Top

Published in:

01-10-2011 | Original Paper

Preformed gentamicin spacers in two-stage revision hip arthroplasty: functional results and complications

Authors: Christophe Pattyn, Thomas De Geest, Pieter Ackerman, Emmanuel Audenaert

Published in: International Orthopaedics | Issue 10/2011

Abstract

Two-stage revisions with antibiotic-loaded spacers have gained popularity for treating infected hip-joint arthroplasties. The aim of this prospective study was to assess patient functionality between stages and treatment impact on duration of hospital stay and to describe related complications. Sixty-one consecutive patients with infected hip arthroplasties underwent two-stage revision with preformed spacer implantation. Mean Harris Hip and Merle d’Aubigné scores between the two stages were 39.9 and 7.6, respectively. Forty-six patients (75.4%) were able to leave hospital between stages. Spacer dislocation occurred in 16.4%. No cases of spacer breakage were noted. Preformed cement spacers provide acceptable functional outcome between revision hip arthroplasty stages and facilitate the surgical procedure without increasing mechanical complication rates.

Del Pozo JL, Patel R (2009) Infection associated with prosthetic joints. N Engl J Med 361:787–794PubMedCrossRef

Hanssen AD, Spangehl MJ (2004) Treatment of infected hip replacement. Clin Orthop Relat Res 420:63–71PubMedCrossRef

Koo KH, Yang JW, Cho SH, Song HR, Park HB, Ha YC, Chang JD, Kin SY, Kim YH (2001) Impregnation of vancomycin, gentamycin, and cefotaxime in the cement spacer for two-stage cementless reconstruction in infected total hip arthroplasty. J Arthroplasty 16:882–892PubMedCrossRef

Yamamoto K, Miyagawa N, Masoaka T, Katori Y, Shisido T, Imakiire A (2009) Cement spacer loaded with antibiotics for infected implants of the hip joint. J Arthroplasty 24:83–89PubMedCrossRef

Younger ASE, Duncan CP, Masri BA, McGraw RW (1997) The outcome of two-stage arthroplasty using a custom-made interval spacer to treat the infected hip. J Arthroplasty 12(6):615–623PubMedCrossRef

Lieberman JR, Callaway GH, Salvatti EA, Brause BD (1994) Treatment of the infected total hip arthroplasty with a two-stage reimplantation protocol. Clin Orthop 301:205–212PubMed

Masri BA, Panagiotopoulos KP, Greidanus NV, Garbuz DS, Duncan CP (2007) Cementless two-stage exchange arthroplasty for infection after total hip arthroplasty. J Arthroplasty 22(1):72–78PubMedCrossRef

Anagnostakos K, Fürst O, Kelm J (2006) Antibiotic-impregnated PMMA hip spacers: current status. Acta Orthop 77:628–637PubMedCrossRef

Kent M, Rachha R, Sood M (2010) A Technique for the fabrication of a reinforced moulded articulating cement spacer in two-stage revision total hip arthroplasty. Int Orthop 34(7):949–953PubMedCrossRef

10.

Yoo JJ, Kwon YS, Koo KH, Yoon KS, Kim YM, Kim HJ (2009) One-stage cementless revision arthroplasty for infected hip replacements. Int Orthop 33(5):1195–1201PubMedCrossRef

11.

Jackson WO, Schmalzreid TP (2000) Limited role of direct exchange arthroplasty in the treatment of infected hip replacements. Clin Orthop Relat Res 381:101–105PubMedCrossRef

12.

Hanssen AD, Rand JA (1998) Evaluation and treatment of infection site of a total hip or knee arthroplasty. J Bone Joint Surg Am 80-A:910–922

13.

Garvin KL, Hansen AD (2005) Infection after total hip artroplasty. Past, present and future. J Bone Joint Surg Am 77-A:1576–1588

14.

Haddad FS, Masri BA, Garbuz DS, Duncan CP (1999) The treatment of the infected hip replacement. The complex case. Clin Orthop Relat Res 369:144–156PubMedCrossRef

15.

Haddad FS, Muirhead-Allwood SK, Manktelow AR, Bacarese Hamilton I (2000) Two-stage uncemented revision hip arthroplasty for infection. J Bone Joint Surg Br 82-B(5):689–694CrossRef

16.

Berry DJ, Chandler HP, Reilly DT (1991) The use of bone allografts in two-stage reconstruction after failure of hip replacement due to infection. J Bone Joint Surg Am 73-A:1460–1468

17.

Gustilo RB, Pasternak HS (1998) Revision total hip arthroplasty with titanium ingrowth prosthesis and bone grafting for failed cemented femoral component loosening. Clin Orthop Relat Res 235:111–119

18.

Hsieh PH, Shih CH, Chang YH, Lee MD, Shih HN, Yang WE (2004) Two-stage revision hip arthroplasty for infection: comparison between the interim use of antibiotic-loaded cement beads and a spacer prosthesis. J Bone Joint Surg Am 86-A:1989–1997PubMed

19.

Jahoda D, Sosna A, Landor I, Vavrik P, Pokorny D (2003) Canulated spacer in the treatment of deep infection of total hip arthroplasty using a two-stage reimplantation. Oper Orthop Traumatol 1:57–69CrossRef

20.

Leunig M, Chosa E, Speck M, Ganz R (1998) A cement spacer for two-stage revision of infected implants of the hip-joint. Int Orthop 22(4):209–214PubMedCrossRef

21.

Shin SS, Della Valle CJ, Ong BC, Meere PA (2002) A simple method for construction of an articulating antibiotic loaded spacer. J Arthroplasty 17(6):785–787PubMedCrossRef

22.

Anagnostakos K, Jung J, Schmid NV, Schmitt E, Kelm J (2009) Mechanical complications and reconstruction strategies at the site of hip spacer implantation. Int J Med Sci 6(5):274–279PubMed

23.

Anagnostakos K, Köhler D, Schmitt E, Kelm J (2009) The “glove” technique: a modified method for femoral fixation of antibiotic-loaded hip spacers. Acta Orthop 80(3):386–388PubMedCrossRef

24.

Jung J, Schmid NV, Kelm J, Schmitt E, Anagnostakos K (2009) Complications after spacer implantation in the treatment of hip joint infections. Int J Med Sci 6(5):265–273PubMed

25.

Thielen T, Maas S, Zuerbes A, Waldmann D, Anagnostakos K, Kelm J (2009) Development of a reinforced PMMA based hip spacer adapted to patients’ needs. Med Eng Phys 31(8):930–936PubMedCrossRef

26.

Kummer FJ, Strauss E, Wright K, Kubiak EN, Di Cesare PE (2008) Mechanical evaluation of unipolar hip spacer constructs. Am J Orthop 37(10):517–518PubMed

27.

Romanò CL, Romanò D, Logoluso N, Meani E (2010) Long-stem versus short-stem preformed antibiotic-loaded cement spacers for two-stage revision of infected total hip arthroplasty. Hip Int 20(1):26–33PubMed

28.

Trampuz A, Hanssen AD, Osmon DR, Mandrekar J, Steckelberg JM, Patel R (2003) Advances in the laboratory diagnosis of prosthetic joint infection. Rev Med Microbiol 14:1–14

Title: Preformed gentamicin spacers in two-stage revision hip arthroplasty: functional results and complications
Authors: Christophe Pattyn
Thomas De Geest
Pieter Ackerman
Emmanuel Audenaert
Publication date: 01-10-2011
Publisher: Springer-Verlag
Published in: International Orthopaedics / Issue 10/2011
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-010-1172-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Preformed gentamicin spacers in two-stage revision hip arthroplasty: functional results and complications

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 10/2011

Reply to comment on Cheng et al.: Comparison study of two surgical options for distal tibia fracture—minimally invasive plate osteosynthesis vs. open reduction and internal fixation

A retrospective analysis of bilateral fractures over sixteen years: localisation and variation in treatment of second hip fractures

In vivo three-dimensional motion analysis of the shoulder joint during internal and external rotation

Surgery for pathological proximal femoral fractures, excluding femoral head and neck fractures

Physeal injuries of the proximal humerus: long-term results in seventy two patients

Is ossification of posterior longitudinal ligament an enthesopathy?