Algorithm of treatment tactic of cancer patients with infection of endoprosthesis
Abstract
Most infectious complications in the bed of the implant are due to colonization of methicillin-resistant flora and are very difficult and high material costs for treatment. More than 50% of infectious complications occur during the first 14 days after the implantation. There are several treatments, which include a mandatory component - the antibiotic therapy. The main goals of surgical treatment of infectious complications are preventing mortality in this group of patients and limb salvage. The scheme of diagnosis and treatment based on evidence of etiological factors, pathogenesis of complications, risk factors contributing to their development and data on the stability of the prosthesis, the indicators of aspirate and of time after surgery. So far a holistic approach to the therapy is not developed because of lack of data and prospective, randomized clinical trials. Our study proposes a new algorithm for the diagnosis and treatment of infectious complications after joint replacement.
About the Authors
D. V. Nisichenko
N.N. Blokhin R ussian C ancer R esearch C enter, R ussian Academy of M edical S ciences
Russian Federation
Russian Federation
N. V. Dmitrieva
N.N. Blokhin R ussian C ancer R esearch C enter, R ussian Academy of M edical S ciences
Russian Federation
Russian Federation
I. N. Petukhova
N.N. Blokhin R ussian C ancer R esearch C enter, R ussian Academy of M edical S ciences
Russian Federation
Russian Federation
V. A. Sokolovskiy
N.N. Blokhin R ussian C ancer R esearch C enter, R ussian Academy of M edical S ciences
Russian Federation
Russian Federation
Е. R. Senzhapova
N.N. Blokhin R ussian C ancer R esearch C enter, R ussian Academy of M edical S ciences
Russian Federation
Russian Federation
М. S. Кubirov
N.N. Blokhin R ussian C ancer R esearch C enter, R ussian Academy of M edical S ciences
Russian Federation
Russian Federation
Z. V. Grigoryevskaya
N.N. Blokhin R ussian C ancer R esearch C enter, R ussian Academy of M edical S ciences
Russian Federation
Russian Federation
М. D. Aliev
N.N. Blokhin R ussian C ancer R esearch C enter, R ussian Academy of M edical S ciences
Russian Federation
Russian Federation
References
1. Darouiche R. O. Treatment of infections associated with surgical implants. N. Engl. J. Med. 2004, v. 350, p. 1422-1429.
2. Liaropoulos L., Siskou O., Kaitelidou D. et al. Private expenditure and the role of private health insurance in Greece: status quo and future trends. Eur. J. Health. Econ. 2009, v. 10 (4), p. 467-474.
3. Tentino J.R.Prosthetic joint infections: bane of orthopedists, challenge for infectious disease specialists. Clin. Infect. Dis. 2003, v. 36 (9), p. 1157-1161.
4. Barrack R.L. Economics of the infected total knee replacement. Orthopedics. 1996, v. 19 (9), p. 780-782.
5. Roberts P., Chan D., Grimer R.J. et al. Prosthetic replacement ofthe distal femur for primary bone tumors. J. Bone Joint Surg. 1991, v. 73B, p. 762-769.
6. Zimmerli W., Trampuz A. Prosthetic joint infections: update in diagnosis and treatment SWISS MED WKLY. 2005, v. 135, p. 243-251.
7. Ward W.G., Eckardt J.J., Johnston-Jones K.S. et al. Five to ten year results of custom endoprosthetic replacement for tumors of the distal femur. In Complications of Limb Salvage. Prevention, Management and Outcome, pp. 483-493. Edited by K.L.B. Brown. Montreal. Isols. 1991.
8. Aliev M., Sokolovsky V., Sushentsov E., Amiraslanov A., Nisichenko D.V. Endoprosthetic replacement at tumors of long bones. Europ. J. Surg. Oncol. 2004, v. 30, № 2, p. 171.
9. Алиев М.Д., Соколовский В.А., Дмитриева Н.В. и соавт. Осложнения при эндопротезировании больных с опухолями костей. Вестник РОНЦ им Н.Н. Блохина РАМН. 2003, № 2 (доп. 1), с. 35-39.
10. Нисиченко Д.В. Инфекционные осложнения у онкологических больных после эндопротезирования крупных суставов. Клиника, диагностика, лечение, профилактика. Диссертация канд. мед. наук. РОНЦ им. Н.Н. Блохина. М., 2010, с. 150-188.
11. Cruess R.L., Bickel W.S., VonKessler K.L.C. Infections in total hips secondary to a primary source elsewhere. Clin. Orthop. 1975, v. 106, p. 99-101.
12. Athanasou N.A. Peri-implant pathology - relation to implant failure and tumor formation J. Long. Term. Eff. Med. Implants. 2007, v. 17 (3), p. 193-206.
13. Соколовский В.А., Дмитриева Н.В., Сушенцов Е.А., Нисиченко Д.В. Инфекционные осложнения после эндопротезирования больных с опухолями костей. Вопросы онкологии. 2005, т. 51, № 3, с. 342-346.
14. Вельков В.В. С-реактивный белок и липопротеин-ассоциированная фосфолипаза А2. Клинико-лабораторный консилиум. Научно-практический журнал. СПб., 2009, № 6 (31), p. 28-33.
15. Lee Y.J., Lee J.H., Shin Y.H. et al. Gender difference and determinants of C-reactive protein level in Korean adults. Clin. Chem. Lab. Med. 2009, v. 47 (7), p. 863-869.
16. Anderson P. Effectiveness of radiotherapy for osteosarcoma that responds to chemotherapy. Meyo Clin. Proc. 2003, v. 78, p. 145-146.
17. File T. Diagnosis and Antimicrobial Therapy of Skin and Soft Tissue Infections (Lecture). Перепечатано Клиническая микробиол. и антимикроб. химиотер. 2003, № 2, т. 5.
18. Bennett M.E., Wolcott R.D., Rhoads D.D. et al. Chronic wounds and the medical biofilm paradigm. J. Wound Care. 2010, v. 19 (2), p. 45-46, 48-50, 52-53.
19. Bose J.C. Natarajan M.V. Distal femoral tumors treated by resection and custom mega-prosthetic replacement. Int. Orthop. 2005, v. 29 (5), p. 309-313. Epub. 2005 Aug. 31.
Review
For citations:
Nisichenko D.V., Dmitrieva N.V., Petukhova I.N., Sokolovskiy V.A., Senzhapova Е.R., Кubirov М.S., Grigoryevskaya Z.V., Aliev М.D. Algorithm of treatment tactic of cancer patients with infection of endoprosthesis. Bone and soft tissue sarcomas, tumors of the skin. 2011;(2):12-34. (In Russ.)
Views:
57
Email this article 
