Comparison of complications associated with commercially available and custom-made articulating spacers in two-stage total hip arthroplasty revision

Sabry, Fady Youssef; Szubski, Caleb R.; Stefancin, John J.; Klika, Alison K.; Barsoum, Wael K.

doi:10.1097/bco.0b013e318297c3fb

Cited by 10 publications

(6 citation statements)

References 11 publications

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“…2 of these selected studies solely focused on QoL during the 2-stage treatment interval (19, 20), 1 did not use a validated (HR)QoL outcome measure (21), 1 described QoL after DAIR treatment (22), and 2 did not differentiate between different joints and type of treatment (22, 23). 12 studies describing (HR)QoL after 2-stage revision for hip PJI were included (24–25–26–27–28–29–30–31–32–33–34–35). None of these studies evaluated (HR)QoL after 1-stage revision.…”

Section: Resultsmentioning

confidence: 99%

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Quality of Life after Staged Revision for Infected Total Hip Arthroplasty: A Systematic Review

et al. 2016

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Section: Resultsmentioning

confidence: 99%

“…There was also great variability in the reporting of absolute scores versus relative scores between 0 and 100. 5 studies provided a standard deviation (SD) when describing (HR)QoL (24, 27–28–29, 33). 6 articles described which statistical test was used and described when results were considered significant (27, 29–30–31–32–33).…”

Section: Resultsmentioning

confidence: 99%

Quality of Life after Staged Revision for Infected Total Hip Arthroplasty: A Systematic Review

et al. 2016

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“…Furthermore, almost all comparative studies demonstrate no difference in eradication rates between differing varieties of dynamic spacers, such as handmade, preformed, dynamic or CUMARS ( 36 , 40 , 58 , 60 , 62 , 85 , 86 ). This is despite some reported concerns of inert prosthetic material (polyethylene) used in CUMARS acting as a substrate for infective recurrence ( 54 , 87 ). The report by Sabry et al suggests possible increased rates of treatment failure (infection recurrence) with their CUMARS variant.…”

Section: Comparison Of Outcomesmentioning

confidence: 98%

Articular spacers in two-stage revision arthroplasty for prosthetic joint infection of the hip and the knee

et al. 2022

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Use of articular antibiotic-eluting cement spacers during two-stage revision arthroplasty for prosthetic joint infection (PJI) is a long-established and proven adjunctive technique during first-stage surgery. Articular spacers come in many forms, either static or dynamic. The authors present an instructional review of current evidence regarding their use. A total of 45 studies (for spacer use in PJI involving either hip or knee) were analysed for data regarding eradication rate, functional outcomes, mechanical complications and the impact on second-stage surgery. A large number of case series and retrospective cohort studies were retrieved, with only a small number of prospective studies (2). High levels of infection eradication were commonly reported (>80%). Outcome scores were commonly reported as indicating good-to-excellent function and pain levels. Second-stage procedures were often not required when dynamic spacers were used. Static spacers were associated with more mechanical complications in both the hip and the knee. In the hip, dynamic spacers were more commonly associated with instability compared to static spacers. Consideration should be given to the use of dual-mobility or constrained definitive acetabular components in these cases at second-stage surgery. The use of antibiotic-eluting polymethylmethacrylate articular spacers in two-stage revision for PJI of hip and knee arthroplasty achieves a high rate of infection eradication. Dynamic spacers may confer a variety of benefits compared to static spacers, with a similar rate of infection eradication.

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“…About the hip joint, studies have documented complications associated with use of articulating spacers, providing a note of caution for when surgeons may consider nonarticulating alternatives. Instability is the most common mode of failure with dislocation rates ranging from 6.4% to 17.5% [5,6,8,17]. Notably, the incidence of dislocation is increased among constructs without an acetabular component or those lacking acetabular cementation [6].…”

Section: Review Of Contemporary Literaturementioning

confidence: 99%

Point/Counterpoint: Nonarticulating vs Articulating Spacers for Resection Arthroplasty of the Knee or Hip

Wyles

Abdel

2020

The Journal of Arthroplasty

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Comparison of complications associated with commercially available and custom-made articulating spacers in two-stage total hip arthroplasty revision

Cited by 10 publications

References 11 publications

Quality of Life after Staged Revision for Infected Total Hip Arthroplasty: A Systematic Review

Quality of Life after Staged Revision for Infected Total Hip Arthroplasty: A Systematic Review

Articular spacers in two-stage revision arthroplasty for prosthetic joint infection of the hip and the knee

Point/Counterpoint: Nonarticulating vs Articulating Spacers for Resection Arthroplasty of the Knee or Hip

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