Unintended Retention of Temporary Articulating Spacers in the Treatment of Periprosthetic Hip Joint Infection

Orthopedics. 2020 Jul 1;43(4):e251-e257. doi: 10.3928/01477447-20200404-08. Epub 2020 Apr 12.

Abstract

A considerable number of patients who underwent a 2-stage exchange protocol for periprosthetic hip joint infection could not complete the second-stage reimplantation. The aim of this study was to evaluate the results of unintended retention of temporary articulating spacers for the treatment of periprosthetic hip joint infection. Ninety-four patients with infection after total hip arthroplasty were treated by using a 2-stage exchange protocol with temporary articulating spacers. Of the 94 patients, 35 did not complete the 2-stage exchange protocol and retained spacers for more than 12 months. The authors retrospectively investigated the clinical and radiographic results after a mean follow-up of 36.1 months. Thirty-one patients had well-healed wounds without recurrent infection and did not receive further surgery for any reason (success group). Spacers were revised in 2 patients, and the other 2 patients underwent incision and debridement because of recurrent infection (failure group). There were no statistical differences between the 2 groups in terms of demographics or presence of resistant organisms. After 3 years of follow-up, temporary articulating spacers functioned well in 89% of the patients who retained them. These results support that retention of temporary articulating spacers could be considered an alternative treatment option for select patients. [Orthopedics. 2020;43(4):e251-e257.].

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthritis, Infectious / surgery*
  • Arthroplasty, Replacement, Hip / methods
  • Bone Cements / adverse effects
  • Female
  • Follow-Up Studies
  • Foreign Bodies / surgery*
  • Hip Joint / surgery*
  • Hip Prosthesis / adverse effects
  • Humans
  • Male
  • Middle Aged
  • Prosthesis-Related Infections / surgery*
  • Reoperation / methods*
  • Replantation / adverse effects
  • Retrospective Studies

Substances

  • Bone Cements