Spacer endoprosthesis for the treatment of infected total hip arthroplasty.
We reviewed the treatment of infected total hip arthroplasty with a temporary spacer endoprosthesis. To fabricate the spacer, antibiotic-loaded cement was inserted into a specially designed mold. A central rod pin was superficially imbedded as an endoskeleton once the cement reached a doughy state. After polymerization, the final product was removed from the mold and inserted as an articulating spacer. Twenty patients were followed for an average of 38 months (range, 26-67 months). There were no recurrent or persistent infections. Eighteen patients underwent a successful 2-stage exchange. Two patients retained the spacer as a definitive treatment method. Complications with the spacer included 2 fractures and 2 dislocations. Overall, this cost-effective technique provided efficient local antibiotic delivery, early mobilization, facilitation of reimplantation, and improved patient satisfaction.
Durbhakula
Sridhar M
SM
Division of Orthopaedic Surgery, Albany Medical Center, New York, USA.
Czajka
John
J
Fuchs
Marc D
MD
Uhl
Richard L
RL
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D001843:Bone Cements; D003646:Debridement; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000601:surgery*; D012086:Reoperation; D014031:Tobramycin / Q000008:administration & dosage; D016896:Treatment Outcome; D014640:Vancomycin / Q000008:administration & dosage
D000900:Anti-Bacterial Agents; D001843:Bone Cements; D014640:Vancomycin; D014031:Tobramycin