Novosti
Khirurgii
This journal is
indexed in Scopus









Year 2020 Vol. 28 No 5

SCIENTIFIC PUBLICATIONS
EXPERIMENTAL SURGERY

DOI: https://dx.doi.org/10.18484/2305-0047.2020.5.498   |  

D.I. VARFOLOMEEV, V.G. SAMODAY

ASSESSMENT OF HIP JOINT SPACER FOR TREATING PATIENTS WITH PERIPROSTHETIC INFECTION

Voronezh State Medical University named after N.N. Burdenko, Voronezh,
Russian Federation

Objective. Assessment of the possibility to use the developed spacer device while treating infectious complications after the hip replacement surgery.
Methods. The hip spacer has been developed to improve the outcomes of periprosthetic infection treatment. The spacer consists of the head, neck and a stem, made of bone cement. The carcass connected with the micropump is located inside it. The carcass is made in the form of four metal tubes which hold a liquid solution of drugs. The pump pistons are made of ferromagnet to interact with a magnet brought to the surface of the body. Drugs are released from the spacer under the external manetic field exposure in the postoperative period. The working spacer model was developed on the basis of the department of traumatology and orthopedics of Voronezh State Medical University named after N.N. Burdenko. Experimental studies on rabbits were conducted to evaluate the functionality of the spacer device. An implant containing Pyrogenalum solution was inserted in the abdominal cavity of animals under the intravenous anesthesia. In the test group the average temperature was estimated prior to and after the introduction of Pyrogenalum (under the magnetic field exposure).
Results. The temperature measured after the onset of the spacer operation differed trustworthy from those measured prior to the onset of the experiment (T-test 17.17, p<0.05). This can be explained by the inoculation of Pyrogenalum contained in the spacer into the blood of animals. Experimental studies demonstrated the possibility of drugs release from the spacer into the wound under the magnetic field exposure on the spacer.
Conclusion. The proposed implant allows increasing the volume and quantity of drugs released from it into the wound. Surgeons can non-invasively control the rate of drugs inoculated directly into blood of the periprosthetic space in postoperative period. This provides the required concentration of drugs to help eradicate infection.

Keywords: hip endoprosthesis, periprosthetic infection, bone cement spacer, revision endoprosthesis
p. 498-504 of the original issue
References
  1. Akhtiamov IF, Kuzmin II. Oshibki i oslozhneniia endoprotezirovaniia tazobedrennogo sustava: ruk dlia vrachei. Kazan, RF: Tsentr operativ. pechati; 2006. 328 p. (In Russ.)
  2. Engesæter LB, Dale H, Schrama JC, Hallan G, Lie SA. Surgical procedures in the treatment of 784 infected THAs reported to the Norwegian Arthroplasty Register. Acta Orthop. 2011 Oct;82(5):530-37. doi: 10.3109/17453674.2011.623572
  3. Pulido L, Ghanem E, Joshi A, Purtill JJ, Parvizi J. Periprosthetic joint infection: the incidence, timing, and predisposing factors. Clin Orthop Relat Res. 2008 Jul;466(7):1710-15. doi: 10.1007/s11999-008-0209-4
  4. Golnik VN, Prokhorenko VM, Pavlov VV. Treatment of early periprosthetic infection at hip replacement. Klin Meditsina. 2012;(4):35-38. https://cyberleninka.ru/article/n/lechenie-ranney-paraproteznoy-infektsii-pri-endoprotezirovanii-tazobedrennogo-sustava (In Russ.)
  5. Eka A, Chen AF. Patient-related medical risk factors for periprosthetic joint infection of the hip and knee. Ann Transl Med. 2015 Sep;3(16):233. doi: 10.3978/j.issn.2305-5839.2015.09.26
  6. Mironov SP, Kotelnikov GP, red. Ortopediia: nats ruk. 2-e izd., pererab. i dop. Moscow, RF: GEOTAR-Media; 2013. 944 p. http://www.geotar.ru/lots/Q0122180.html (In Russ.)
  7. Zubritsky VF, Kozlov YuA. Infectious complications during large joint replacement. Vestn Nats Med-Khirurg Tsentra im NI Pirogova. 2012;7(1):98-103. http://www.pirogov-vestnik.ru/upload/uf/e43/magazine_2012_1.pdf (In Russ.)
  8. Artiukh VA, Bozhkova SA. Vtoroi etap dvukhetapnogo revizionnogo endoprotezirovaniia. V kn: Artiukh VA, Bozhkova SA, sost. Dvukhetapnoe revizionnoe endoprotezirovanie v lechenii periproteznoi infektsii v oblasti tazobedrennogo sustava: Federalnye klinicheskie rekomendatsii. S-Petersburg, RF; 2015. p. 23-29. In Russ.)
  9. Zagorodnii NV. Endoprotezirovanie tazobedrennogo sustava. Osnovy i praktika: ruk. Moscow, RF: GEOTAR-Media; 2012. 704 p. http://www.studentlibrary.ru/book/ISBN9785970422250.html (In Russ.)
  10. Kuzin MI, Kostiuchenok BM, red. Rany i ranevaia infektsiia: ruk dlia vrachei. Moscow, RF: Meditsina; 1990. 592 p. (In Russ.)
  11. Atıcı T, Şahin N, Çavun S, Özakin C, Kaleli T. Antibiotic release and antibacterial efficacy in cement spacers and cement beads impregnated with different techniques: In vitro study. Eklem Hastalik Cerrahisi. 2018 Aug;29(2):71-78. doi: 10.5606/ehc.2018.59021
  12. Murylev VYu, Kukovenko GA, Elizarov PM, Ivanenko LR, Sorokina GL, Rukin YA, Alekseev SS, Germanov V.G. The first-stage treatment lgorithm for deep infected total hip arthroplasty.Traumatology and Orthopedics of Russia. 2018;24(4):95-104. doi: 10.21823/2311-2905-2018-24-4-95-104 (In Russ.)
  13. Marczak D, Synder M, Sibiński M, Polguj M, Dudka J, Kowalczewski J. Two stage revision hip arthroplasty in periprosthetic joint infection. Comparison study: with or without the use of a spacer. Int Orthop. 2017 Nov;41(11):2253-58. doi: 10.1007/s00264-017-3500-8
  14. Faschingbauer M, Reichel H, Bieger R, Kappe T. Mechanical complications with one hundred and thirty eight (antibiotic-laden) cement spacers in the treatment of periprosthetic infection after total hip arthroplasty. Int Orthop. 2015 May;39(5):989-94. doi: 10.1007/s00264-014-2636-z
  15. van Vugt TAG, Arts JJ, Geurts JAP. Antibiotic-loaded polymethylmethacrylate beads and spacers in treatment of orthopedic infections and the role of biofilm formation. Front Microbiol. 2019 Jul 25;10:1626. doi: 10.3389/fmicb.2019.01626. eCollection 2019.
  16. Samokhin AG, Fedorov EA, Kozlova YN, Tikunova NV, Pavlov VV, Morozova VV, Krclien SO. Application of the lvtic bacteriophages during surgical treatment of the periprosthetic infection of the hip joint endoprosthesis (pilot study). Sovrem Problemy Nauki i Obrazovaniia. 2016;(6):209. https://www.science-education.ru/ru/article/view?id=25851 (In Russ.)
Address for correspondence:
394036, Russian Federation,
Voronezh, Studencheskaya str., 10,
Voronezh State Medical University
Named after N.N. Burdenko,
the Department of Traumatology and Orthopedics,
tel. +7 4732 57-96-67
e-mail: v_samoday@mail.ru,
Valery G. Samoday
Information about the authors:
Varfolomeev Denis I., Traumatologist-Orthopedist, Attendee of the Department of Traumatology and Orthopedics, Voronezh State Medical University Named after N.N. Burdenko, Voronezh, Russian Federation.
https://orcid.org/0000-0002-2133-6510
Samoday Valery G., MD, Professor, Head of the Department of Traumatology and Orthopedics, Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russian Federation.
https://orcid.org/0000-0003-1414-0832
Contacts | ©Vitebsk State Medical University, 2007