Radiographic parameters and mechanical complications of articulating vs. non-articulating hip spacers

Area of Science:

• Orthopedic surgery
• Infectious disease management
• Biomaterials science

Background:

• Periprosthetic joint infection (PJI) is a significant complication following total hip arthroplasty.
• Standard PJI treatment involves two-stage revision surgery with antibiotic-loaded cement spacers.
• This study evaluates articulating versus non-articulating hip spacers for PJI management.

Purpose of the Study:

• To compare radiological outcomes and complication rates of articulating and non-articulating hip spacers in PJI treatment.
• To assess the impact of spacer type on leg length discrepancy and femoral offset.
• To evaluate infection control and mechanical complication rates associated with different spacer types.

Main Methods:

• Retrospective review of 71 hip spacers (34 articulating, 37 non-articulating) in 38 patients (2004-2022).
• Data collected included leg length discrepancy, femoral offset, infection control, and mechanical complications.
• Infection analysis focused on patients treated exclusively with one spacer type.

Main Results:

• Articulating spacers significantly improved leg length preservation (mean discrepancy -3.7 mm vs. -16.9 mm).
• Non-articulating spacers better maintained physiological femoral offset (1.1 vs. 0.7).
• Mechanical complications, particularly spacer dislocations, were higher with articulating spacers (45% vs. 10%).
• No significant difference in infection control was observed between spacer types.

Conclusions:

• Non-articulating spacers were linked to fewer mechanical complications in this exploratory cohort.
• Articulating spacers demonstrated superior leg length preservation.
• Observed differences are associative, not causal, due to study limitations and should be interpreted cautiously.