Preservation of the original femoral cement mantle during the management of infected cemented total hip replacement by two-stage revision
| Autor: | M. J. W. Hubble, J. R. Howell, Graham A. Gie, A. J. Timperley, J. R. Morley, S. M. Blake |
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| Rok vydání: | 2012 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Prosthesis-Related Infections Revision procedure medicine.medical_treatment Arthroplasty Replacement Hip Perforation (oil well) Total hip replacement Two stage revision Recurrence Cement mantle medicine Operating time Humans Orthopedics and Sports Medicine Stage (cooking) Cementation Aged Aged 80 and over business.industry Bone Cements Bacterial Infections Middle Aged Arthroplasty Combined Modality Therapy Surgery Anti-Bacterial Agents Prosthesis Failure Treatment Outcome Female business Follow-Up Studies |
| Zdroj: | The Journal of bone and joint surgery. British volume. 94(3) |
| ISSN: | 2044-5377 |
| Popis: | The removal of all prosthetic material and a two-stage revision procedure is the established standard management of an infected total hip replacement (THR). However, the removal of well-fixed femoral cement is time-consuming and can result in significant loss of bone stock and femoral shaft perforation or fracture. We report our results of two-stage revision THR for treating infection, with retention of the original well-fixed femoral cement mantle in 15 patients, who were treated between 1989 and 2002. Following partial excision arthroplasty, patients received local and systemic antibiotics and underwent reconstruction and re-implantation at a second-stage procedure, when the infection had resolved. The mean follow-up of these 15 patients was 82 months (60 to 192). Two patients had positive microbiology at the second stage and were treated with six weeks of appropriate antibiotics; one of these developed recurrent infection requiring further revision. Successful eradication of infection was achieved in the remaining 14 patients. We conclude that when two-stage revision is used for the treatment of peri-prosthetic infection involving a THR, a well-fixed femoral cement mantle can be safely left in situ, without compromising the treatment of infection. Advantages of this technique include a shorter operating time, reduced loss of bone stock and a technically more straightforward second-stage procedure. |
| Databáze: | OpenAIRE |
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