Abstract
We describe our novel approach to managing infected periprosthetic fractures using a revision implant for temporary fracture stabilisation.
A series of 12 consecutive patients aged between 74 and 83 years (average age 81.51, SD 6.32) who were referred to the senior author with periprosthetic fracture and microbiologically proven infection, were managed by radical debridement and antibiotic therapy along with temporary implantion of a long stem cannulated, proximally hydroxyappatite coated and distally locked femoral prosthesis (Cannulock, Orthodesign, Christ-church, UK). Strut grafts, demineralised bone matrix and cable plating system where used in addition where indicated. Post operatively patients were allowed to mobilise as allows and antibiotics were continued until biochemical markers returned to normal.
A good clinical outcome and excellent functional outcome was noted in all 12 cases. No cases of immediate post operative complications such as DVT or PE were noted in any cases. In particular there were no instances of infections associated with prolonged immobilisation and hospital stay. Ten patients underwent a definitive revision hip replacement procedure within an average of 4.3 weeks (range 3.9 to 5.7, SD 2.15). Two patients required a second debridement and delayed definitive treatment due to persistently high inflammatory markers.
We believe that this novel approach significantly improves functional outcome in the management of infected periprosthetic fractures.
Correspondence should be addressed to BHS c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.
