The Influence of Spacer Design on the Rate of Complications in Two-Stage Revision Hip Arthroplasty

Jones, Christopher W.; Selemon, Nicolas A.; Nocon, Allina; Bostrom, Mathias P.; Westrich, Geoffrey H.; Sculco, Peter K.

doi:10.1016/j.arth.2019.02.012

“…For hips, two types of joint spacers were used 13,14 . For type I, 1-2 Kirschner wires with a diameter of 5 mm that were bent to approximately 130° in advance were used as stents, which were placed in a silicone mold imitating the shape of the joint, embedded with antibiotic-impregnated cement and molded under pressure (Fig.…”

Section: The Process Of Revision Surgery and Preparation Of Joint Spamentioning

confidence: 99%

“…1 CD). For knees, two types of spacers were also used [13][14][15] : for type I, an aseptic silicone mold imitating the joint shape was used, and a joint-like spacer was made intraoperatively ( Fig. 1 EF); for type II, the removed femoral end prosthesis was washed, soaked in povidone iodine solution and resterilized, and the resterilized tibial prosthesis was used or replaced with a new polyethylene tibial component ( Fig.…”

Section: The Process Of Revision Surgery and Preparation Of Joint Spamentioning

confidence: 99%

Compared with Two-Stage Revision, Destination Joint Spacers Have a Similar Infection-Relief Rate and a Higher Complication Rate

Cai¹,

Fang²,

Lin³

et al. 2020

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0

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Background: Two-stage revision is regarded as the “gold standard” for periprosthetic joint infection (PJI) treatment, in which antibiotic-impregnated spacers play an important role. However, some patients are unable to undergo reimplantation of the prosthesis after spacer implantation. The clinical outcomes of these patients remain unknown. The purpose of this research was to study the infection-relief rate and clinical outcome of these patients.Methods: From January 2006 to December 2017, data from PJI patients who underwent implantation with antibiotic-impregnated cement spacers in our center due to chronic PJI were collected retrospectively. Age, sex, body mass index (BMI) and laboratory test results were recorded, and the infection-relief rate and clinical outcomes were observed.Results: A total of 62 patients who were diagnosed with PJI were enrolled, with an age of 65.13 ±9.94 (39-88) years. There were 21 cases in the destination joint spacer group and 41 cases in the temporary spacer group (reimplantation of prosthesis after infection relief). The Charlson comorbidity index (CCI) in the destination joint spacer group was higher than that in the temporary spacer group. Our study showed that the infection-relief rate of destination joint spacers was similar to that of two-stage revision, but the incidence of complications was higher than that of two-stage revision, especially for the type I spacer used in this study.Conclusions: The infection-relief rate of destination joint spacers was similar to that of two-stage revision, but the complication rate was higher than that of two-stage revision (especially for the type I spacer).

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“…For hips, two types of joint spacers were used 13,14 . For type I, 1-2 Kirschner wires with a diameter of 5 mm that were bent to approximately 130° in advance were used as stents, which were placed in a silicone mold imitating the shape of the joint, embedded with antibiotic-impregnated cement and molded under pressure ( Fig 1AB).…”

Section: The Process Of Revision Surgery and Preparation Of Joint Spamentioning

confidence: 99%

“…For type II, 105 mm femoral stem, 28 mm femoral head and 32 mm femoral neck (CM-CZ; AK Medical, Beijing, China) were used as scaffolds, which were embedded with antibiotic-impregnated cement and molded under pressure (Fig 1 CD). For knees, two types of spacers were also used [13][14][15] : for type I, an aseptic silicone mold imitating the joint shape was used, and a joint-like spacer was made intraoperatively (Fig 1 EF); for type II, the removed femoral end prosthesis was washed, soaked in povidone iodine solution and resterilized, and the resterilized tibial prosthesis was used or replaced with a new polyethylene tibial component (Fig 1 GH). The antibiotics used in the antibiotic-impregnated joint spacer were selected according to the microbial culture and drug sensitivity test results.…”

Section: The Process Of Revision Surgery and Preparation Of Joint Spamentioning

confidence: 99%

Compared with two-stage revision, retained spacers have a similar infection-relief rate and a higher complication rate

Cai

¹

,

Fang

²

,

Lin

³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

Background: Periprosthetic joint infection (PJI) is a devastating complication for joint arthroplasty, there are many challenges in therapy. The treatment of PJI including surgery and systemic administration of antibiotics. As for surgery, two-stage revision is regarded as the “gold standard” for PJI treatment presently, in which antibiotic-impregnated spacers play an important role. However, some patients are unable to undergo reimplantation of the prosthesis after spacer implantation, this spacer, namely, “destination joint spacer”. The clinical outcomes of these patients remain unknown. The purpose of this research was to study the infection-relief rate and clinical outcome of these patients.Methods: From January 2006 to December 2017, data from PJI patients who underwent implantation with antibiotic-impregnated cement spacers in our center due to chronic PJI were collected retrospectively. Age, sex, body mass index (BMI) and laboratory test results were recorded, and the infection-relief rate and clinical outcomes were observed.Results: A total of 62 patients who were diagnosed with PJI were enrolled, with an age of 65.13 ±9.94 (39-88) years. There were 21 cases in the destination joint spacer group and 41 cases in the temporary spacer group (reimplantation of prosthesis after infection relief). The Charlson comorbidity index (CCI) in the destination joint spacer group was higher than that in the temporary spacer group. Our study showed that the infection-relief rate of destination joint spacers was similar to that of two-stage revision, but the incidence of complications was higher than that of two-stage revision, especially for the type I spacer used in this study.Conclusions: The infection-relief rate of destination joint spacers was similar to that of two-stage revision, but the complication rate was higher than that of two-stage revision (especially for the type I spacer).

show abstract

“…For hips, two types of joint spacers were used 13,14 . For type I, 1-2 Kirschner wires with a diameter of 5 mm that were bent to approximately 130° in advance were used as stents, which were placed in a silicone mold imitating the shape of the joint, embedded with antibiotic-impregnated cement and molded under pressure (Fig1AB).…”

Section: The Process Of Revision Surgery and Preparation Of Joint Spamentioning

confidence: 99%

Compared with two-stage revision, retained spacers have a similar infection-relief rate and a higher complication rate

Cai

¹

,

Fang

²

,

Lin

³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

Background: Periprosthetic joint infection (PJI) is a devastating complication for joint arthroplasty, there are many challenges in therapy. The treatment of PJI including surgery and systemic administration of antibiotics. As for surgery, two-stage revision is regarded as the “gold standard” for PJI treatment presently, in which antibiotic-impregnated spacers play an important role. However, some patients are unable to undergo reimplantation of the prosthesis after spacer implantation, this spacer, namely, “destination joint spacer”. The clinical outcomes of these patients remain unknown. The purpose of this research was to study the infection-relief rate and clinical outcome of these patients.Methods: From January 2006 to December 2017, data from PJI patients who underwent implantation with antibiotic-impregnated cement spacers in our center due to chronic PJI were collected retrospectively. Age, sex, body mass index (BMI) and laboratory test results were recorded, and the infection-relief rate and clinical outcomes were observed.Results: A total of 62 patients who were diagnosed with PJI were enrolled, with an age of 65.13 ±9.94 (39-88) years. There were 21 cases in the destination joint spacer group and 41 cases in the temporary spacer group (reimplantation of prosthesis after infection relief). The Charlson comorbidity index (CCI) in the destination joint spacer group was higher than that in the temporary spacer group. Our study showed that the infection-relief rate of destination joint spacers was similar to that of two-stage revision, but the incidence of complications was higher than that of two-stage revision, especially for the type I spacer used in this study.Conclusions: The infection-relief rate of destination joint spacers was similar to that of two-stage revision, but the complication rate was higher than that of two-stage revision (especially for the type I spacer).

show abstract

The Influence of Spacer Design on the Rate of Complications in Two-Stage Revision Hip Arthroplasty

Cited by 49 publications

References 18 publications

Compared with Two-Stage Revision, Destination Joint Spacers Have a Similar Infection-Relief Rate and a Higher Complication Rate

Compared with Two-Stage Revision, Destination Joint Spacers Have a Similar Infection-Relief Rate and a Higher Complication Rate

Compared with two-stage revision, retained spacers have a similar infection-relief rate and a higher complication rate

Compared with two-stage revision, retained spacers have a similar infection-relief rate and a higher complication rate

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