Another brick in the wall of orthopedic knowledge

Although Pink Floyd famously sang “We don’t need no education”, it’s important to recognize that education, serves as the foundation for expanding our knowledge. Recently, Tecres organized the International Congress in Verona on Friday, 21st, 2024, focusing on “Bone Cements and Cementation: Diagnosis and Management of Infections in Orthopedic Surgery”. This event was a significant milestone, a crucial brick that Tecres added to the wall of orthopedic knowledge.

The congress was a successful enlightening event, witnessed by the presence of over 60 participants from Italy, Portugal, Germany, Slovakia, Lithuania, Poland, Moldova, Norway, Lebanon, Argentina, and Brazil. During the congress, experts delved into the history of bone cement - a versatile biomaterial used across various medical disciplines, from cranioplasty to orthopedics and even drug delivery.

The excellent results reported in International Registers emphasize the clear benefits of cemented hips in the elderly compared to cementless hips which have a much higher periprosthetic fracture rate (Prof Fabio D’Angelo, Varese - ITA).

Post-operative infection is a devastating complication which has led to the increased use worldwide of antibiotic-loaded bone cement. Nowadays, many diagnostic tools are available, but the cost is a major limitation (Dr Igor Lazic, Munich - GER).

Periprosthetic joint infections (PJI) are growing and becoming more and more complex. A centralization of the treatment and a multi-disciplinary approach would be beneficial in terms of results and costs. Culture-negative PJI is a further complication which require economic investment (Dr Roberto Rostagno, Vercelli - ITA).

The key to PJI treatment is the proper approach to the infection and the proper patient evaluation for deciding the debridement type, its extension and the reconstruction procedure as well as a dedicated team (Dr Rosalba Tortia, Vercelli – ITA). The DAIR is a valuable procedure to save the implant, but it can produce good results only if done within 3-4 weeks (Dr. Laura Ravera, Vercelli – ITA). One-stage revision requires experience, dedicated personnel but can produce excellent results as shown by Prof Mustafa Citak from the ENDO-Klinik of Hamburg – GER. Nonetheless, when the pathogen is not known, in case of sepsis, bad soft tissues and previous surgeries the two-stage revision is the golden standard since it provides the possibility of a second look before the finale reimplantation (Dr Igor Lazic, Munich - GER).

Preformed articulated spacers provide a better function compared to static spacers, limit the risk off mechanical failure, have a known antibiotic release and synergistic bactericidal effect (G+V) and reduce the surgical time while providing (Prof Fabio D’Angelo, Varese – ITA).

Preformed spacers help surgeon and patient in terms of clinical results and quality of life. This has been confirmed by more than 130 peer-reviewed papers reporting excellent results all over the world (Giovanni Calonego, Verona – ITA). Eventually, the surgeon shall not be afraid to perform a salvage procedure such as resection arthroplasty and amputation which may solve a critical situation and still provide an adequate quality of life (Dr Domenico Aloj, Vercelli – ITA).

The meeting concluded with a lecture on Cal-Cemex, a unique bone substitute made by PMMA and beta-TCP which combines the mechanical strength of PMMA and the biological action of TCP (Dr Andrea Pizzoli, Mantova – ITA).

Recordings of the speeches are available in the Academy area > webinar on demand. For info mail to academy@tecres.it