Abstract
Aim: To review the early complications associated with staged revision hip Arthroplasty utilising the Biomet antibiotic loaded cement spacer.
Method: We report on 80 consecutive staged revision hip replacements using the Biomet antibiotic loaded cement system in our institution over 3 years (1999–2002), performed by three consultant surgeons, with a minimum 1 year follow up.
Results: Our patients had an average age of 68 (range 48–90) years, with an equal sex distribution.
The median time between the first and second stage was 147 (range 50–619) days.
Fractures of the Biomet antibiotic loaded acrylic spacer occurred in 11% revisions when associated with an increase in time between stages and there was a 7% dislocation rate.
Patients did not receive a revision prosthesis in 19% cases and had early recurrent sepsis following their two stage procedure in 6%. Three patients had a single episode of dislocation of their revision hip prosthesis within a month postoperatively. Two patients had a proximal DVT and one patient had a pulmonary embolus. The mortality within eight weeks was 7%, rising to 10% within a year. This may be related to patient sepsis and comorbidities or the energy expenditure required to mobilise following a first stage procedure that we have analysed.
Conclusions: The risks of staged revision hip surgery for infection are substantial when considering the time involved, the energy expenditure required to mobilise following a first stage, the possibility of not achieving a revision hip prosthesis and the mortality rate.
The Biomet antibiotic loaded cement system articulates and maintains soft tissue length in the majority of patients for the duration required between stages.
The abstracts were prepared by Mr Peter Kay, Editorial Secretary. Correspondence should be addressed to British Hip Society, The Hip Centre, Wrightington Hospital, Appley Bridge, Wigan, Lancashire WN6 9EP.
