248
· DOS Abstracts
Extended Antibiotic Prophylaxis is associated
with Low Rate of Infection after Tumor Resection
and Endoprosthetic Reconstruction involving the
Proximal Femur
Werner H. Hettwer, Thea B. Hovgaard, Peter Horstmann, Thomas A. Grum-
Schwensen, Michael M. Petersen
Department of Orthopedics, Rigshospitalet, University of Copenhagen
Background:
Endoprosthetic reconstruction after tumor resection involving
the proximal femur is associated with a substantially higher risk of periprosthetic
joint infection (PJI), with reported rates around 10% in a recent systematic re-
view. The optimal duration of antibiotic prophylaxis for this patient population
is unknown.
Purpose / Aim of Study:
To determine the rate of infection and other compli-
cations after tumor resection and endoprosthetic reconstruction at our institu-
tion.
Materials and Methods:
We performed a retrospective review of all adult pa-
tients who underwent endoprostetic reconstruction of the proximal femur after
tumor resection for primary bone sarcomas (n=11) or metastatic bone disease
(n=113) in our department from 2010 to 2013. We found 118 patients (F/M
=64/54) with a mean age of 65 years (range 16 – 92) received a total of 124
implants.
Findings / Results:
We identified 18 major complications (15%): 12 disloca-
tions (10%), 5 PJI (4%), one mechanical complication (1%) and one local recur-
rence (1%) resulting in a total of 23 revision procedures. Two- stage revision
was performed sucessfully in 3 of the 4 patients with infection. Ten patients
with instability underwent successful stabilisation by implantation of a con-
strainment device and did not experience further episodes of dislocation.
Conclusions:
Compared to the published average we found a low infection rate
(4 %) after tumor related enoprothetic reconstruction. Given the very low in-
fection rate identified in our patients, we see no reason to change our current
practice of extended antibiotic prophylaxis for high risk patients until very con-
vincing evidence to the contrary becomes available.
195.
