Initial results of managing severe bone loss in infected total joint arthroplasty using customized articulating spacers.
Twenty-three cases of infected total joint arthroplasty with substantial bone loss were treated with a cement spacer, which was customized intraoperatively to achieve joint stability and to allow motion. All but one of the patients were ambulatory with the spacer in place. Spacer dislocation occurred in 1 hip patient (9%) and in none of the knee patients. Articulating antibiotic-impregnated spacers with intraoperative customization is our preferred treatment of cases of infected total joint arthroplasty even in the presence of bone loss.
Incavo
Stephen J
SJ
Department of Orthopaedic Surgery, The Methodist Hospital, Houston, Texas 77030, USA. sjincavo@tmh.tmc.edu
Russell
Robert D
RD
Mathis
Kenneth B
KB
Adams
Holly
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D001843:Bone Cements / Q000627:therapeutic use*; D002177:Candidiasis / Q000150:complications / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000382:microbiology*; D016459:Prosthesis-Related Infections / Q000150:complications* / Q000188:drug therapy*; D012086:Reoperation / Q000295:instrumentation / Q000379:methods; D013203:Staphylococcal Infections / Q000150:complications / Q000188:drug therapy; D013290:Streptococcal Infections / Q000150:complications / Q000188:drug therapy; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D001843:Bone Cements