Two-Stage Reconstruction of Infected Hip Joints

Diwanji, Sanket R.; Kong, Il Kyu; Park, Young Hoon; Cho, Sang Gwon; Song, Eun Kyoo; Yoon, Taek Rim

doi:10.1016/j.arth.2007.06.007

Cited by 55 publications

(58 citation statements)

References 18 publications

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“…This was comparable to ranges in the literature from 83% to 95% [5,6,14,15,[18][19][20]22]. In one of the few long-term followup studies, Sanchez-Sotelo et al [19] performed a retrospective review of 169 patients undergoing two-stage revision THA for infection and investigated the rates of both mechanical failure and reinfection.…”

Section: Discussionsupporting

confidence: 79%

“…There were some limitations to our study. First, the sample size was limited to 33 patients; however, given the relative infrequency of infections, our sample size was consistent with other reported figures in the literature [5,6,18]. Second, our followup was limited to a minimum of 24 months as a result of the participating centers having adopted this particular prosthesis only in recent years.…”

Section: Discussionmentioning

confidence: 77%

“…The gold standard for a chronic, delayed presentation infection has remained a two-stage revision procedure with an antibiotic spacer. While many studies have reported infection control with a two-stage procedure [5,[18][19][20][21][22], they provided no clear attribution to the effect of the various spacers used in these studies. Antibiotic concentration has also been controversial.…”

Section: Discussionmentioning

confidence: 94%

“…Surgical options have included component retention with local irrigation and debridement with or without polyethylene liner exchange, one-or two-stage revisions, or resection arthroplasty [19,21]. For chronic, delayed infections, most surgeons in North American have considered a two-stage revision the gold standard [3,20], often utilizing a spacer of either partial load-bearing design [8] or an interpositional, nonload-bearing design [5,7,8,20] between stages with concurrent parenteral antibiotic therapy. Partial loadbearing spacers have offered the benefits of preserving bone stock, maintaining the soft tissue envelope, and potentially improving functionality between stages [7,8].…”

Section: Introductionmentioning

confidence: 99%

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Does a Prefabricated Gentamicin-impregnated, Load-bearing Spacer Control Periprosthetic Hip Infection?

Degen

Davey

Howard

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Introduction Treating deep infection following THA has been a challenge. While the standard treatment has remained a two-stage revision, spacer designs, incorporated antibiotics, and concentrations have varied. Since control of infection may relate to choice and concentration of antibiotics, it is important to report rates of control from various spacers. Questions/purposes We therefore determined (1) the rate of infection control and (2) complications associated with a prefabricated, load-bearing, gentamicinimpregnated hip spacer in treating periprosthetic infections of the hip. Methods We retrospectively reviewed 33 patients with periprosthetic THA infections treated with a prefabricated, partial load-bearing, gentamicin-impregnated hemiarthroplasty spacer. Thirty of the 33 patients underwent second stage reimplantation after a mean 15 weeks. We collected patient demographic data, laboratory values, infecting organism, size of spacer mold, antibiotic selection, complications, and infection control rates from two academic centers. Recurrent infection at last followup was determined by the presence of physical symptoms or signs or elevated serologic tests. The minimum followup was 24 months (mean, 43 months; range, 24-70 months).

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Does a Prefabricated Gentamicin-impregnated, Load-bearing Spacer Control Periprosthetic Hip Infection?

Degen

Davey

Howard

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…Scharfenberger et al [20] reported an average HHS of 62.3. Diwanji et al [21] reported an increase to 57.62 points. In our series, we observed an increase of HHS to 51.4 and all patients could walk with partial weight bearing.…”

Section: Discussionmentioning

confidence: 93%

The use of a preformed spacer in two-stage revision of infected hip arthroplasties

et al. 2011

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Two-stage revision with the use of an antibiotic-loaded cement spacer has spread widely as a successful treatment for THA infection. Between 1999 and 2008, 28 patients with infected THA were treated with two-stage implant revision using a preformed spacer. The spacer was left in situ for 5.5 months (range 1-13 months), and the patients were allowed to walk with partial weight bearing. At a mean follow-up of 53 months (range 18-106 months), recurrence of infection was observed in only one patient. Complications were observed in five patients: three spacer dislocations, one distal femoral fracture occurred during stem removal, and one femoral artery pseudo-aneurysm. The mean HHS increased from 43 points (range 13-77) to 82 points (range 35-96). Though small prospective studies are reported in literature, good eradication rate and good functional outcomes encourage for the use of an antibiotic-loaded cement spacer. The industrial production ensures procedure standardization, well-defined physical and chemical properties to the device and eliminates time necessary to intraoperatory manufacturing.

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Periprosthetic Joint Infection after Total Hip and Knee Arthroplasty

Zimmerli¹,

Clauss²

2015

Bone and Joint Infections

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Two-Stage Reconstruction of Infected Hip Joints

Cited by 55 publications

References 18 publications

Does a Prefabricated Gentamicin-impregnated, Load-bearing Spacer Control Periprosthetic Hip Infection?

Does a Prefabricated Gentamicin-impregnated, Load-bearing Spacer Control Periprosthetic Hip Infection?

The use of a preformed spacer in two-stage revision of infected hip arthroplasties

Periprosthetic Joint Infection after Total Hip and Knee Arthroplasty

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