title: Cementless two-stage exchange arthroplasty for infection after total hip arthroplasty.
abstract: We retrospectively reviewed all patients at one center with an infected total hip arthroplasty treated with 2-stage revision using cementless components for the second stage and the PROSTALAC articulated spacer at the first stage. Twenty-nine patients were reviewed and followed for at least 2 years postoperatively. An isolated Staphylococcus species was cultured in 76% (22/29) of patients. Three (10.3%) of 29 patients had recurrent infection at the site of the prosthesis. One of the 3 patients ultimately underwent a Girdlestone arthroplasty. Another patient was managed with irrigation and debridement, whereas the final patient was treated with intravenous antibiotics alone. Treatment of infection at the site of a hip arthroplasty with 2-stage revision using cementless components and an articulated spacer yields recurrence rates similar to revisions where at least one of the components at the second stage is fixed with antibiotic-loaded cement.
authors.affiliation: Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Bassam A
authors.initials: BA
authors.lastname: Masri
authors.forename: Kostas P
authors.initials: KP
authors.lastname: Panagiotopoulos
authors.forename: Nelson V
authors.initials: NV
authors.lastname: Greidanus
authors.forename: Donald S
authors.initials: DS
authors.lastname: Garbuz
authors.forename: Clive P
authors.initials: CP
authors.lastname: Duncan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D001843:Bone Cements; D005260:Female; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000382:microbiology* / Q000517:prevention & control / Q000601:surgery*; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D055502:Secondary Prevention; D013203:Staphylococcal Infections / Q000517:prevention & control / Q000601:surgery
chemical_list: D001843:Bone Cements