Stay Short or Go Long? Can a Standard Cemented Femoral Prosthesis Be Used at Second-Stage Total Hip Arthroplasty Revision for Infection Following an Extended Trochanteric Osteotomy?

Is Extended Trochanteric Osteotomy Safe for Use in Two-stage Revision of Periprosthetic Hip Infection? A Systematic Review

“…16 Five studies used either wires or cables for the ETO fixation (during the first step), while the number of wires/cables utilized ranged among studies between two and four. [12][13][14][15][16] One study examined different fixation methods and number of fixators (cables, wires) and found no difference in the outcomes of ETO fixation and union. 15 Finally, Morshed et al performed an ETO on the first stage, but they did not use any type of fixation in an effort to improve eradication of infection 9 (►Table 3).…”

“…9,12,[14][15][16] In contrast, one study used antibiotic beads without any spacer in 99% of cases (101 patients) and cement spacer in 1% (1 patient). 13 The mean interval between the first and the second stage was reported in five studies 9,[12][13][14][15] and it ranged between 9.7 9 and 50 weeks 12 (►Table 3).…”

“…16 The stem type chosen for revision was cementless in four out of six studies included in this review. 9,12,14,16 In addition to cementless stems, Petrie et al and Levine et al utilized cemented stems in 17 and 7% of their cases, respectively 13,15 (►Table 3).…”

“…Petrie et al compared cemented standard stems implanted after eradication of infection in the second stage (with suspected ETO union) versus cementless long stems with diaphyseal fixation. 13 The decision on the use of standard stems was based on the assessment of the proximal femoral bone loss at the time point of the second revision stage: cases with minor to moderate bone defects were treated with standard cemented stems, while any case with severe bone loss received long stems with diaphyseal fixation. 13 Regardless of the stem type, Petrie et al found no significant differences amongst groups in the postoperative outcomes at a mean follow-up of 66 months.…”

“…13 The decision on the use of standard stems was based on the assessment of the proximal femoral bone loss at the time point of the second revision stage: cases with minor to moderate bone defects were treated with standard cemented stems, while any case with severe bone loss received long stems with diaphyseal fixation. 13 Regardless of the stem type, Petrie et al found no significant differences amongst groups in the postoperative outcomes at a mean follow-up of 66 months. 13 Prophylactic cerclage at time of second stage was reported to be applied in one patient with osteoporotic bone.…”