The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

The Performances of Conventional Titanium and Silver-Coated Megaprostheses in Non-oncological and Post-oncological Patients: An Analysis of Infection Failures in 142 Patients

Document Type : RESEARCH PAPER

Authors
Federico Sacchetti 1
Raphael Kilian 2
Francesco Muratori 3
Stephane Cherix 4
Lorenzo Foschi 3
Riccardo Morganti 1
Domenico Andrea Campanacci 3
Rodolfo Capanna 1
1 Department of Orthopaedic and Trauma Surgery, University of Pisa, Italy
2 Department of Ophtalmology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
3 Department of Oncology and Surgery at Robotic Address of the Hospital Careggi University of Florence, Firenze FI, Italy
4 Department of Orthopaedic and Trauma Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
10.22038/abjs.2021.58351.2889
Abstract
Background: Megaprostheses are one of the preferred choices of reconstruction after tumor resection. Periprosthetic 
joint infections are one of the most serious complications of joint prostheses surgeries. In this study, our aim was to 
analyze the efficacy of silver-coated megaprostheses in reducing the risk of prosthesis-related infection.
Methods: One hundred forty-two patients who had undergone implantation of a mega-endoprosthesis for nonneoplastic or post-neoplastic conditions were included in this retrospective study. The end-point of the survival analysis 
was the prosthesis failure due to infection. 
Results: Thirty-eight patients had undergone implantation of a silver-coated megaprosthesis and 104 patients a 
megaprosthesis without silver coating. The survival analysis showed an overall infection-free survival rate of 82.3% at 
five years and 61.9% at 10 years. Silver-coated prostheses had an HR of 0.72 (95% CI: 0.26-2.05; P=0.54).
Conclusion: Implantation of a silver-coated mega-prosthesis in non-oncological patients did not significantly reduce 
the risk of prosthesis-related infection.
Level of evidence: III
Keywords
Endoprosthesis
Infection
Megaprosthesis
Periprosthetic infection
Silver
Silver-coated
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The Archives of Bone and Joint Surgery
Volume 10, Issue 5
May 2022
Pages 439-446

  • Receive Date 25 June 2021
  • Revise Date 13 October 2021
  • Accept Date 11 November 2021