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Revision of infected hip replacement. Two-stage procedure with a temporary gentamicin spacer
I Ivarsson1, O Wahlström, K Djerf
1Department of Orthopedics, University Hospital, Linköping, Sweden.
Acta Orthopaedica Scandinavica
|February 1, 1994
Abstract:
We revised 5 infected totally-replaced hips in 2 stages. At the first operation a gentamicin-loaded modelled cement spacer was inserted, and the definitive prosthesis was inserted 3-8 weeks later. 9-24 months after the last operation, there was a recurrent infection in 1 case. 2 of the patients could walk in the interval.
Insights
This study revised 5 infected total hip replacements using a two-stage procedure with a gentamicin-loaded cement spacer. The method showed a low recurrent infection rate, with most patients regaining mobility.
Area of Science:
- Orthopedic Surgery
- Infectious Disease Management
Background:
- Periprosthetic joint infection (PJI) is a serious complication following total hip replacement.
- Managing infected total hip replacements requires effective treatment strategies to eradicate infection and restore function.
Purpose of the Study:
- To evaluate the efficacy of a two-stage revision surgery for infected total hip replacements.
- To assess the outcomes of using a gentamicin-loaded cement spacer in the management of PJI.
Main Methods:
- A retrospective review of 5 patients who underwent two-stage revision for infected total hip replacements.
- Stage 1 involved insertion of a gentamicin-loaded, modeled cement spacer.
- Stage 2 involved definitive prosthesis insertion 3-8 weeks after the initial surgery.
Main Results:
- One case (20%) experienced recurrent infection within 9-24 months post-operatively.
- Two patients could ambulate during the interval between surgeries.
- The majority of patients tolerated the two-stage procedure.
Conclusions:
- The two-stage revision with a gentamicin-loaded cement spacer is a viable option for managing infected total hip replacements.
- This approach demonstrates a potentially low rate of recurrent infection and allows for interim patient mobility.