Piya Pinsornsak1, Ta Niruktisarn1, Potsawat Surabotsopon1, Krit Boontanapibul2. 1. Department of Orthopedics, Faculty of Medicine, Thammasat University, Khlong Luang, Pathum Thani, Thailand. 2. Department of Orthopedics, Chulabhorn International College of Medicine, Thammasat University, Klong Luang, Pathum Thani, Thailand. krit.boontanapibul@gmail.com.
Abstract
PURPOSE: A handmade antibiotic cement spacer is the easiest method for producing a spacer for treating chronic periprosthetic joint infection after total hip arthroplasty (THA). However, a molded spacer offers more head and stem sizes to match the patient's anatomy. The purpose of this study was to evaluate the functional outcomes and complications between handmade and molded spacers. METHODS: This retrospective case note study compared the functional results, re-infection rate, and spacer related complications after the first stage and second stage exchange arthroplasty between a handmade spacer and a novel molded cement spacer with three sizes of femoral head (45, 50, and 55 mm) and two stem sizes (small, large). RESULTS: Fifteen chronically infected THA patients were identified: nine handmade and 6 molded spacers. The modified Harris Hip Score showed no inter-group differences pre-operatively and after first stage and second stage exchange arthroplasty. The erythrocyte sedimentary rates and C-reactive protein concentrations were similar at all time points, and there were no re-infections. The molded spacer group showed lower post-operative complications with no spacer fractures, spacer dislocations, and periprosthetic fractures, but two had spacer subsidence. The handmade spacer had two spacer fractures, one spacer dislocation with a periprosthetic femoral fracture, and four cases of spacer subsidence. CONCLUSION: Our small study showed no differences in functional outcomes and no re-infections in either group, but higher spacer-related complications occurred in the handmade spacer group. These data suggest molded spacers are better than handmade spacers.
PURPOSE: A handmade antibiotic cement spacer is the easiest method for producing a spacer for treating chronic periprosthetic joint infection after total hip arthroplasty (THA). However, a molded spacer offers more head and stem sizes to match the patient's anatomy. The purpose of this study was to evaluate the functional outcomes and complications between handmade and molded spacers. METHODS: This retrospective case note study compared the functional results, re-infection rate, and spacer related complications after the first stage and second stage exchange arthroplasty between a handmade spacer and a novel molded cement spacer with three sizes of femoral head (45, 50, and 55 mm) and two stem sizes (small, large). RESULTS: Fifteen chronically infected THA patients were identified: nine handmade and 6 molded spacers. The modified Harris Hip Score showed no inter-group differences pre-operatively and after first stage and second stage exchange arthroplasty. The erythrocyte sedimentary rates and C-reactive protein concentrations were similar at all time points, and there were no re-infections. The molded spacer group showed lower post-operative complications with no spacer fractures, spacer dislocations, and periprosthetic fractures, but two had spacer subsidence. The handmade spacer had two spacer fractures, one spacer dislocation with a periprosthetic femoral fracture, and four cases of spacer subsidence. CONCLUSION: Our small study showed no differences in functional outcomes and no re-infections in either group, but higher spacer-related complications occurred in the handmade spacer group. These data suggest molded spacers are better than handmade spacers.
Authors: Thomas K Fehring; Susan Odum; Stephen Struble; Keith Fehring; William L Griffin; J Bohannon Mason Journal: J Arthroplasty Date: 2007-07-26 Impact factor: 4.757
Authors: Dariusz Marczak; Marek Synder; Marcin Sibiński; Michał Polguj; Julian Dudka; Jacek Kowalczewski Journal: Int Orthop Date: 2017-05-18 Impact factor: 3.075