{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:46:01Z","timestamp":1787755561814,"version":"build-2784847793"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,7,19]]},"abstract":"\n Background:<\/jats:title>\n Surgical site infection (SSI) after segmental endoprosthetic reconstruction in patients treated for oncologic conditions remains both a devastating and a common complication. The goal of the present study was to identify variables associated with the success or failure of treatment of early SSI following the treatment of a primary bone tumor with use of a segmental endoprosthesis.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n The present study used the Prophylactic Antibiotic Regimens in Tumor Surgery (PARITY) data set to identify patients who had been diagnosed with an SSI after undergoing endoprosthetic reconstruction of a lower extremity primary bone tumor. The primary outcome of interest in the present study was a dichotomous variable: the success or failure of infection treatment. We defined failure as the inability to eradicate the infection, which we considered as an outcome of amputation or limb retention with chronic antibiotic suppression (>90 days or ongoing therapy at the conclusion of the study). Multivariable models were created with covariates of interest for each of the following: surgery characteristics, cancer treatment-related characteristics, and tumor characteristics. Multivariable testing included variables selected on the basis of known associations with infection or results of the univariable tests.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Of the 96 patients who were diagnosed with an SSI, 27 (28%) had successful eradication of the infection and 69 had treatment failure. Baseline and index procedure variables showing significant association with SSI treatment outcome were moderate\/large amounts of fascial excision \u22651 cm\n 2<\/jats:sup>\n ) (OR, 10.21 [95% CI, 2.65 to 46.21]; p = 0.001), use of local muscle\/skin graft (OR,11.88 [95% CI, 1.83 to 245.83]; p = 0.031), and use of a deep Hemovac (OR, 0.24 [95% CI, 0.05 to 0.85]; p = 0.041). In the final multivariable model, excision of fascia during primary tumor resection was the only variable with a significant association with treatment outcome (OR, 10.21 [95% CI, 2.65 to 46.21]; p = 0.018).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n The results of this secondary analysis of the PARITY trial data provide further insight into the patient-, disease-, and treatment-specific associations with SSI treatment outcomes, which may help to inform decision-making and management of SSI in patients who have undergone segmental bone reconstruction of the femur or tibia for oncologic indications.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence:<\/jats:title>\n \n Prognostic\n Level III<\/jats:underline>\n . See Instructions for Authors for a complete description of levels of evidence.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.2106\/jbjs.22.01376","type":"journal-article","created":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T11:05:27Z","timestamp":1689764727000},"page":"87-96","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":9,"title":["Surgical Site Infection in Patients Managed with an Endoprosthesis for the Treatment of Cancer"],"prefix":"10.2106","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1385-5468","authenticated-orcid":false,"given":"G.S.","family":"Ray","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4643-3827","authenticated-orcid":false,"given":"P.","family":"Werth","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire"},{"name":"Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6249-5393","authenticated-orcid":false,"given":"J.H.","family":"Alexander","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Wexner Medical Center, The Ohio State University, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.C.","family":"Eward","sequence":"additional","affiliation":[{"name":"Duke Health Department of Orthopaedic Surgery, Duke Cancer Center, Duke, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3338-5878","authenticated-orcid":false,"given":"N.M.","family":"Bernthal","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Santa Monica, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.M.","family":"Jeys","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Royal Orthopaedic Hospital, Birmingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Funovics","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Medical University of Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6321-1804","authenticated-orcid":false,"given":"R.","family":"Windhager","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Medical University of Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.T.","family":"Temple","sequence":"additional","affiliation":[{"name":"Miller School of Medicine, University of Miami, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0681-9004","authenticated-orcid":false,"given":"S.","family":"Lozano-Calderon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6224-7410","authenticated-orcid":false,"given":"R.S.","family":"Avedian","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Stanford Health Care, Redwood City, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6022-2807","authenticated-orcid":false,"given":"P.C.","family":"Jutte","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4778-4522","authenticated-orcid":false,"given":"M.","family":"Ghert","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9617-9882","authenticated-orcid":false,"given":"P.","family":"Ruggieri","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Orthopaedic Oncology, Padova University, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0371-010X","authenticated-orcid":false,"given":"E.R.","family":"Henderson","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire"},{"name":"Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the PARITY Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,7,19]]},"reference":[{"key":"bib1-20250430","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-540-77960-5_7","article-title":"The Long-Term Risks of Infection and Amputation with Limb Salvage Surgery Using 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