Andriollo Luca, Sangaletti Rudy, Velluto Calogero, Perticarini Loris, Benazzo Francesco, Rossi Stefano Marco Paolo
Robotic Prosthetic Surgery Unit-Sports Traumatology Unit, Fondazione Poliambulanza Hospital, 25124 Brescia, Italy.
Department of Orthopedics, Catholic University of the Sacred Heart, 00168 Rome, Italy.
J Clin Med. 2024 May 24;13(11):3092. doi: 10.3390/jcm13113092.
Periprosthetic joint infection (PJI) represents a challenge following hip or knee arthroplasty, demanding immediate intervention to prevent implant failure and systemic issues. Bacterial biofilm development on orthopedic devices worsens PJI severity, resulting in recurrent hospitalizations and significant economic burdens. The objective of this retrospective cohort study is to evaluate the efficacy of this novel antiseptic solution, never previously evaluated in vivo, in managing early post-operative or acute hematogenous PJI following primary hip and knee joint replacements. The inclusion criteria consist of patients with total hip arthroplasty (THA) or knee arthroplasty diagnosed with acute PJI through preoperative and intraoperative investigations, in accordance with the MSIS ICM 2018 criteria. The minimum required follow-up was 12 months from the cessation of antibiotic therapy. This novel antiseptic lavage solution is composed of ethanol, acetic acid, sodium acetate, benzalkonium chloride and water. Data included demographic characteristics, diagnostic criteria, surgical techniques, post-operative treatment and follow-up outcomes. A total of 39 patients treated with Debridement, Antibiotics Pearls and Retention of the Implant (DAPRI) procedures using this solution between May 2021 and April 2023 were analyzed. At a mean follow-up of 24.6 ± 6.4 months, infection recurrence-free survival rates were 87.2%, with no local allergic reactions or relevant systemic adverse effects detected. Persistent PJI necessitated two-stage revision surgery. This novel antiseptic lavage solution shows promise as an adjunctive tool in the treatment of PJI, demonstrating support in infection control while maintaining a favorable safety profile.
人工关节周围感染（PJI）是髋关节或膝关节置换术后面临的一项挑战，需要立即进行干预以防止植入物失效和出现全身问题。骨科器械上细菌生物膜的形成会加重PJI的严重程度，导致患者反复住院并造成巨大经济负担。这项回顾性队列研究的目的是评估这种新型防腐溶液（此前从未在体内进行过评估）在处理初次髋关节和膝关节置换术后早期或急性血源性PJI方面的疗效。纳入标准包括根据MSIS ICM 2018标准，通过术前和术中检查被诊断为急性PJI的全髋关节置换术（THA）或膝关节置换术患者。从停止抗生素治疗起，所需的最短随访时间为12个月。这种新型防腐灌洗溶液由乙醇、醋酸、醋酸钠、苯扎氯铵和水组成。数据包括人口统计学特征、诊断标准、手术技术、术后治疗和随访结果。对2021年5月至2023年4月期间使用该溶液通过清创、抗生素珠和保留植入物（DAPRI）程序治疗的39例患者进行了分析。平均随访24.6±6.4个月时，无感染复发生存率为87.2%，未检测到局部过敏反应或相关全身不良反应。持续性PJI需要进行两阶段翻修手术。这种新型防腐灌洗溶液有望作为治疗PJI的辅助工具，在控制感染的同时保持良好的安全性。
