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This retrospective study investigates the efficacy of calcium sulfate carriers loaded with antibiotics in two-stage revision surgery for periprosthetic joint infections (PJI). Forty patients (27.5% hip, 27.5% shoulder, 45% knee) with PJI underwent two-stage revision with local application of antibiotic-loaded calcium sulfate at both stages, alongside systemic antibiotics. The study reports a 97% infection eradication rate at the end of the follow-up period.
Antibiotic-loaded calcium sulfate carriers in two-stage revision arthroplasty for PJI demonstrate a high infection eradication rate, suggesting a valuable adjunct to standard treatment protocols.
Background/Objectives: The prevalence of joint replacement surgeries has significantly increased over the last century, leading to a corresponding rise in complications, particularly periprosthetic joint infection (PJI). The management of a PJI involves various strategies, including debridement, antibiotic therapy, and staged revision procedures. A notable advancement in treatment is the use of calcium sulfate reabsorbable carriers, recognized for their biocompatibility, osteoconductivity, and localized antibiotic delivery. Recent reports indicate that when combined with conventional treatment regimens, calcium sulfate carriers can achieve infection eradication rates exceeding 90%. This study aims to evaluate the efficacy of calcium sulfate carriers in managing periprosthetic infections, specifically assessing their impact on healing rates in patients undergoing treatment. Study Design & Methods: A retrospective analysis was conducted at our institution, focusing on patients diagnosed with PJIs treated with 2-stage revision surgery with local application of calcium sulfate carriers with antibiotics at both stages, and systemic antibiotic therapy, and comparing results with different surgical procedures. Results: The study included 40 patients (24 males and 16 females), with a mean age of 68.7 (range 48–87) years. The affected joints included the hip (27.5%), shoulder (27.5%), and knee (45%). The findings revealed that 97% of patients achieved infection eradication at the end of the follow-up period. Conclusions: These results highlight the complexities of managing PJIs and the significant role of calcium sulfate carriers in improving outcomes, supporting their use as a standard practice in confirmed PJI cases.
