Management of Severe Proximal Femur Bone Loss With a Modular Articulating Antibiotic Spacer
| Autor: | Simon C. Mears, Paul K. Edwards, Wesley H. Mayes |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Total hip replacement Revision hip replacement Periprosthetic reimplantation lcsh:Geriatrics revision hip replacement 03 medical and health sciences 0302 clinical medicine lcsh:Orthopedic surgery articulating spacer medicine Orthopedics and Sports Medicine 030212 general & internal medicine 030222 orthopedics Resident Corner periprosthetic joint infection proximal femur bone loss Proximal femur business.industry Rehabilitation Surgery lcsh:RD701-811 lcsh:RC952-954.6 Femoral bone Geriatrics and Gerontology business |
| Zdroj: | Geriatric Orthopaedic Surgery & Rehabilitation Geriatric Orthopaedic Surgery & Rehabilitation, Vol 10 (2019) |
| ISSN: | 2151-4593 2151-4585 |
| Popis: | Introduction: Management of periprosthetic infection in total hip arthroplasties is challenging, especially when there is severe loss of proximal femoral bone stock. When a 2-stage approach is used, either a static or an articulating spacer may be considered. Static spacers leave the patient with a flail leg, which can be very difficult with massive bone loss. The purpose of this study is to report a novel technique for articulating antibiotic spacers and report our results. Materials and Methods: We describe a technique for an articulating hip spacer in the setting of a large amount of proximal femoral bone loss using a locked intramedullary nail, modular femoral body, and an all-polyethylene constrained acetabular component. This technique allowed for mobilization of the patient without a flail leg. Four patients underwent 2-stage reconstruction, and the case series is reported here. Results: No complications occurred due to the spacer, and in all cases, a second reconstruction was later carried out after treatment with intravenous antibiotics. Three of 4 patients did well after 2-stage reconstruction, with 1 patient ultimately requiring an amputation. Discussion: We feel this technique improves upon previously reported large spacers due to the stability and maintenance of leg length. Conclusion: This technique offers a modular solution to address massive bone loss of the proximal femur in the face of periprosthetic joint infection. |
| Databáze: | OpenAIRE |
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