Mouldable Collagen–Tricalciumphosphate Is a Safe Carrier for Local Antibiotics—Short-Term Results in Revision Hip Arthroplasty

TL;DR

This study shows that using a collagen-tricalciumphosphate composite to deliver local antibiotics in hip revision surgery is safe and effective for treating joint infections.

Contribution

The study demonstrates the safety and efficacy of a new mouldable composite as a local antibiotic carrier in hip arthroplasty.

Findings

No cases of hypercalcaemia were observed in patients using the composite.

Implant survival was achieved in 92% of patients during a 12-month follow-up.

Local antibiotic delivery using the composite did not cause significant systemic complications.

Abstract

Background: Improving local antibiotic delivery is a promising approach to improve infection control and potentially shorten systemic treatment in periprosthetic joint infection (PJI). This study investigates the use of an antibiotic-loaded, mouldable collagen–tricalciumphosphate composite in treatment of hip PJI. Methods: 124 application cases in 79 patients were included from a referral centre; systemic adverse infects, local complications, and infection control were analysed. Results: In most cases, either vancomycin or meropenem were used. Pathogens were previously known in 82 (66%) cases with polymicrobial infection in 20 (25%) patients. There were no cases of hypercalcaemia. Acute kidney injure was present in 14 (11%) cases. Chronic kidney failure persisted in two cases. During a mean follow-up of 12 (SD 9.3; range 3–35) months, implant survival was achieved in 73 (92%) patients; revision due to PJI was performed in 19 cases. Conclusion: Mouldable collagen–tricalciumphosphate composite bone substitute as a local antibiotic carrier in revision hip arthroplasty appears to be a valid option for local antibiotic delivery without systemic complications. Implant survival of 92% supports the hypothesis that local antibiotic therapy is an important component in the treatment of PJI.

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