5.16 Rare Breast Cancer: Tumor Types
unicompartment prosthesis fell out of favor with many ..
Based on our data, we cannot draw conclusions about prognostic factors for treatment success or failure. We did observe that treatment succeeded in almost all of our patients with a PJI caused by a This finding may not sound surprising since has low virulence and its natural course of infection is often smouldering and low-grade in nature. However, Barberan et al. did show a 50% relapse rate in patients with a PJI caused by coagulase negative staphylococci (CNS) and who were treated with a conservative treatment regime (i.e. surgical debridement with implant retention and a 3 month course of antibiotic treatment). In addition, Byren et al. showed that when antibiotic treatment is discontinued, even after a long period of suppression therapy (with a minimum of 180 days), relapse of infection occurs in around 30% of patients. Therefore, long-term antibiotic treatment in patients with a PJI due CNS does have additional value to suppress the infection, and its favorable outcome is not merely due to its natural course. We also observed a high success rate in patients with a 'standard' prosthesis, in comparison with patients with a 'tumor' prosthesis, in whom 50% of AST failed. In previous studies on AST, the type of prosthesis is not mentioned. However, it is known, that tumor prostheses are more prone to infection in comparison to standard prostheses. This may be partly explained by poor soft tissue and/or bone stock due to radiation therapy, and the larger surface area of a 'tumor' prosthesis. In contrast to other studies, in our cohort of patients, we did not observe higher failure rates in patients with multiple prior revision surgeries or in patients with knee arthroplasties.
Joint Arthroplasties and Prostheses | RadioGraphics
Besides demographic characteristics, we collected several patients' parameters considered to be related to outcome; i.e. the patients' underlying disease that led to joint arthroplasty, the affected joint, the number of revision surgeries that were performed in the affected joint prior to the start of AST, the type of prosthesis that was used (i.e. a standard or tumor prosthesis), the cultured micro-organisms that were accounted as the causative pathogens of the infection, the number of surgical debridements and lavages before suppression therapy was started and the indication reported for AST. We also evaluated the degree of inflammation by collecting the C-reactive protein (CRP), Erythrocyte Sedimentation Rate (ESR) and leucocytes in blood closest around the start of AST.