A ceramic bone substitute containing gentamicin gives good outcome in trochanteric hip fractures treated with dynamic hip screw and in revision of total hip arthroplasty: A case series

Research output: Contribution to journalArticle

Abstract

BACKGROUND: The primary objective was to investigate the clinical and radiological outcome in patients undergoing major hip surgery using a novel antibiotic containing bone substitute for local augmentation in trochanteric fracture fixation or revision of total hip arthroplasty (THA).

METHODS: We implanted a novel biphasic bone substitute CERAMENT™|G consisting of hydroxyapatite, calcium sulphate and gentamicin for bone regeneration and local antibiotic delivery in 20 patients treated surgically for trochanteric femoral fracture or uncemented hip revision. Preoperative, postoperative, 3 months and 1 year clinical and radiological assessment were performed including registration of any complications. In one trochanteric fracture patient, histological analyses were performed of bone biopsies taken at removal of hardware.

RESULTS: None of the trochanteric fractures or revision of THA showed any large migration. No local wound disturbances were seen and no infection was observed at one year follow-up. All trochanteric fractures healed at 3 months with a minimal sliding screw displacement on average 3 mm. Radiological analysis showed signs of bone remodeling and new bone formation in the substitute, illustrated also by histology in the biopsies taken from one trochanteric fracture at one year post-op.

CONCLUSIONS: Local CERAMENT™|G was shown to be safe in a limited prospective major hip surgery study. Remodeling of the bone graft substitute was observed in all patients.

TRIAL REGISTRATION: EU-CTR2018-004414-18 Retrospectively registered on November 20, 2018.

Details

Authors
Organisations
External organisations
  • Skåne University Hospital
  • Lithuanian University of Health Sciences
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Orthopedics

Keywords

  • Aged, Aged, 80 and over, Anti-Bacterial Agents/administration & dosage, Arthroplasty, Replacement, Hip/adverse effects, Bone Remodeling, Bone Screws, Bone Substitutes, Calcium Sulfate, Drug Combinations, Durapatite, Feasibility Studies, Female, Follow-Up Studies, Fracture Fixation, Internal/adverse effects, Gentamicins/administration & dosage, Hip/diagnostic imaging, Hip Fractures/diagnostic imaging, Humans, Male, Middle Aged, Osteogenesis, Postoperative Complications, Prospective Studies, Radiography, Reoperation/adverse effects, Treatment Outcome
Original languageEnglish
Article number438
Pages (from-to)438
JournalBMC Musculoskeletal Disorders
Volume19
Issue number1
Publication statusPublished - 2018 Dec 6
Publication categoryResearch
Peer-reviewedYes