Megaprostheses coating to prevent periprosthetic joint infection in oncological patients: a systematic review

Abstract

Objective: Periprosthetic joint infection (PJI) is the most feared complication after prosthesis implantation, especially in the oncological population. Anti-microbial coatings are a new potential strategy to reduce this infection risk further. This study aims to provide an overview of the coating technologies currently being used or explored in megaprostheses to minimize the PJI rate following surgery.

Materials and methods: A detailed literature examination was conducted in studies published between January 2004 and October 2023 in the PubMed Central and Medline databases. A rigorous and systematic approach conforming to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) was followed.

Results: The literature research produced 396 results. At the end of the screening phase, only 11 papers met the inclusion criteria. The infection rate (IR) in the silver group was 10%: 40 patients out of 392, while the non-silver group's IR was 2.45% (just 4 cases out of 163 people).

Conclusions: Despite our study's limitations, today, orthopedic implants must have antimicrobial properties, and silver, hydrogel, and iodine coating represent new technologies that can help in infection prevention and treatment.