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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.

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.

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