The results of screw augmentation of acetabular cement spacers for the treatment of periprosthetic hip joint infection

Autor: Qing-Song Li, Jing-Yao Jin, Dong-Min Jung, Sheng-Yu Jin, Kyung-Soon Park, Taek-Rim Yoon
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
lcsh:Diseases of the musculoskeletal system
medicine.medical_treatment
Arthroplasty
Replacement
Hip
Cement spacer
Bone Screws
Periprosthetic
Dentistry
Augmentation
Prosthesis
0302 clinical medicine
lcsh:Orthopedic surgery
Foreign-Body Migration
Orthopedics and Sports Medicine
030212 general & internal medicine
Dislodgement
Aged
80 and over
030222 orthopedics
Cement spacers
Bone Cements
Middle Aged
Two stage
Anti-Bacterial Agents
surgical procedures
operative
Treatment Outcome
Acrylates
Female
Infection
Stability
Research Article
musculoskeletal diseases
Adult
Reoperation
medicine.medical_specialty
Prosthesis-Related Infections
03 medical and health sciences
medicine
Humans
Aged
Retrospective Studies
Cement
business.industry
Screw
Acetabulum
equipment and supplies
lcsh:RD701-811
Harris Hip Score
Orthopedic surgery
Surgery
lcsh:RC925-935
business
Zdroj: Journal of Orthopaedic Surgery and Research
Journal of Orthopaedic Surgery and Research, Vol 15, Iss 1, Pp 1-10 (2020)
ISSN: 1749-799X
Popis: IntroductionProsthesis of antibiotic-loaded acrylic cement (PROSTALAC) is widely used in two-stage revision arthroplasty in periprosthetic joint infection (PJI) after total hip arthroplasty (THA). In our institution, we encountered several cases of acetabular cement spacer dislodgement. The aim of this study was to compare the results of two-stage revision arthroplasties with antibiotic-loaded cement spacers with or without screws on the acetabulum for PJI.Patients and methodsThis retrospective study included 44 patients who underwent a two-stage revision THA for PJI from June 2007 to May 2017. We divided the patients into two groups: group 1 consisted of 21 patients (21 hips) who underwent two-stage revision arthroplasty with screw augmentation, while group 2 consisted of 23 patients (23 hips) who underwent the same surgery without screw augmentation at the acetabular cement spacer. We compared the migration and dislodgement of the acetabular cement spacer between the two groups.ResultsBefore the second-stage surgery, there was less vertical migration of the cement spacer in group 1 compared to group 2 (1.2 mm vs 3.1 mm,p< 0.001). There was also less medial migration of the cement spacer in group 1 (0.6 mm vs 1.6 mm,p= 0.001). After the first stage, the mean Harris Hip score was significantly higher in group 1 than in group 2 (75 vs 65,p= 0.033). Cement spacer rotation or total movement out of the acetabular area occurred in six patients, all in group 2. After first stage reinfection occurred in two patients, one in each group.ConclusionsScrew augmentation to the acetabulum in the first-stage surgery provides better stability of acetabular antibiotic cement spacers without increasing reinfection rate.
Databáze: OpenAIRE
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