Clinical results and complications of a two-stage procedure in hip infection using preformed antibiotic-loaded cement spacers

Acta Orthop Belg. 2019 Dec;85(4):516-524.

Abstract

Antibiotic-loaded cement spacers are used in two- stage hip replacement. The aim of our study was to compare our results using a Spacer-G with previous results reported in the literature. From June 2002 to April 2010, all patients treated with a two-stage revision were retrospectively reviewed. On the basis of the results of the first-stage procedure, 52 patients underwent the second stage, six developed a dislocation, in eight the spacer was maintained, and five patients developed an acute infection of the spacer or the infection was not resolved. With regard to the second-stage procedure the revision was successful in 44 patients, a re-infection developed in four patients and the definitive prosthesis presented a mechanical complication in four more. The literature results reported that 97.5% of the spacers were reimplanted, although 12.09% of them developed a dislocation. Surgeons must assess several aspects so as to avoid mechanical complications like dislocation and re- infections during the two stages of the procedure.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use*
  • Arthroplasty, Replacement, Hip*
  • Bone Cements / pharmacology*
  • Female
  • Hip Prosthesis*
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / microbiology
  • Postoperative Complications / therapy*
  • Prosthesis-Related Infections / microbiology
  • Prosthesis-Related Infections / therapy*
  • Reoperation
  • Retrospective Studies

Substances

  • Anti-Bacterial Agents
  • Bone Cements