Spacer endoprosthesis for the treatment of infected total hip arthroplasty

We reviewed the treatment of infected total hip arthroplasty with a temporary spacer endoprosthesis. To fabricate the spacer, antibiotic-loaded cement was inserted into a specially designed mold. A central rod pin was superficially imbedded as an endoskeleton once the cement reached a doughy state....

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Bibliographic Details
Published in:The Journal of arthroplasty 2004-09, Vol.19 (6), p.760-767
Main Authors: Durbhakula, Sridhar M., Czajka, John, Fuchs, Marc D., Uhl, Richard L.
Format: Article
Language:English
Subjects:
2-stage exchange
Aged
Aged, 80 and over
Anti-Bacterial Agents - administration & dosage
Arthroplasty, Replacement, Hip - instrumentation
articulating spacer
Bone Cements
Debridement
endoprosthesis
Female
Follow-Up Studies
Hip Prosthesis - adverse effects
Humans
infection
Male
Middle Aged
Postoperative Complications
Prosthesis Design
Prosthesis-Related Infections - surgery
Reoperation
Tobramycin - administration & dosage
total hip arthroplasty
Treatment Outcome
Vancomycin - administration & dosage
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Summary:We reviewed the treatment of infected total hip arthroplasty with a temporary spacer endoprosthesis. To fabricate the spacer, antibiotic-loaded cement was inserted into a specially designed mold. A central rod pin was superficially imbedded as an endoskeleton once the cement reached a doughy state. After polymerization, the final product was removed from the mold and inserted as an articulating spacer. Twenty patients were followed for an average of 38 months (range, 26–67 months). There were no recurrent or persistent infections. Eighteen patients underwent a successful 2-stage exchange. Two patients retained the spacer as a definitive treatment method. Complications with the spacer included 2 fractures and 2 dislocations. Overall, this cost-effective technique provided efficient local antibiotic delivery, early mobilization, facilitation of reimplantation, and improved patient satisfaction.
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2004.02.037