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. 2022 Jun 1;36(6):317-320.
doi: 10.1097/BOT.0000000000002287.

Removal of Antibiotic Cement-Coated Interlocking Nails

Talal B Abalkhail  1   2 , Ahmed H Elhessy  1 , Janet D Conway  1
Affiliations

Removal of Antibiotic Cement-Coated Interlocking Nails

Talal B Abalkhail et al. J Orthop Trauma. .

Abstract

Objectives: To report the outcomes of antibiotic cement-coated interlocking nail (ACCIN) removal, detail a removal technique that mitigates debonding of coating, and describe how to address occurrences intraoperatively.

Design: Retrospective case series.

Setting: Level II trauma center.

Patients: Twenty-eight patients who underwent ACCIN removal between January 2014 and August 2019.

Intervention: Removal of ACCINs that were coated using the silicone tubing method.

Main outcome measurements: Successful removal of the nail with intact antibiotic coating.

Results: A total of 42 ACCIN removals were included in this study. Successful ACCIN removal was achieved in 37 cases (88.1%), with debonding in only 5 cases (11.9%). Eight nails (19%) required 1 additional removal procedure, and 3 nails (7.1%) required 2 additional removal procedures. The main reasons for the additional procedures were nonunion and persistent infection.

Conclusions: ACCIN insertion and removal can be challenging. The proper technique of coating and insertion can facilitate later removal. Removal of knee-long fusion rods can be more challenging.

Level of evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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Conflict of interest statement

No funding was received for this study. J.D. Conway is a consultant for Zimmer Biomet, Bonesupport, and Smith+Nephew and receives fellowship support from Biocomposites. The spouse of J.D. Conway receives royalties from the University of Florida. The remaining authors report no conflict of interest. The following organizations supported institution #1: Biocomposites, DePuy Synthes Companies, MHE Coalition, Orthofix, OrthoPediatrics, Pega Medical, Smith+Nephew, Stryker, and Zimmer Biomet.

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