Retaining well-fixed cementless stem in the treatment of infected hip arthroplasty
DOI:
https://doi.org/10.3109/17453674.2013.795830Abstract
Background and purpose Two-stage reconstruction, reimplantation after removal of an infected prosthesis, has been considered to be the gold standard for treatment of infected hip arthroplasty. However, during the removal of a well-fixed femoral stem, the proximal femur can be damaged and a sequestrum can be formed, which might lead to chronic osteomyelitis and difficulty in reimplantation. We wanted to determine whether infection after hip arthroplasty can be treated without removal of a well-fixed stem.Methods We treated 19 patients who had an infection after hip replacement, but a well-fixed cementless stem, with 2-stage reconstruction. At the first stage, we removed the acetabular cup, the liner and the head, but not the stem. We then implanted a cup of cement spacer. After control of infection, we reimplanted the acetabular component and head.Results 2 patients did not undergo second-stage reconstruction because they were satisfied with the pain relief and the activity that they had with the cement-spacer implantation. The remaining 17 patients underwent the second-stage of the reconstruction using cementless arthroplasty. At a mean follow-up time of 4 (2–8) years, 15 of the patients had no recurrence of infection, with satisfactory clinical and radiographic outcome.Interpretation This second-stage reconstruction after retention of the stem could be an alternative treatment option for periprosthetic infection with a well-fixed stem.Downloads
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Published
2013-06-01
How to Cite
Lee, Y.-K., Lee, K. H., Nho, J.-H., Ha, Y.-C., & Koo, K.-H. (2013). Retaining well-fixed cementless stem in the treatment of infected hip arthroplasty. Acta Orthopaedica, 84(3), 260–264. https://doi.org/10.3109/17453674.2013.795830
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Acta Orthopaedica (Scandinavica) content is available freely online as from volume 1, 1930. The journal owner owns the copyright for all material published until volume 80, 2009. As of June 2009, the journal has however been published fully Open Access, meaning the authors retain copyright to their work. As of June 2009, articles have been published under CC-BY-NC or CC-BY licenses, unless otherwise specified.