A cement spacer for two-stage revision of infected implants of the hip joint.
We report the technical details and clinical results of twelve patients who had deep infections of implants in the hip joint and were treated by two-stage revision, using a gentamicin-loaded, hand-moulded cement spacer inserted for the period between resection and reimplantation arthroplasty. During management with the spacer, usually for 4 months, patients were almost free of pain and mobile with good leg control, spending 2/3 of the treatment period at home. Six of twelve spacers failed locally due to dislocation [5] or cement fracture [1], and more than two further episodes of surgery were required in 3 patients. Problems with dislocation of the spacer were significantly higher when the head to neck offset was lacking (P < 0.05) or when anchorage in the femoral shaft was poor. Nevertheless, infection after reimplantation arthroplasty did not occur by the time of follow-up (2.2 years). Based on these data, we consider that the use of the cement spacer is a promising approach to the treatment of complicated infections of the hip joint.
Leunig
M
M
Department of Orthopaedic Surgery, University of Berne, Switzerland.
Chosa
E
E
Speck
M
M
Ganz
R
R
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000379:methods; D001843:Bone Cements / Q000627:therapeutic use*; D004343:Drug Implants; D004434:Early Ambulation; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019904:Polymethyl Methacrylate / Q000627:therapeutic use*; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D011859:Radiography; D012086:Reoperation / Q000295:instrumentation / Q000379:methods
D000900:Anti-Bacterial Agents; D001843:Bone Cements; D004343:Drug Implants; D005839:Gentamicins; D019904:Polymethyl Methacrylate