endoprosthesis in the treatment of periprosthetic joint infections

Abstract

Background Periprosthetic joint infection is the most feared complication of joint arthroplasty. The incidence vary between studies and countries being about a 2% and reaching a 5% in revision arthroplasties, but this numbers are expected to rise due to the growing number of arthroplasties that are being performed. The prognosis and evolution of those following revision arthroplasties, who became infected, is worse, than in those in which infection occurs in the first arthroplasty. Periprosthetic joint infection causes pain, discomfort and disability of the joint, and its management implies prolonged and sometimes complex therapies and long hospital stays, that not always succeed in solve the problem, or they do, by leaving the patient with low performance status and reduced life quality. As the current treatments, still doesn’t have the best rate of success. The use of silver-coated prosthesis is proposed as a promising treatment, regarding the anti-infective properties of silver and the encouraging results obtained in previous studies. Purpose The main purpose of this study is to prove the increment in the treatment success of periprosthetic joint infection by performing an attempted eradication with implant replacement and antibiotics implanting a silver-coated prosthesis. Design A randomized, controlled multicentric clinical trial will be performed in charge of the department of internal medicine from Hospital Josep Trueta of Girona, with the participation of hospitals Vall d ’Hebron and Clinic from Barcelona. Participants Patients with hip or knee periprosthetic joint infection with surgical indication for attempting implant replacement in 1-stage or 2-satage exchange. Coming to the hospitals Josep Trueta from Girona, Vall d’hebron and Clinic from Barcelona