title: The use of a preformed spacer in two-stage revision of infected hip arthroplasties.
abstract: Two-stage revision with the use of an antibiotic-loaded cement spacer has spread widely as a successful treatment for THA infection. Between 1999 and 2008, 28 patients with infected THA were treated with two-stage implant revision using a preformed spacer. The spacer was left in situ for 5.5 months (range 1-13 months), and the patients were allowed to walk with partial weight bearing. At a mean follow-up of 53 months (range 18-106 months), recurrence of infection was observed in only one patient. Complications were observed in five patients: three spacer dislocations, one distal femoral fracture occurred during stem removal, and one femoral artery pseudo-aneurysm. The mean HHS increased from 43 points (range 13-77) to 82 points (range 35-96). Though small prospective studies are reported in literature, good eradication rate and good functional outcomes encourage for the use of an antibiotic-loaded cement spacer. The industrial production ensures procedure standardization, well-defined physical and chemical properties to the device and eliminates time necessary to intraoperatory manufacturing.
authors.affiliation: Department of Orthopaedic and Traumatologic Sciences, University of Insubria, Varese, Italy. fabio.dangelo@uninsubria.it
authors.forename: F
authors.initials: F
authors.lastname: D'Angelo
authors.forename: L
authors.initials: L
authors.lastname: Negri
authors.forename: T
authors.initials: T
authors.lastname: Binda
authors.forename: G
authors.initials: G
authors.lastname: Zatti
authors.forename: P
authors.initials: P
authors.lastname: Cherubino
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods*; D001424:Bacterial Infections / Q000150:complications* / Q000188:drug therapy; D001843:Bone Cements; D016503:Drug Delivery Systems; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D001843:Bone Cements