Acetabular spacers in 2-stage hip revision: is it worth it? A single-centre retrospective study
Hip Int 2017; 27(2): 187 - 192
Article Type: ORIGINAL RESEARCH ARTICLE
AuthorsGiorgio Burastero, Marco Basso, Giuliana Carrega, Luca Cavagnaro, Francesco Chiarlone, Carlo Salomone, Gabriele Papa, Lamberto Felli
The aim of this work is to evaluate an acetabular antibiotic loaded bone cement spacer in 2-stage revision surgery as a potential approach able to reduce complications during the inter-stage period (i.e. dislocation, acetabular wear), as well as simplify 2-stage hip revision surgery and improve hip biomechanics.
We performed a retrospective comparative study and evaluated clinical, radiological and surgical data of 71 patients affected by periprosthetic hip infection who were treated with 2-stage exchange. 31 patients were treated using an acetabular spacer in addition to the femoral (group A) while 40 underwent a standard revision surgery (femoral spacer only, group B).
Mean time of surgery for the first stage was 148 ± 59 minutes and 142 ± 45 minutes for group A and B respectively; we noted a statistically significant reduction (26 min, p = 0.015) in the same parameter for the second stage (83 ± 35 minutes for group A and 109 ± 36 minutes for group B). We observed the following interstage complications: 5 femoral spacer dislocations (1 for group A and 4 for group B); 1 spacer fracture (group B), 1 spacer fracture (group A), 2 periprosthetic fractures (group B) and 2 patients with acetabular spacer instability (group B). Additionally, we observed a significant improvement in leg length restoration for group A (p = 0.03).
Our data show that the acetabular spacer technique is able to reduce the interstage complication rate and allow improved hip biomechanics restoration.
- • Accepted on 16/07/2016
- • Available online on 25/11/2016
- • Published in print on 31/03/2017
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- Burastero, Giorgio [PubMed] [Google Scholar] 1
- Basso, Marco [PubMed] [Google Scholar] 2
- Carrega, Giuliana [PubMed] [Google Scholar] 1
- Cavagnaro, Luca [PubMed] [Google Scholar] 2, * Corresponding Author (firstname.lastname@example.org)
- Chiarlone, Francesco [PubMed] [Google Scholar] 2
- Salomone, Carlo [PubMed] [Google Scholar] 1
- Papa, Gabriele [PubMed] [Google Scholar] 2
- Felli, Lamberto [PubMed] [Google Scholar] 2
Infectious Diseases and Septic Orthopaedics, Hospital St. Mary of Mercy, Albenga - Italy
Orthopaedic Clinic - IRCCS University Hospital San Martino IST, Genova - Italy