Publications by authors named "L MORANTE"
Biologic graft infection (BGI) is one of the main complications in graft reconstructions. However, very little evidence exists regarding the epidemiology of BGI, as most of the data come from sparse reports. Moreover, most of the series did not detail the treatment and outcome of graft infections.
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- Periprosthetic joint infections (PJI) and fracture-related infections (FRI) of the distal femur can lead to significant bone loss, and a two-stage treatment protocol utilizing articulated silver-coated megaprosthesis was studied.
- A review of three institutions included 45 patients, showing an estimated 91.1% survival rate free from recurrence of infection two years after surgery, with complications primarily involving non-infection-related issues.
- Significant findings indicated that a longer resection length negatively impacted infection control, while the initial diagnosis (PJI or FRI) did not significantly affect outcomes, affirming the safety and effectiveness of this treatment approach.
Article Synopsis
- Modular megaprostheses (MPs) are used for limb salvage after bone tumor resection and can also address massive bone defects in non-cancer cases, with a systematic review analyzing their epidemiology.
- The review examined 69 studies, discovering that a total of 2,598 MPs were used primarily for periprosthetic fractures, with the distal femur being the most frequently treated site, representing over 52% of cases.
- Complications occurred in nearly 20% of cases, with the most common being soft tissue failures and infections, highlighting that patients with significant bone loss or previous complications should be treated similarly to oncologic patients due to limited treatment options.
Purpose: A staged revision with placement of a temporary antibiotic-loaded cement spacer after removal of the implant is the "gold standard" for treatment of chronic prosthetic joint infection (PJI). It enables local delivery of antibiotics, maintenance of limb-length and mobility, easier reimplantation. However, bacterial colonization of spacers and mechanical complications can also occur.
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- The treatment of knee periprosthetic joint infection using a two-stage protocol with static and articulated spacers allows for local antibiotic delivery and preservation of knee function.
- A systematic review analyzed 87 studies and 4250 spacers, finding no significant difference in infection rates or complications between static and articulated spacers.
- However, articulated spacers were associated with significantly better knee flexion post-reimplantation (100.3° vs. 91.6°), though the review highlights potential biases due to the varying quality of the studies included.