title: A modified cement spacer technique for infected total hip arthroplasties with significant bone loss.
abstract: Complications related to femoral spacers are common during addressing infected total hip arthroplasties by 2-stage revision. We evaluated 11 patients who had 2-stage revisions with massive bone loss after removal of the infected components by a trochanteric osteotomy. All femoral cement spacers were assembled on intramedullary nails. Femurs were protected by a plate, whereas acetabuli were augmented by a cage or roof ring depending on the remaining bone stock. This additional hardware was covered with antibiotic-impregnated cement. Infection was eradicated in 10 (90.9%) of 11 patients within 3.5 months in average. None of the patients had spacer fracture, periprosthetic fracture, or dislocation. Augmentation by hardware covered with antibiotic-impregnated cement is effective and may reduce complications until definitive treatment is performed.
authors: Division of Orthopaedic Surgery, Department of Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada.
authors: Oren
authors: O
authors: Ben-Lulu
authors: Ali
authors: A
authors: Farno
authors: Allan E
authors: AE
authors: Gross
authors: David J
authors: DJ
authors: Backstein
authors: Yona
authors: Y
authors: Kosashvili
authors: Oleg A
authors: OA
authors: Safir
mesh_terms: D000077:Acetabulum / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D001843:Bone Cements; D001858:Bone Nails; D005260:Female; D005269:Femur / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D006617:Hip Dislocation / Q000453:epidemiology / Q000209:etiology; D006621:Hip Joint / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D015994:Incidence; D008297:Male; D010027:Osteotomy; D057068:Periprosthetic Fractures / Q000453:epidemiology / Q000209:etiology; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000601:surgery*; D012086:Reoperation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D001843:Bone Cements