Rh. Quinn et al., Management of infected bulk allografts with antibiotic-impregnated polymethylmethacrylate spacers, ORTHOPEDICS, 24(10), 2001, pp. 971-975
Twenty-seven patients developed infection following bulk allograft transpla
ntation and were treated with resection of the allograft, placement of an a
ntibiotic-impregnated polymethylmethacrylate (PMMA) spacer, and intravenous
antibiotics. Overall, the infection was eradicated in 14 (52%) of 27 patie
nts. Of the 11 patients who did not undergo allograft reimplantation, 5 und
erwent amputations for persistent infection in the presence of the spacer a
nd 4 had a retained spacer at most recent follow-up.
No significant correlation was noted between successful eradication of the
infection and age, sex, diagnosis, adjuvant therapy, acute or chronic infec
tion, number of operative procedures, type of allograft procedure, duration
of antibiotics, or type of organism. Although deep infection of allograft
transplantations continues to result in a high rate of failure, this method
of management results in successful limb salvage in almost half of the pat
ients.