title: A cement spacer for two-stage revision of infected implants of the hip joint.
abstract: 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.
authors.affiliation: Department of Orthopaedic Surgery, University of Berne, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Leunig
authors.forename: E
authors.initials: E
authors.lastname: Chosa
authors.forename: M
authors.initials: M
authors.lastname: Speck
authors.forename: R
authors.initials: R
authors.lastname: Ganz
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D001843:Bone Cements; D004343:Drug Implants; D005839:Gentamicins; D019904:Polymethyl Methacrylate