Table of Contents Author Guidelines Submit a Manuscript
BioMed Research International
Volume 2016, Article ID 9079041, 6 pages
http://dx.doi.org/10.1155/2016/9079041
Clinical Study

Silver-Coated Hip Megaprosthesis in Oncological Limb Savage Surgery

1Division of Orthopedic and Traumatology, Catholic University of the Sacred Heart, Rome, Italy
2Division of Orthopedic and Traumatology, Messina University, Messina, Italy

Received 22 April 2016; Revised 16 June 2016; Accepted 10 July 2016

Academic Editor: Sandra Utzschneider

Copyright © 2016 F. Donati et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Silver coating has demonstrated good antimicrobial activity and low toxicity. Silver-coated megaprostheses have been introduced in oncological musculoskeletal surgery considering the high rate of infection. We conducted a retrospective analysis on 68 cases of primary or metastatic bone tumors, affecting the proximal femur, treated between 2005 and 2016 with wide margins resection and tumor implants reconstruction. All patients were treated by the same surgeon, with antibiotic prophylaxis according to a standard protocol. In 55.9% of patients silver-coated hip hemiarthroplasty was implanted; in the remaining 44.1% uncoated megaprostheses were implanted. Patients were reevaluated recording the complications and focusing the analysis on infective complications. The average follow-up was 46.5 months. No patient has shown any sign of local or general silver toxicity. A SEM analysis was conducted on the 3-silver-coated hip hemiarthroplasty explanted confirming a severe degradation with a small amount of residual silver on the coating surface. Silver-coated hip prostheses have a lower rate of early infection than traditional implants but showed a reduction of antimicrobial activity for silver coating wear. We recommend using silver-coated prosthesis as primary implants for limb salvage surgery, in primary or metastatic bone tumors affecting the proximal femur, considering the absence of signs of toxicity and the lower rate of early infection.