Two-Stage Revision Total Hip Arthroplasty for Periprosthetic Infections Using Antibiotic-Impregnated Cement Spacers of Various Types and Materials

Abstract EN

Antibiotic-impregnated hip cement spacers of various types and materials have been used in the treatment of periprosthetic hip infections.

We developed a handmade spacer by using polymethylmethacrylate (PMMA) and/or α-tricalcium phosphate (α-TCP).

In this study, we retrospectively reviewed the surgical outcomes in 36 consecutive patients treated with 2-stage revision total hip arthroplasty by using our antibiotic-impregnated hip cement spacers.

We aimed to analyze the infection control and reinfection rates after revision surgery.

Moreover, we analyzed the possible predictors of postoperative reinfection.

After exclusion of 1 patient who died immediately after the first-stage surgery, infection was controlled in 33 of the 36 hips (success rate, 91.7%).

Two of these 33 hips underwent resection arthroplasty.

Of the 36 hips that had been treated with the antibiotic-cement spacer, 31 hips (86.1%) were eligible for the second-stage prosthesis re-implantation.

The 31 protocol hip joints of patients followed up for >6 months (mean, 48.6 months).

Ten of these 31 hips (32.3%) became reinfected.

No possible predictor examined differed significantly between the reinfection-positive and reinfection-negative groups.

However, spacers consisting of PMMA cement alone were associated with the highest risk of reinfection.

Therefore, α-TCP-containing antibiotic-impregnated hip cement spacers might decrease the reinfection rate in patients undergoing re-implantation.