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Patient-specific articulating spacer for two-stage shoulder arthroplasty exchange
Kilian List1, Laura Elisa Streck2, Chiara Gaal2
1Department of Orthopedic Surgery, Koenig-Ludwig-Haus, University of Wuerzburg, Brettreichstraße 11, 97074, Wuerzburg, Germany. kilian.rueckl@gmail.com.
Objective:
Two-stage exchange with an antibiotic-loaded polymethylmethacrylate (PMMA) spacer is standard treatment for chronic periprosthetic joint infection of the shoulder. We present a safe and simple technique for patient-specific spacer implants.
Indication:
(Chronic) periprosthetic joint infection of the shoulder.
Relative Contraindications:
Known allergy against components of PMMA bone cements. Inadequate compliance for two-stage exchange. Patient is unfit to undergo two-stage exchange.
Surgical Technique:
Hardware removal, histologic and microbiologic samples, and debridement. Preparation of targeted or calculated antibiotic-loaded PMMA. Tailoring of patient-specific spacer. Spacer implantation.
Postoperative Management:
Rehabilitation protocol. Antibiotic treatment. Reimplantation after successful eradication of infection.
