Top

Archives of Orthopaedic and Trauma Surgery

Published in:

01-05-2012 | Hip Arthroplasty

Temporary cement tectoplasty: a technique to improve prefabricated hip spacer stability in two-stage surgery for infected hip arthroplasty

Authors: X. Flores, P. S. Corona, J. Cortina, E. Guerra, C. Amat

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 5/2012

Abstract

This technical note describes an intraoperatively custom-made, antibiotic-loaded bone cement roof, used in conjunction with a prefabricated hip spacer to improve component stability, as part of the first stage of a two-stage procedure for an infected hip implant. This technique was successfully used in seven cases who presented with extensive superior and/or posterio-superior acetabular defect, which created a risk of spacer dislocation. With this technique we were able to avoid any further dislocation in these seven cases. We believe that the technique may reduce postoperative spacer dislocation in cases with extensive acetabular defects, while improving clinical outcomes.

Cui Q, Mihalko WM (2007) Antibiotic-impregnated cement spacers for the treatment of infection associated with total hip or knee arthroplasty. Joint Bone Joint Surg Am 89:871–882CrossRef

Hanssen AD, Rand JA (1999) Evaluation and treatment of infection at the site of a total hip or knee arthroplasty. Instr Course Lect 48:111–122PubMed

Jacobs C, Christensen CP, Berend ME (2009) Static and mobile antibiotic-impregnated cement spacers for the management of prosthetic joint infection. J Am Acad Orthop Surg 17:356–368PubMed

Hsieh P-H, Shih C-H, Chang Y-H (2004) Two-stage revision hip arthroplasty for infection: comparison between the interim use of antibiotic-loaded cement beads and spacer prosthesis. J Bone Joint Surg Am 86:1989–1997PubMed

Hsieh P-H, Shih C-H, Chang Y-H (2005) Treatment of deep infection of the hip associated with massive bone loss: two-stage revision with an antibiotic-loaded interim cement prosthesis followed by reconstruction with allograft. J Bone Joint Surg Br 87-B:770–775CrossRef

Paprosky WG, Perona PG, Lawrence JM (1994) Acetabular defect classification and surgical reconstruction in revision arthroplasty. A 6-year follow-up evaluation. J Arthroplast 9:33–44CrossRef

Anagnostakos K, Wilmes P, Schmitt E, Kelm J (2009) Elution of gentamicin and vancomycin from polymethylmethacrylate beads and hip spacers in vivo. Acta Orthop 80(2):193–197PubMedCrossRef

Bori G, Soriano A, García S, Gallart X, Mallofre C, Mensa J (2009) Neutrophils in frozen section and type of microorganism isolated at the time of resection arthroplasty for the treatment of infection. Arch Orthop Trauma Surg 129(5):591–595PubMedCrossRef

Tohtz SW, Müller M, Morawietz L, Winkler T, Perka C (2010) Validity of frozen sections for analysis of periprosthetic loosening membranes. Clin Orthop Relat Res 468(3):762–768PubMedCrossRef

10.

Frank CB, Adams M, Kroeber M, Wentzensen A, Heppert V, Schulte-Bockholt D, Guehring T (2011) Intraoperative subcutaneous wound closing culture sample: a predicting factor for periprosthetic infection after hip- and knee-replacement? Arch Orthop Trauma Surg 131(10):1389–1396 (Epub Jun 14)PubMedCrossRef

11.

Corona P, Gil E, Guerra E, Soldado F, Amat C, Flores X, Pigrau C (2011) Percutaneous interface biopsy in dry-aspiration cases of chronic periprosthetic joint infections: a technique for preoperative isolation of the infecting organism. Int Orthop. doi:10.1007/s00264-011-1418-0

12.

Sudo A, Hasegawa M, Fukuda A, Uchida A (2008) Treatment of infected hip arthroplasty with antibiotic-impregnated calcium hydroxyapatite. J Arthroplast 23(1):145–150CrossRef

13.

Takigami I, Ito Y, Ishimaru D, Ogawa H, Mori N, Shimizu T, Terabayashi N, Shimizu K (2010) Two-stage revision surgery for hip prosthesis infection using antibiotic-loaded porous hydroxyapatite blocks. Arch Orthop Trauma Surg 130(10):1221–1226 (Epub 2009 Oct 30)PubMedCrossRef

14.

Affatato S, Mattarozzi A, Taddei P, Robotti P, Soffiatti R, Sudanese A, Toni A (2003) Investigations on the wear behaviour of the temporary PMMA-based hip Spacer-G. Proc Inst Mech Eng H 217(1):1–8PubMed

15.

Villa T, Carnelli D (2007) Experimental evaluation of the biomechanical performances of a PMMA-based knee spacer. Knee 14(2):145–153 (Epub 2007 Jan 4)PubMedCrossRef

16.

Fink B, Rechtenbach A, Büchner H, Vogt S, Hahn M (2011) Articulating spacers used in two-stage revision of infected hip and knee prostheses abrade with time. Clin Orthop Relat Res 469(4):1095–1102 (Epub 2010 Jul 28)PubMedCrossRef

17.

Baker RP, Duncan CP (2011) Acyclic acetabular roof reconstruction for severe superior segmental acetabular bone loss in 2-stage surgery for infected hip arthroplasty. J Arthroplast. doi:10.1016/j.arth.2011.05.002

Title: Temporary cement tectoplasty: a technique to improve prefabricated hip spacer stability in two-stage surgery for infected hip arthroplasty
Authors: X. Flores
P. S. Corona
J. Cortina
E. Guerra
C. Amat
Publication date: 01-05-2012
Publisher: Springer-Verlag
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 5/2012
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-012-1461-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Temporary cement tectoplasty: a technique to improve prefabricated hip spacer stability in two-stage surgery for infected hip arthroplasty

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 5/2012

Accuracy of measurement of femoral anteversion in femoral shaft fractures using a computer imaging software: a cadaveric study

The direct lateral approach: impact on gait patterns, foot progression angle and pain in comparison with a minimally invasive anterolateral approach

Erratum to: Radiological radio-carpal and mid-carpal motion after operative treatment of dorsal radio-carpal fracture dislocations

Erratum to: Intra-articular injection of hyaluronic acid (MW 1,500–2,000 kDa; HyalOne®) in symptomatic osteoarthritis of the hip: a prospective cohort study

Follow-up investigation of open trigger digit release

Predictive factors of cervical spondylotic myelopathy in patients with lumbar spinal stenosis