Dariusz Marczak1, Marek Synder2, Marcin Sibiński3, Michał Polguj4, Julian Dudka5, Jacek Kowalczewski1. 1. Orthopaedic Department, Postgraduate Medical Education Center, Otwock ul. Konarskiego 13, 05-400, Otwock, Poland. 2. Department of Orthopaedics and Pediatric Orthopaedics, Medical University of Lodz, ul. Pomorska 251, 92-213, Łódź, Poland. 3. Department of Orthopaedics and Pediatric Orthopaedics, Medical University of Lodz, ul. Pomorska 251, 92-213, Łódź, Poland. sibinskimar@gmail.com. 4. Department of Angiology, Chair of Anatomy, Medical University of Łódź, ul. Narutowicza 60, 90-136, Łódź, Poland. 5. Samodzielny Publiczny Zakład Opieki Zdrowotnej, Szpital Specjalistyczny im Stefana Żeromskiego, Kraków os. Na Skarpie 66, 31-913, Kraków, Poland.
Abstract
PURPOSE: The aim of this study was to compare two methods of two-stage surgery for PJI (periprosthetic joint infection) after THA (total hip arthroplasty): one with and one without the use of an antibiotic-loaded cement spacer. METHODS: This retrospective study was performed on 99 consecutive patients (99 hips) with a minimum follow-up of 24 months. Patients were divided into two groups: (1) in whom the operation was performed using a spacer, and (2) for whom a spacer was not used. RESULTS: For the whole cohort, the results improved between pre-operative and final follow-up. Recurrence of infection was found in nine out of 98 patients (9.2%) and was not significantly different between the two groups. Patients treated with a spacer had better functional improvement in the interim period, but the VAS score was better in the non-spacer group. The improvement in final function was better in the spacer group with regard to HHS, but not according to WOMAC score or VAS at final follow-up. CONCLUSION: The resection arthroplasty should be awarded particular consideration in cases of poor soft tissue quality, bone stock deficiency, when complications related to spacer use are expected or chances of new hip endoprosthesis implantation are low.
PURPOSE: The aim of this study was to compare two methods of two-stage surgery for PJI (periprosthetic joint infection) after THA (total hip arthroplasty): one with and one without the use of an antibiotic-loaded cement spacer. METHODS: This retrospective study was performed on 99 consecutive patients (99 hips) with a minimum follow-up of 24 months. Patients were divided into two groups: (1) in whom the operation was performed using a spacer, and (2) for whom a spacer was not used. RESULTS: For the whole cohort, the results improved between pre-operative and final follow-up. Recurrence of infection was found in nine out of 98 patients (9.2%) and was not significantly different between the two groups. Patients treated with a spacer had better functional improvement in the interim period, but the VAS score was better in the non-spacer group. The improvement in final function was better in the spacer group with regard to HHS, but not according to WOMAC score or VAS at final follow-up. CONCLUSION: The resection arthroplasty should be awarded particular consideration in cases of poor soft tissue quality, bone stock deficiency, when complications related to spacer use are expected or chances of new hip endoprosthesis implantation are low.
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