title: The Use of a Supra-Acetabular Antibiotic-Loaded Cement Shelf to Improve Hip Stability in First-Stage Infected Total Hip Arthroplasty.
abstract: Antibiotic-loaded cement spacers in first-stage revision total hip arthroplasty (THA) for managing infection are associated with high dislocation and fracture rates. The aim of this study was to report the use of an antibiotic-loaded cemented supra-acetabular roof augmentation to reinforce hip stability after cement spacer insertion for first-stage total hip revision in the treatment of infected THA.
  
  
  
  We retrospectively reviewed a consecutive series of 50 THAs involving 47 patients with an infected hip requiring staged revisions of THA. We documented dislocation, reinfection, and time for revision and outcome.
  
  
  
  There were no cases of hip dislocation, cement fractures, or any other technical complications associated with the use of the roof augmentation lip. Thirteen cases (26%) had a cemented spacer for longer than 120 days. Seven (14%) cases had recurrent infection after staged revision THA.
  
  
  
  The antibiotic-loaded cemented supra-acetabular roof augment improved femoral head spacer coverage for patients requiring a staged revision THA for infection.
authors.affiliation: Orthopedic Department, Mount Sinai Hospital, Toronto, Ontario, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Drexler
authors.affiliation: Orthopedic Department, Mount Sinai Hospital, Toronto, Ontario, Canada.
authors.forename: Paul R T
authors.initials: PR
authors.lastname: Kuzyk
authors.affiliation: Orthopedic Department, Mount Sinai Hospital, Toronto, Ontario, Canada.
authors.forename: Kevin
authors.initials: K
authors.lastname: Koo
authors.affiliation: Orthopedic Department, Mount Sinai Hospital, Toronto, Ontario, Canada.
authors.forename: Allan E
authors.initials: AE
authors.lastname: Gross
authors.affiliation: Orthopedic Department, Mount Sinai Hospital, Toronto, Ontario, Canada.
authors.forename: Yona
authors.initials: Y
authors.lastname: Kosashvili
authors.affiliation: ProDoc, Graz, Austria.
authors.forename: Nickola
authors.initials: N
authors.lastname: Reischl
authors.affiliation: Orthopedic Division, Tel-Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Tal Frenkel
authors.initials: TF
authors.lastname: Rutenberg
authors.affiliation: Orthopedic Department, Mount Sinai Hospital, Toronto, Ontario, Canada.
authors.forename: Oleg
authors.initials: O
authors.lastname: Safir
mesh_terms: D000077:Acetabulum / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D001843:Bone Cements / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D012086:Reoperation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D001843:Bone Cements
keywords: Antibiotic-loaded; First-stage infected; Supra-acetabular cement shelf; Total hip arthroplasty