The use of a preformed spacer in two-stage revision of infected hip arthroplasties

Two-stage revision with the use of an antibiotic-loaded cement spacer has spread widely as a successful treatment for THA infection. Between 1999 and 2008, 28 patients with infected THA were treated with two-stage implant revision using a preformed spacer. The spacer was left in situ for 5.5 months...

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Bibliographic Details
Published in:Musculoskeletal surgery 2011-08, Vol.95 (2), p.115-120
Main Authors: D’Angelo, F., Negri, L., Binda, T., Zatti, G., Cherubino, P.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Aneurysms
Anti-Bacterial Agents - administration & dosage
Antibiotics
Arthroplasty, Replacement, Hip - adverse effects
Arthroplasty, Replacement, Hip - methods
Bacterial Infections - complications
Bacterial Infections - drug therapy
Bone Cements
Care and treatment
Chemical properties
Drug Delivery Systems
Female
Follow-Up Studies
Health aspects
Humans
Infection
Male
Medicine
Medicine & Public Health
Middle Aged
Original Article
Orthopedics
Prosthesis Design
Prosthesis-Related Infections - drug therapy
Prosthesis-Related Infections - microbiology
Prosthesis-Related Infections - surgery
Recurrence
Reoperation
Retrospective Studies
Surgical Orthopedics
Treatment Outcome
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Summary:Two-stage revision with the use of an antibiotic-loaded cement spacer has spread widely as a successful treatment for THA infection. Between 1999 and 2008, 28 patients with infected THA were treated with two-stage implant revision using a preformed spacer. The spacer was left in situ for 5.5 months (range 1–13 months), and the patients were allowed to walk with partial weight bearing. At a mean follow-up of 53 months (range 18–106 months), recurrence of infection was observed in only one patient. Complications were observed in five patients: three spacer dislocations, one distal femoral fracture occurred during stem removal, and one femoral artery pseudo-aneurysm. The mean HHS increased from 43 points (range 13–77) to 82 points (range 35–96). Though small prospective studies are reported in literature, good eradication rate and good functional outcomes encourage for the use of an antibiotic-loaded cement spacer. The industrial production ensures procedure standardization, well-defined physical and chemical properties to the device and eliminates time necessary to intraoperatory manufacturing.
ISSN:2035-5106
2035-5114
DOI:10.1007/s12306-011-0128-5