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.
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
- • Accepted on 16/07/2016
- • Available online on 25/11/2016
- • Published in print on 31/03/2017
This article is available as full text PDF.
- 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 (email@example.com)
- 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