Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
, 2015, 368124

Iodine-Supported Hip Implants: Short Term Clinical Results

Affiliations
Clinical Trial

Iodine-Supported Hip Implants: Short Term Clinical Results

Tamon Kabata et al. Biomed Res Int.

Abstract

We developed a new povidone iodine coating technology for titanium hip implants and performed a clinical trial to assess its usefulness in suppressing postoperative infection. Results indicate that iodine-supported titanium has favorable antibacterial activity, biocompatibility, and no cytotoxicity. Thirty joints in 28 patients were treated using iodine-supported implants. Fourteen joints were revision total hip arthroplasty (THA) after periprosthetic infection, 13 were primary THA for immunosuppressive conditions or pyogenic arthritis, and 3 were conversions from hemiarthroplasty to THA for immunosuppressive conditions. Two examinations were conducted sequentially until final follow-up: white blood cell (WBC) and C-reactive protein (CRP) were measured pre- and postoperatively and thyroid hormone levels in the blood were examined. The mean follow-up period was 33 months (14-78). There were no signs of infection in any patient at the last follow-up. WBC and CRP levels returned to normal within several weeks. No abnormalities of thyroid gland function were detected. Loosening of the implants did not occur in any patient. Excellent bone ingrowth and ongrowth were found around prostheses. No cytotoxicity or adverse effects were detected. These results suggest that iodine-supported THA implants can be highly effective in preventing and treating postoperative infections.

Figures

Figure 1
Figure 1
An uncoated hip prosthesis (a) and an iodine-supported hip prosthesis (b).
Figure 2
Figure 2
Electron micrograph of the oxide layer: more than 50,000 pores/mm2.
Figure 3
Figure 3
Case of a 65-year-old man. PJI with methicillin-resistant coagulase-negative staphylococcus. Previous treatments including single-stage revision, implant removal, several irrigation, debridement, and ALAC treatments were performed by former surgeon, but suppression of PJI could not be obtained (a). Before iodine-supported prosthesis implantation, inflammation was still active, but the infection was cured after thorough debridement and implantation of iodine-supported hip prosthesis. CRP was 0.1 mg/dL and WBC was 4,400/ll 12 months later (b).
Figure 4
Figure 4
Case of an 82-year-old man. Pyogenic arthritis of the right hip joint with methicillin-sensitive Staphylococcus aureus (MSSA). Irrigation and antibiotics treatment in former hospital could not suppress infection, which resulted in femoral head destruction (a). Right hip joint was filled with infected scar tissue and debris of the destructed femoral head. Single-stage implantation was performed after thorough debridement (b). GT: greater trochanter, LT: lesser trochanter, and FH: femoral head. One year after surgery, his hip function was almost normal, and iodine-supported hip prosthesis was well fixed. CRP was 0.2 mg/dL and WBC was 3,810/ll 12 months later (c).
Figure 5
Figure 5
Changes in white blood cell (WBC) counts (/mm3). WBC counts tended to be high several days after the surgery but returned to normal by 1 or 2 weeks.
Figure 6
Figure 6
Changes in C-reactive protein (CRP; mg/dL). CRP level returned to normal level within 4 weeks after implantation.
Figure 7
Figure 7
The free triiodothyronine (FT3; pg/mL), free thyroxine (FT4; ng/dL), and thyroid-stimulating hormone (TSH; μIU/mL) levels were within the normal ranges during the study period.

Similar articles

See all similar articles

Cited by 3 articles

References

    1. Kurtz S. M., Ong K. L., Lau E., Bozic K. J. Impact of the economic downturn on total joint replacement demand in the United States: updated projections to 2021. The Journal of Bone & Joint Surgery. 2014;96(8):624–630. doi: 10.2106/jbjs.m.00285. - DOI - PubMed
    1. Ridgeway S., Wilson J., Charlet A., Katafos G., Pearson A., Coello R. Infection of the surgical site after arthroplasty of the hip. The Journal of Bone & Joint Surgery—British Volume. 2005;87(6):844–850. doi: 10.1302/0301-620x.87b6.15121. - DOI - PubMed
    1. Perka C., Haas N. Periprosthetic infection. Chirurg. 2011;82(3):218–226. doi: 10.1007/s00104-010-2014-3. - DOI - PubMed
    1. Bauer T. W., Parvizi J., Kobayashi N., Krebs V. Diagnosis of periprosthetic infection. The Journal of Bone & Joint Surgery—American Volume. 2006;88(4):869–882. doi: 10.2106/jbjs.e.01149. - DOI - PubMed
    1. Bozic K. J., Kurtz S. M., Lau E., Ong K., Vail D. T. P., Berry D. J. The epidemiology of revision total hip arthroplasty in the united states. The Journal of Bone & Joint Surgery Series A. 2009;91(1):128–133. doi: 10.2106/jbjs.h.00155. - DOI - PubMed

Publication types

MeSH terms

Feedback