{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:30:52Z","timestamp":1787027452381,"version":"build-2736575974"},"reference-count":47,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T00:00:00Z","timestamp":1786752000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background\/Objectives: One-stage revision has become an increasingly accepted strategy for the treatment of chronic periprosthetic joint infection (PJI) of the knee in carefully selected patients. The use of a resorbable defensive antibacterial coating (DAC\u00ae hydrogel) represents an attractive adjunct to reduce bacterial adhesion and biofilm formation on revision implants. However, evidence regarding its long-term performance is limited. Methods: We retrospectively reviewed 52 consecutive patients undergoing one-stage revision for knee PJI or an infected spacer between 2014 and 2023 using a standardized surgical and antimicrobial protocol including local application of DAC hydrogel loaded with vancomycin alone or vancomycin plus meropenem. Clinical, microbiological, and radiographic outcomes were evaluated. Infection-free survival was assessed using Kaplan\u2013Meier analysis. Results: Forty-eight patients underwent revision for PJI and four for septic spacers. Four patients were unavailable for final evaluation. At follow-up of 7.7 \u00b1 2.9 years (range 2.5\u201312.2 years), 47 of 48 clinically evaluable patients remained infection-free, corresponding to a crude infection-free proportion of 97.9%. Kaplan\u2013Meier infection-free survivorship at 12 years was 98.1% (95% CI, 87.1\u201399.7%). Mean Knee Society Score improved from 47.7 to 84.4 points, while functional KSS improved from 41.9 to 82.9 points. Pain at rest decreased from 6.9 to 0.7 and pain during movement from 8.1 to 1.6 on the visual analogue scale. Conclusions: This series represents, to our knowledge, the longest reported follow-up of one-stage knee revision using the DAC hydrogel coating. The favorable outcomes observed with this hybrid fixation strategy support further investigation of this approach in larger, long-term, comparative multicenter studies.<\/jats:p>","DOI":"10.3390\/antibiotics15080791","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:01:26Z","timestamp":1786968086000},"page":"791","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Use of a Bioresorbable Antibacterial Coating (DAC\u00ae Hydrogel) in One-Stage Revision of Infected Knee Arthroplasty: Long-Term Study"],"prefix":"10.3390","volume":"15","author":[{"given":"Nicola","family":"Logoluso","sequence":"first","affiliation":[{"name":"I.R.C.C.S. Istituto Ortopedico Galeazzi, Centro di Chirurgia Ricostruttiva e delle Infezioni Osteoarticolari, Via Cristina Belgioioso 173, 20157 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Pellegrini","sequence":"additional","affiliation":[{"name":"ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, U.O.C Chirurgia Ricostruttiva delle Infezioni, Piazza Cardinal Ferrari 1, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delia","family":"Romano\u2019","sequence":"additional","affiliation":[{"name":"I.R.C.C.S. Istituto Ortopedico Galeazzi, Centro di Chirurgia Ricostruttiva e delle Infezioni Osteoarticolari, Via Cristina Belgioioso 173, 20157 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerio","family":"Pascale","sequence":"additional","affiliation":[{"name":"I.R.C.C.S. Istituto Ortopedico Galeazzi, Ortopedia Clinicizzata, Via Cristina Belgioioso 173, 20157 Milano, Italy"},{"name":"Dipartimento di Scienze Biomediche per la Salute, Universit\u00e0 degli Studi di Milano, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Suardi","sequence":"additional","affiliation":[{"name":"ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, U.O.C Chirurgia Ricostruttiva delle Infezioni, Piazza Cardinal Ferrari 1, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6726-0593","authenticated-orcid":false,"given":"Carlo Luca","family":"Romano\u2019","sequence":"additional","affiliation":[{"name":"Romano Institute, Rruga Kongresi i Manastirit, Kompleksi Zirkon, 1007 Tirana, Albania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Stubnya, B.G., Schulz, M., V\u00e1ncsa, S., Szil\u00e1gyi, G.S., Szatm\u00e1ri, A., and Bejek, Z. 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