{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T04:40:05Z","timestamp":1791520805753,"version":"4.3.4"},"reference-count":48,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,11,4]],"date-time":"2020-11-04T00:00:00Z","timestamp":1604448000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This study investigates the effect of superficial vancomycin coating (SVC) in two\u2010 or more\u2010stage exchange procedures of prosthetic knee joint infections. We hypothesized that spacer treatment with SVC result in lower reinfection rates than conventional spacers after prosthetic reimplantation. Our secondary aim was to determine the demographic and treatment factors associated with reinfection rates. This retrospective cohort study compromised 96 cases with prosthetic knee infections. Twenty\u2010four cases were treated with a temporary SVC spacer and 72 cases with conventional spacers. Prosthetic reinfection occurred after a median observation period of 1.7\u2009\u00b1\u20094.0 years in 24 cases (25%). The prevalence of having a reinfection was not significantly different between the two treatment groups (13% [3 cases] in the SVC group vs. 29% [21 cases] in the conventional spacer group [<jats:italic>p<\/jats:italic>\u2009=\u2009.104]). In seven cases (7.3%), two in the SVC group (8.3%) and five (6.9%) in the conventional spacer group (<jats:italic>p<\/jats:italic>\u2009\u2265\u2009.999), histological, respectively microbiological evaluations from the intraoperative specimens revealed persistent infection at the second stage. Nevertheless, in all seven cases no significant higher risk of periprosthetic reinfection was observed during follow\u2010up (<jats:italic>p<\/jats:italic>\u2009=\u2009.750). Our secondary investigation of cofactors revealed that spacers additionally stabilized by nails were significantly associated with a 3.9\u2010fold higher hazard ratio of sustaining a reinfection of revision prosthesis (<jats:italic>p<\/jats:italic>\u2009=\u2009.005).<\/jats:p>","DOI":"10.1002\/jor.24892","type":"journal-article","created":{"date-parts":[[2020,10,29]],"date-time":"2020-10-29T10:42:47Z","timestamp":1603968167000},"page":"1700-1709","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Risk of reinfection after two\u2010 or multiple\u2010stage knee revision surgery using superficial vancomycin coating and conventional spacers"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3402-6589","authenticated-orcid":false,"given":"Florian","family":"Amerstorfer","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Trauma Medical University of Graz  Graz 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of Graz  Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6842-4526","authenticated-orcid":false,"given":"Stefan","family":"Fischerauer","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Medical University of Graz  Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3633-3240","authenticated-orcid":false,"given":"Mathias","family":"Glehr","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Medical University of Graz  Graz 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