Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Infections
Abstract number: 26076
ANTIBIOTIC LOADED CEMENT SPACER IN TWO-STAGE REVISION OF
INFECTED TOTAL HIP PROTHESIS
Radu Adrian RADULESCU, Adrian Emilian BADILA, Octavian NUTIU, Robert
MANOLESCU, Cristian NITA, Ionut JAPIE, Traian CIOBANU
Bucharest University Hospital, Bucharest (ROMANIA)
Aim: to evaluate the outcome of the two-stage revision hip arthroplasty using a
antibiotic loaded cement spacer. Material and methods: We used antibiotic loaded
cement spacers in 18 two-stage hip revision arthroplasty for infected hip prothesis.
The spacers were either preformed or custom made. High doses of gentamicin
and/or vancomycin were incorporated in these devices. The mean age of patients
was 66 years (extremes: 39-72). Mobilization with minimal weight bearing was
allowed and antibiotherapy for 3 months was indicated. The average time elapsed
between the 2 stages of revision was 171 days (extremes: 92 -284 days). Local
clinical status, radiological aspect and serological markers of inflammation were
recorded. Reimplantation was performed when there were no more clinical,
radiological or serological signs of infection. The mean follow-up after reimplantation
was 38 months. Results: The infection healed in 16 out of 18 cases. Additional
surgical procedures were necessary in 3 cases. All the patients with reimplanted
prosthesis showed no clinical, radiological or serological signs of infection during the
follow-up. At 12 months after reimplantation the average Harris Hip Score was 81
(extremes: 49-96). Conclusions: The medium terms results of two-stage hip revision
arthroplasty using a antibiotic loaded cement spacer are very good. The spacer will
fill the space, will release antibiotic, will prevent the ascension of the femur, limb
shortening and will allow a certain hip mobility. This procedure improves the quality of
life for the patient between the 2 stages and it participates in the healing of infection.
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