First clinical experience with a custom-made acetabular implant featuring a zinc-containing biocoating for the treatment of deep periprosthetic surgical site infections
Year: 2026
Type: article
Abstract: INTRODUCTION: Periprosthetic joint infection (PJI) of the hip is one of the leading causes of revision hip arthroplasty. An analysis of current treatment practices has shown increasing PJI recurrence rates, along with a rise in Gram-negative infections in the PJI etiology. Our study examined the clinical course of acute infection caused by Staphylococcus aureus / Klebsiella pneumoniae in a patient treated with a prototype acetabular component with a zinc-containing calcium phosphate coating applied by microarc oxidation, used as a spacer. CASE DESCRIPTION: We present a clinical case of a patient with chronic deep periprosthetic infection (recurrence) after total hip arthroplasty of the right hip. A custom implant with a zinc-containing calcium phosphate coating was used. Surgical treatment included removal of the right hip prosthesis, debridement of the surgical site, implantation of the custom implant, and placement of an Osteomed femoral component as a spacer. On postoperative day 21, a fistula appeared and was considered a PJI recurrence. On day 22, a repeat procedure was performed: total removal of the articulating spacer (custom acetabular component with Zn-containing coating), intraoperative sampling of tissue surrounding the acetabular and femoral components, and placement of a block spacer. In material from the implant screw holes and surrounding tissues, we found areas of subtotal necrosis of loose connective tissue interspersed with dense, diffuse inflammatory infiltrate of polynuclear leukocytes. Elemental analysis showed no zinc ions in the tissues surrounding the implant. CONCLUSION: The implant with zinc-containing calcium phosphate coating did not exhibit bactericidal activity in acute PJI, as there was no diffusion of zinc ions into the surrounding tissues, or diffusion was too weak to provide sufficient zinc locally.
DOI: 10.17816/vto699937
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7204242647