TWO-STAGE REVISION WITH CEMENT SPACER MOLD FOR INFECTED TOTAL HIP ARTHROPLASTY

Abstract

Infection has been one of the serious complications after total hip arthroplasty. It forces physical and mental stress to the patients. We have routinely applied two-stage revision for infected replaced hip joint. Cement spacer mold technique has been used for the purpose since 2002. The purpose of this study is to analysis of peri-operative status and functional outcome of the patients underwent the two-stage revision procedure.

Nine joints of the eight patients were included in the study. Seven patients were female and one was male and its average age was 64 years (55–81 years). After removal of implant, antibiotic-loaded cement spacer prosthesis which was made by the cement spacer mold (Biomet, Warsaw, USA), was inserted. The leg length, range of motion of the hip, walking ability and complications between first and second-stage operation were analyzed. The change of leg length after first stage operation compared with prior operation was ranged from −18 mm to +13 mm with an average of 20 mm. Average range of hip flexion was 70°(40–90°). Patients could walk with crutches after first-stage operation. Complications after first stage operation were found in two cases; fracture of femoral cement spacer prosthesis and dislocation of the femoral spacer. There was no case of recurrence of infection.

Clinical assessment of two-stage revision for infected replaced hip joint with cement spacer mold showed favorable functional outcome and a few complications after first-stage operation. It also showed satisfactory short-term outcome after second-stage operation.