Chronic infection following total hip arthroplasty: Any role for ilizarov?

Клюшин, Н. М.; Ермаков, А. М.; Subramanyam, Koushik Narayan; Jaipuria, Jiten

doi:10.4103/jllr.jllr_8_17

J Limb Lengthen Reconstr

2017

DOI: 10.4103/jllr.jllr_8_17

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Chronic infection following total hip arthroplasty: Any role for ilizarov?

Н. М. Клюшин

А. М. Ермаков

Koushik Narayan Subramanyam

et al.

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Cited by 3 publications

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“…5 However, the biggest challenge in this setting is lack of availability of readymade stable spacers, unlike arthroplasty situations. 6 The ideal spacer should span the whole length of the defect, be stable enough to permit full weight-bearing, and be easily removable during revision surgery.…”

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confidence: 99%

“…The most definitive modality of treating this perimegaprosthetic infection is 2-stage revision with antibiotic-laden spacer implantation in the interim period 5. However, the biggest challenge in this setting is lack of availability of ready-made stable spacers, unlike arthroplasty situations 6. The ideal spacer should span the whole length of the defect, be stable enough to permit full weight-bearing, and be easily removable during revision surgery.…”

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confidence: 99%

See 1 more Smart Citation

A Novel Spacer Device for Treatment of Perimegaprosthetic Infections in Bone Tumor Surgeries Around the Knee

Клюшин

Stepanjan

Subramanyam

et al. 2020

Techniques in Orthopaedics

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Background: Megaprosthesis constitutes the mainstay of limb salvage after bone tumor surgery, and the rate of perimegaprosthetic infection is relatively high. Although the ideal management of perimegaprosthetic infection is 2-stage revision, the ideal antibiotic spacer device is lacking.Methods: We designed a novel spacer device unique to this situation. It is a modular device made of titanium with variable size of the components. This customizes the spacer specific to the situation on the basis of the length of medullary canal and the size of the defect. Antibioticimpregnated bone cement introduced into the medullary canal on both sides and at the site of the defect provides excellent stability and ability to weight-bear. Modularity ensures that components can be easily assembled and removed at the time of revision surgery. As a proof of concept, we used this spacer in 2 patients with perimegaprosthetic infection as a bridge between debridement and definitive reconstruction.Results: Both patients were young male individuals with multiple episodes of perimegaprosthetic infection in the past. Debridement resulted in defect of 24 and 28 cm, respectively. Both of them had spacer application along with antibiotic bone cement. Infection could be well controlled, and patients could be made to fully weight-bear with the spacer. Successful revision prostheses could be implanted 12 and 18 months from index surgery with no relapse of infection at 2-year follow-up. Conclusion:We recommend this novel spacer device to ensure stability and functionality in 2-stage revision surgeries of infected megaprostheses.

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mentioning

confidence: 99%

mentioning

confidence: 99%

A Novel Spacer Device for Treatment of Perimegaprosthetic Infections in Bone Tumor Surgeries Around the Knee

Клюшин

Stepanjan

Subramanyam

et al. 2020

Techniques in Orthopaedics

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“Fibula plus Ilizarov”: a Simpler Strategy Than Bone Transport for Major Bone Defects in Children

Subramanyam

Mundargi

Umerjikar

2021

Techniques in Orthopaedics

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Bone infection in children can cause extensive diaphyseal defects that are challenging to reconstruct. We report a modified technique of ours in 2 of our patients. One was a 10-year-old boy with 8 cm tibial defect and the other was 13-year-old boy with 7 cm femoral defect. The first stage of treatment involved radical debridement, sequestrectomy, antibiotic spacer application, stabilization with conventional external fixation, and 6 weeks of antibiotic therapy. The second stage of treatment consisted of intramedullary autologous fibular strut grafting stabilized with intramedullary K-wire supplemented with corticocancellous graft and stabilized with simple Ilizarov fixator. Patients began full weight bearing walking with fixator at three months of application. Fibular graft incorporated at 4 and 8 months for the femoral and tibial defects respectively. At follow-up of 3 years both patients are independent ambulators with preserved joint range of motion. We present this simple, cost-effective, and replicable technique.

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Semper ascendens

Chaudhary¹

2017

J Limb Lengthen Reconstr

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Chronic infection following total hip arthroplasty: Any role for ilizarov?

Cited by 3 publications

References 2 publications

A Novel Spacer Device for Treatment of Perimegaprosthetic Infections in Bone Tumor Surgeries Around the Knee

A Novel Spacer Device for Treatment of Perimegaprosthetic Infections in Bone Tumor Surgeries Around the Knee

“Fibula plus Ilizarov”: a Simpler Strategy Than Bone Transport for Major Bone Defects in Children

Semper ascendens

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