What is debridement, antibiotics, and implant retention in orthopaedic oncology?
| Title: | What is debridement, antibiotics, and implant retention in orthopaedic oncology? |
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| Authors: | Zeeshan Khan; Zainab Aqeel Khan; Tomas Zamora; Ashish Gulia; Santiago A Lozano-Calderon; Vineet J Kurisunkal; Lee M Jeys; Minna K Laitinen; Santiago Abad Repiso; Hesham Abdelbary; Alejandro Abiad Mejia; Ahmed A Abood; Ghaith Abou-Nouar; Juan C Abril Martin; Ayman Abu Elhamd; Adesegun Abudu; Marthelena Acosta; Keisuke Ae; Manish Agarwal; Vivek Ajit Singh; Toru Akiyama; Jose I Albergo; John Alexander; Patricio A Alfaro; Bugra Alpan; Ibrahim Alshaygy; Jose Amaya-Valero; Megan Anderson; Dimosthenis Andreou; Lucas Annabell; Christopher Anthony; Ahmed Aoude; Iraia Arteagoitia-Colino; Apichat Asavamongkolkul; William Aston; Libe Asua Mentxaka; Christine Azzopardi; Thomas Baad-Hansen; Ismail T Badr; Francisco Baixauli-Garcia; Gavin Baker; Tessa Balach; Giacomo G Baldi; Janie Barry; Georges Basile; Stefano Bastoni; Mohammad Hardian Basuki; Henrik Bauer; Lee Bayliss; Ricardo G Becker; Angad Bedi; Joseph Benevenia; Francisco Bengoa; Peter Bergh; Marko Bergovec; Nicholas Bernthal; Odion Binitie; David Boddie; Michele Boffano; Patricia Bonilla Huertas; Anna B Borgognoni; Rajesh Botchu; Jos Bramer; Harriet Branford-White; Rahat Brar; Demien Broekhuis; Samuel E Broida; Tymoteusz Budny; Zachary Dc Burke; Jorge Cabrolier; Jorge R Calvo Tapies; Jose A Calvo-Haro; Dominico Campanacci; Rodrigo Cardoso; Richard Carey Smith; Pedro I Carvallo; Nicolas Casales Fresenga; Jose Manuel Casanova; Oscar Ceballos; Juan Luis Cebrian Parra; Laura K Certain; Sara Chacon Cartaya; Chung Ming Chan; Yoon Joo Cho; Peter Choong; Yang-Guk Chung; Dawid Ciechanowicz; Miguel Angel Clara-Altamirano; David Clever; Sebastian Matheo Colina; Luis Consuegra; Cory Couch; Gillian Cribb; Carlos Cuervo; Laurence A Cusick; Solomon Dadia; Tanios Dagher; Dietmar Dammerer; Mark Davies; Nerys Davies; Luis Pablo de la Rosa Martino; Francisco Javier de Santos de la Fuente; Marieke de Vaal; Claudia Deckers; Javier Delgado Obando; Shaneel Deo; Niklas Deventer; Claudia Di Bella; Gregory Domson; Davide Maria Donati; Desiree M Dorleijn; Jacques Du Toit; Debra Dunne; Rodolfo Duran Ciarrochi; Elina Ekman; Ahmed M El Ghoneimy; Makoto Endo; Levent Eralp; Mahmoud Etaiwi; Scott Evans; Robin Evrard; Will Eward; Alberto Farese; Peter C Ferguson; Pedro Filipe Ferreira Cardoso; Fabrice Fiorenza; Michael Flint; Hector Flores; Joao Freitas; Bruno Fuchs; Tomohiro Fujiwara; Philipp T Funovics; Marcos Galli Serra; Zakareya Gamie; Carlos Garces-Zarzalejo; Aaron Gazendam; Carsten Gebert; Jasper G Gerbers; Craig Gerrand; Michelle Ghert; Kanishka M Ghosh; Max Gibbons; Anne Gomez-Mascard; Luis Carlos Gomez-Mier; Jesus Gomez-Vallejo; Marcos R Gonzalez; Fausto Gonzalez-Lizan; Georg Gosheger; Stuart Goudie; Krista Goulding; Stavros D Goumenos; Anthony Griffin; Sanjay Gupta; Amit Gupta; Maurice Guzman; Mohammed Haitham; Jendrik Hardes; Francisco Hardoy; Yusuf Hasan; Georg Hauer; Helard Havard; Rex Haydon; John Healey; Nerea Hernandez Gonzalez; Adriana Hernandez-Lopez; Asle Hesla; Matthew Hess; Thomas Hilton; Chindanai Hongsaprabhas; Francis Hornicek; Keith Hosking; Eleanor Houghton; Oluwaseyi K Idowu; Joseph Ippolito; Marc Isler; Shintaro Iwata; Jake Jagiello; Neil Jenkins; Tom Jeys; Charlotte Jeys; BOOM participants; Elisa Pala; Guy Morris; Ajay Puri; Pietro Ruggieri |
| Contributors: | Khan, Zeeshan; Aqeel Khan, Zainab; Zamora, Toma; Gulia, Ashish; A Lozano-Calderon, Santiago; J Kurisunkal, Vineet; M Jeys, Lee; K Laitinen, Minna; Abad Repiso, Santiago; Abdelbary, Hesham; Abiad Mejia, Alejandro; A Abood, Ahmed; Abou-Nouar, Ghaith; C Abril Martin, Juan; Abu Elhamd, Ayman; Abudu, Adesegun; Acosta, Marthelena; Ae, Keisuke; Agarwal, Manish; Ajit Singh, Vivek; Akiyama, Toru; I Albergo, Jose; Alexander, John; A Alfaro, Patricio; Alpan, Bugra; Alshaygy, Ibrahim; Amaya-Valero, Jose; Anderson, Megan; Andreou, Dimostheni; Annabell, Luca; Anthony, Christopher; Aoude, Ahmed; Arteagoitia-Colino, Iraia; Asavamongkolkul, Apichat; Aston, William; Asua Mentxaka, Libe; Azzopardi, Christine; Baad-Hansen, Thoma; T Badr, Ismail; Baixauli-Garcia, Francisco; Baker, Gavin; Balach, Tessa; G Baldi, Giacomo; Barry, Janie; Basile, George; Bastoni, Stefano; Hardian Basuki, Mohammad; Bauer, Henrik; Bayliss, Lee; G Becker, Ricardo; Bedi, Angad; Benevenia, Joseph; Bengoa, Francisco; Bergh, Peter; Bergovec, Marko; Bernthal, Nichola; Binitie, Odion; Boddie, David; Boffano, Michele; Bonilla Huertas, Patricia; B Borgognoni, Anna; Botchu, Rajesh; Bramer, Jo; Branford-White, Harriet; Brar, Rahat; Broekhuis, Demien; E Broida, Samuel; Budny, Tymoteusz; Dc Burke, Zachary; Cabrolier, Jorge; R Calvo Tapies, Jorge; A Calvo-Haro, Jose; Campanacci, Dominico; Cardoso, Rodrigo; Carey Smith, Richard; I Carvallo, Pedro; Casales Fresenga, Nicola; Manuel Casanova, Jose; Ceballos, Oscar; Luis Cebrian Parra, Juan; K Certain, Laura; Chacon Cartaya, Sara; Ming Chan, Chung; Joo Cho, Yoon; Choong, Peter; Chung, Yang-Guk; Ciechanowicz, Dawid; Angel Clara-Altamirano, Miguel; Clever, David; Matheo Colina, Sebastian; Consuegra, Lui; Couch, Cory; Cribb, Gillian; Cuervo, Carlo; A Cusick, Laurence; Dadia, Solomon; Dagher, Tanio; Dammerer, Dietmar; Davies, Mark; Davies, Nery |
| Publisher Information: | British Editorial Society of Bone and Joint Surgery |
| Publication Year: | 2025 |
| Collection: | Padua Research Archive (IRIS - Università degli Studi di Padova) |
| Subject Terms: | bone tumor; megaprosthesi; periprosthetic joint infection |
| Description: | Following resection of a primary bone tumour, reconstruction is commonly performed using either a megaprosthesis or biological reconstruction. Periprosthetic joint infection (PJI) remains one of the most frequent complications. Various treatment strategies exist for PJI, including debridement, antibiotics, and implant retention (DAIR), and single-and two-stage revision, although consensus on optimal management remains elusive. This study aimed to investigate the global practices regarding DAIR in tumour cases through an electronic survey among orthopaedic oncology surgeons. Methods A global cross-sectional observational survey study was distributed to 272 orthopaedic oncology surgeons who attended the BOOM Consensus Meeting in January 2024. The survey contained 19 multiple choice questions focusing on DAIR practices. Responses were collected anonymously and analyzed using descriptive statistics. Results The survey was completed by 173/272 surgeons (64%) from 44 countries. While 62% (169/272) routinely performed radical soft-tissue debridement in DAIR, only 39% exchanged all modular components, indicating variability in surgical approaches. DAIR was more commonly performed in acute rather than chronic infections, with 55% finding it very useful in acute cases. The use of local antibiotic delivery was supported by 56%, although only 49% found antibiotic cement coatings beneficial. Systemic antibiotic duration post-DAIR varied, with 39% favouring six weeks and 35% preferring three months. Conclusion The study highlights global inconsistencies in DAIR practices for PJI in orthopaedic oncology, with financial disparities impacting modular component exchange. Standardized definitions are lacking, and we propose that if only polyethylene is changed, then the procedure is referred to as poly exchange; we recommend defining the procedure as DAIR when extensive debridement, lavage, and removal, wash, and reimplanting of all modular components is done while retaining stable stems, followed by suppressive antibiotic ... |
| Document Type: | article in journal/newspaper |
| Language: | English |
| Relation: | info:eu-repo/semantics/altIdentifier/pmid/41260234; info:eu-repo/semantics/altIdentifier/wos/WOS:001621324100002; volume:6; issue:11; firstpage:1495; lastpage:1503; numberofpages:9; journal:BONE & JOINT OPEN; https://hdl.handle.net/11577/3577883 |
| DOI: | 10.1302/2633-1462.611.bjo-2025-0114.r2 |
| Availability: | https://hdl.handle.net/11577/3577883; https://doi.org/10.1302/2633-1462.611.bjo-2025-0114.r2 |
| Rights: | info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| Accession Number: | edsbas.23EA46AF |
| Database: | BASE |