New Technique for Custom-Made Spacers in Septic Two-Stage Revision of Total Hip Arthroplasties

The choice of spacer in the interim phase of two-stage revision hip arthroplasty is crucial. Conventional concepts like a Girdlestone situation, handformed or preformed bone cement spacers show complications like soft-tissue contractions, abrasion of bone cement particles, dislocation, breakage and...

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Bibliographic Details
Main Authors: Moritz Mederake (Author), Ulf Krister Hofmann (Author), Bernd Fink (Author)
Format: Book
Published: MDPI AG, 2021-09-01T00:00:00Z.
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Summary:The choice of spacer in the interim phase of two-stage revision hip arthroplasty is crucial. Conventional concepts like a Girdlestone situation, handformed or preformed bone cement spacers show complications like soft-tissue contractions, abrasion of bone cement particles, dislocation, breakage and a low level of mobility in the interim phase. To address these disadvantages, the senior author developed a new technique for custom-made spacers in septic two-stage revision of total hip arthroplasties using prosthetic implants with individualized antibiotic mixture in the cement applying a mechanical inferior cementation method. The aim of this study was to evaluate the results of these spacers with respect to their non-inferiority in terms of reinfection and survival-rate of the new implant and to describe the complications associated with this procedure. Our collective consisted of 130 patients with a median follow-up of nearly five years. With a reinfect-free rate of 92% and a spacer-related complication rate of 10% (8% articular dislocation, 1% periprosthetic joint fracture, 1% breakage), this procedure seems to be safe and superior regarding complications compared to conventional concepts. Further studies are necessary to show the clinical benefit of this procedure.
Item Description:10.3390/antibiotics10091073
2079-6382