A new biarticular cement spacer technique for infected total hip and knee arthroplasty with massive bone loss

• Published in: Hip international 2021-03, Vol.31 (2), p.242-249
• Main Authors: Sanz-Ruiz, Pablo, Matas-Diez, Jose Antonio, Villanueva-Martinez, Manuel, Carbo-Laso, Esther, Lopez-Torres, Irene Isabel, Vaquero-Martín, Javier
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents; Arthritis, Infectious - surgery; Arthroplasty, Replacement, Hip - adverse effects; Arthroplasty, Replacement, Knee; Bone Cements; Humans; Prosthesis-Related Infections - diagnosis; Prosthesis-Related Infections - surgery; Reoperation
• ISSN: 1120-7000; 1724-6067
• DOI: 10.1177/1120700019884557

Introduction: The management of massive femoral bone defects following prosthetic infection remains a surgical challenge, particularly when the entire femur is affected. Methods: We present the first results of a new biarticular cement spacer with antibiotic technique using a cephalomedullary nail for the treatment of infected hip arthroplasty involving complete femoral bone loss. Results: 5 patients with a minimum follow-up of 1 year were included. In all cases 2-stage replacement due to hip periprosthetic infection was carried out, with the need for a biarticular complete femoral spacer in view of the magnitude of the bone defect. The infection was resolved in all patients, with no complications (spacer fracture or dislocation) associated to spacer use, and the patients were all able to maintain the sitting position with active knee movements between the 2 surgical stages. Improvement with respect to preoperative functional status was observed in all cases, as evidenced by the Harris Hip Score (HHS) (from 24.2 to 73; p