A Modified Cement Spacer Technique for Infected Total Hip Arthroplasties With Significant Bone Loss

Abstract Complications related to femoral spacers are common during addressing infected total hip arthroplasties by 2-stage revision. We evaluated 11 patients who had 2-stage revisions with massive bone loss after removal of the infected components by a trochanteric osteotomy. All femoral cement spa...

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Bibliographic Details
Published in:The Journal of arthroplasty 2012-04, Vol.27 (4), p.613-619
Main Authors: Ben-Lulu, Oren, MD, Farno, Ali, MD, Gross, Allan E., MD, FRCSC, O. Ont, Backstein, David J., MD, Med, FRCSC, Kosashvili, Yona, MD, Safir, Oleg A., MD, Med, FRCSC
Format: Article
Language:English
Subjects:
Acetabulum - microbiology
Acetabulum - pathology
Acetabulum - surgery
Aged
Aged, 80 and over
Anti-Bacterial Agents - therapeutic use
Arthroplasty, Replacement, Hip - adverse effects
Arthroplasty, Replacement, Hip - instrumentation
Arthroplasty, Replacement, Hip - methods
Bone Cements
Bone Nails
cement spacer
Female
Femur - microbiology
Femur - pathology
Femur - surgery
Hip Dislocation - epidemiology
Hip Dislocation - etiology
Hip Joint - microbiology
Hip Joint - pathology
Hip Joint - surgery
Hip Prosthesis
Humans
Incidence
infected
Male
Orthopedics
Osteotomy
Periprosthetic Fractures - epidemiology
Periprosthetic Fractures - etiology
Prosthesis-Related Infections - drug therapy
Prosthesis-Related Infections - surgery
Reoperation - adverse effects
Reoperation - instrumentation
Reoperation - methods
Retrospective Studies
total hip arthroplasty
Treatment Outcome
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Description
Summary:Abstract Complications related to femoral spacers are common during addressing infected total hip arthroplasties by 2-stage revision. We evaluated 11 patients who had 2-stage revisions with massive bone loss after removal of the infected components by a trochanteric osteotomy. All femoral cement spacers were assembled on intramedullary nails. Femurs were protected by a plate, whereas acetabuli were augmented by a cage or roof ring depending on the remaining bone stock. This additional hardware was covered with antibiotic-impregnated cement. Infection was eradicated in 10 (90.9%) of 11 patients within 3.5 months in average. None of the patients had spacer fracture, periprosthetic fracture, or dislocation. Augmentation by hardware covered with antibiotic-impregnated cement is effective and may reduce complications until definitive treatment is performed.
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2011.06.031