A Modified Cement Spacer Technique for Infected Total Hip Arthroplasties With Significant Bone Loss

• Published in: The Journal of arthroplasty Vol. 27; no. 4; pp. 613 - 619
• Main Authors: Ben-Lulu, Oren, MD, Farno, Ali, MD, Gross, Allan E., MD, FRCSC, O. Ont, Backstein, David J., MD, Med, FRCSC, Kosashvili, Yona, MD, Safir, Oleg A., MD, Med, FRCSC
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-04-2012
• Subjects: Acetabulum - microbiology; Acetabulum - pathology; Acetabulum - surgery; Aged; Aged, 80 and over; Anti-Bacterial Agents - therapeutic use; Arthroplasty, Replacement, Hip - adverse effects; Arthroplasty, Replacement, Hip - instrumentation; Arthroplasty, Replacement, Hip - methods; Bone Cements; Bone Nails; cement spacer; Female; Femur - microbiology; Femur - pathology; Femur - surgery; Hip Dislocation - epidemiology; Hip Dislocation - etiology; Hip Joint - microbiology; Hip Joint - pathology; Hip Joint - surgery; Hip Prosthesis; Humans; Incidence; infected; Male; Orthopedics; Osteotomy; Periprosthetic Fractures - epidemiology; Periprosthetic Fractures - etiology; Prosthesis-Related Infections - drug therapy; Prosthesis-Related Infections - surgery; Reoperation - adverse effects; Reoperation - instrumentation; Reoperation - methods; Retrospective Studies; total hip arthroplasty; Treatment Outcome; cement spacer; infected; total hip arthroplasty
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/j.arth.2011.06.031

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.