Recon

Question 1

Treatment success rates for infected arthroplasty

Answer 1

10 - 25% eradication rate with ABs alone
50 - 55% eradication rate with Poly exchange (acute case)
75 - 100% eradication rate with One-stage revision
70 - 90% eradication rate with Two-stage revision (chronic case)

Question 2

Indications for One-stage infected arthroplasty revision

Answer 2

No sinus tract
Healthy patient
Healthy tissue
No prolonged antibiotics
No bone graft
Low virulence organism
Good antibiotic sensitivity

Question 3

Ideal conditions and plan for Two-stage infected arthroplasty revision

Answer 3

Medically fit for multiple surgeries
Good bone stock
Delayed re-implantation (35% success if 2 weeks, 70% success if 6 weeks)
Cementless reimplantation (in Hip)

Question 4

What is the dose of Antibiotic per cement Mix in revision surgery

Answer 4

Per 40g mix of cement:

Standard (commercially available) is 2g of ABs per mix
High dose is 3.6g of ABs per mix
Max dose is 12.5g of Tobramycin or 10.5g of Vancomycin

Real world:
3g Vanco (3 vials) and 3.6g Tobra (3 vials) per 40g mix
Use more liquid monomer per bag of cement