Impregnation of vancomycin, gentamicin, and cefotaxime in a cement spacer for two-stage cementless reconstruction in infected total hip arthroplasty

Koo, Kyung Hoi; Yang, Jin Won; Cho, Se Hyun; Song, Hae Ryong; Park, Hyung Bin; Ha, Yong Chan; Chang, Jun Dong; Kim, Shin‐Yoon; Kim, Young Hoo

doi:10.1054/arth.2001.24444

Cited by 159 publications

(97 citation statements)

References 31 publications

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“…In this study, the reinfection rate was 8.3% (1/12) and even though the study population was small, this compares favourably with 7-17% reinfection rates reported for onestage exchange with cemented components [1,10,20], 5-15% for two-stage exchange with cemented components [4,6] and 5-13% for two-stage exchange with cementless components [7,13,14,18].…”

Section: Discussionsupporting

confidence: 62%

“…However, the intermediate and long-term results of revision hip arthroplasty implants inserted with cement have not been encouraging; in particular, failure and loosening rates are unacceptably high [2,19]. On the other hand, the clinical results of twostage revision arthroplasty performed with a cementless prosthesis in patients with an infected hip arthroplasty are encouraging and comparable to those of cemented reconstruction [7,13,14,18]. Therefore, we hypothesised that one-stage cementless revision hip arthroplasty may have a role in the treatment of carefully selected patients with an infected hip replacement.…”

Section: Introductionmentioning

confidence: 99%

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One-stage cementless revision arthroplasty for infected hip replacements

Yoo

Koo

Yoon

et al. 2008

International Orthopaedics (SICOT)

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We hypothesised that one-stage cementless revision hip arthroplasty may have advantages and a role in the treatment of selected patients with an infected hip replacement. We retrospectively reviewed all patients with an infected hip replacement treated with one-stage revision using cementless implants. Twelve patients were reviewed and followed up for at least three years (average: 7.2 years, range: 3.3-11.3 years) postoperatively. One recurrence of infection and one aseptic stem loosening were detected during followup. Grafted bone, which was used in eight patients, appeared to have united to host bone in all patients. The success rate of treatment was 83.3% when infection recurrence or component loosening were regarded as failure. One-stage revision hip arthroplasty using cementless implants appears to have a role in the treatment of carefully selected patients with an infected hip replacement if meticulous débridement is performed and appropriate antibiotics are properly used.Résumé Notre hypothèse de travail était la suivante: le changement en un temps par une prothèse sans ciment d'une prothèse totale de hanche infectée, est la bonne indication thérapeutique. Matériel et méthode: nous avons revu de façon rétrospective tous les patients présentant une hanche infectée traitée par une révision en un temps en utilisant un implant sans ciment. 12 patients ont été revus et suivis pendant au moins 3 ans (7,2 ans en moyenne, 3,3 et 11,3 ans postopératoire). Résultats: nous avons observé une récidive d'infection et un descellement aseptique durant cette période de suivi. L'os greffé chez 8 patients nous apparaît comme ayant consolidé à l'os hôte chez tous les patients. Le pourcentage de succès thérapeutique est de 83,3% si l'on regarde la récurrence de l'infection ou le descellement aseptique. En conclusion: les révisions en un temps en utilisant un implant sans ciment nous apparaissent comme un traitement de choix chez les patients sélectionnés avec soin et présentant une infection de prothèse totale de hanche.

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Section: Discussionsupporting

confidence: 62%

Section: Introductionmentioning

confidence: 99%

One-stage cementless revision arthroplasty for infected hip replacements

Yoo

Koo

Yoon

et al. 2008

International Orthopaedics (SICOT)

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“…These are available as off-the-shelf implants, for example the Spacer-G (TECRES S.p.A, Verona, Italy) (Fig. 1), but can also be manufactured by the surgeon using moulds with a suitable metal rod for reinforcement [23]. More recently, systems have been developed which use small conventional implants with a metal-on-polyethylene bearing.…”

Section: Use Of Spacersmentioning

confidence: 99%

“…Early studies of cementless revision prostheses reported an infection recurrence rate of up to 18% and stem subsistence of up to 30% [23,29]. Improvements in technology, especially modularity, has produced outcomes at least equal to cemented implants.…”

Section: Second Stage Reconstruction Optionsmentioning

confidence: 99%

Infection in total hip replacement: meta-analysis

Senthi

Munro

Pitto

2010

International Orthopaedics (SICOT)

141

106

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“…Molds of different sizes are used to form the femoral and tibial components with the antibiotic mixture serving as the base. Antibiotics are added without exceeding 10% of the total weight of the bone cement to keep from compromising the structural integrity of the spacer (36)(37).…”

Section: Articulating Spacers With a Cement-on-cement Interfacementioning

confidence: 99%