Two-stage revision hip arthroplasty for infection with a custom-made, antibiotic-loaded, cement prosthesis as an interim spacer.
BACKGROUND
Two-stage reconstruction is a well-recognized treatment for deep infection of hip joint implants. The purpose of the study was to report the results of our treatment using a standardized protocol.


METHODS
Forty-two consecutive patients with deep infection of the hip prosthesis were treated according to a prospective, two-stage resection/reimplantation protocol. Between stages, a custom-made, antibiotic-loaded, cement prosthesis was implanted as an interim spacer.


RESULTS
Infection was eradicated in 41 patients after the first-stage operation. Thirty-six patients remained with the ability to walk with the interim cement pros-thesis. For 40 patients who underwent reimplantation, recurrence of infection was observed in only 1 patient at an average of 55.2 months' follow-up.


CONCLUSIONS
We have found that our two-stage treatment protocol is a reliable approach for the management of infected hip prostheses. It is effective for eradicating infection and for providing a mobile and functional joint through the treatment course.
Hsieh
Pang-Hsin
PH
Department of Orthopedics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Chen
Lih-Huei
LH
Chen
Chi-Hwa
CH
Lee
Mel S
MS
Yang
Wen-E
WE
Shih
Chun-Hsiung
CH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D006622:Hip Prosthesis / Q000009:adverse effects* / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D012086:Reoperation
D000900:Anti-Bacterial Agents