Management of infected megaprosthesis with debridement and implant preservation using glutaraldehyde
Keywords:
Megaprosthesis, infection, debridementAbstract
Introduction:
Megaprosthesis infection is one of the most feared complications after a prosthesis insertion. It may increase the morbidity of the patients who are already in a dismal condition due to their cancerous condition. However, the prevalence of infection is reported to be between 3% and 31%. Many risk factors have been identified to be associated with increased risk of infection, but currently, no consensus on treatment is accepted.
Methods:
We present a series of two cases of megaprosthesis infection. The first one is a 39-year old male, with infected implant of the left distal femur post-wide excision and infected megaprosthesis due to Giant Cell Tumor Campanacci grade III. The second one is a 25-year old female with infected endoprosthesis post-wide excision of osteosarcoma of the right distal femur Enneking IIB. Both came after several months of megaprosthesis surgery. General examinations were within range and local examinations showed typical inflamed thigh. Debridement surgery with implant re-sterilization were performed to both cases. Post-operative results were satisfactory and the patients were relieved of pain.
Results:
Although no methods have been accepted as the gold standard, we performed debridement to our cases in order to resterilize
the implant. This gave the patients the advantage of shorter duration of surgery and less economical burden. We also treated the S. aureus infections conservatively. The outcomes for both patients were satisfactory.
Conclusion:
Debridement and irrigation with implant retention were effective for infected megaprosthesis cases and the results were favorable. Longer follow-ups are needed to ascertain the survival rate of the cases.
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References
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