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Two-Stage Revision Total Hip Arthroplasty for Periprosthetic Infections Using Antibiotic-Impregnated Cement Spacers of Various Types and Materials

Antibiotic-impregnated hip cement spacers of various types and materials have been used in the treatment of periprosthetic hip infections. We developed a handmade spacer by using polymethylmethacrylate (PMMA) and/or α-tricalcium phosphate (α-TCP). In this study, we retrospectively reviewed the surgi...

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Autores principales: Uchiyama, Katsufumi, Takahira, Naonobu, Fukushima, Kensuke, Moriya, Mitsutoshi, Yamamoto, Takeaki, Minegishi, Yojiro, Sakai, Rina, Itoman, Moritoshi, Takaso, Masashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3871498/
https://www.ncbi.nlm.nih.gov/pubmed/24381509
http://dx.doi.org/10.1155/2013/147248
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author Uchiyama, Katsufumi
Takahira, Naonobu
Fukushima, Kensuke
Moriya, Mitsutoshi
Yamamoto, Takeaki
Minegishi, Yojiro
Sakai, Rina
Itoman, Moritoshi
Takaso, Masashi
author_facet Uchiyama, Katsufumi
Takahira, Naonobu
Fukushima, Kensuke
Moriya, Mitsutoshi
Yamamoto, Takeaki
Minegishi, Yojiro
Sakai, Rina
Itoman, Moritoshi
Takaso, Masashi
author_sort Uchiyama, Katsufumi
collection PubMed
description Antibiotic-impregnated hip cement spacers of various types and materials have been used in the treatment of periprosthetic hip infections. We developed a handmade spacer by using polymethylmethacrylate (PMMA) and/or α-tricalcium phosphate (α-TCP). In this study, we retrospectively reviewed the surgical outcomes in 36 consecutive patients treated with 2-stage revision total hip arthroplasty by using our antibiotic-impregnated hip cement spacers. We aimed to analyze the infection control and reinfection rates after revision surgery. Moreover, we analyzed the possible predictors of postoperative reinfection. After exclusion of 1 patient who died immediately after the first-stage surgery, infection was controlled in 33 of the 36 hips (success rate, 91.7%). Two of these 33 hips underwent resection arthroplasty. Of the 36 hips that had been treated with the antibiotic-cement spacer, 31 hips (86.1%) were eligible for the second-stage prosthesis re-implantation. The 31 protocol hip joints of patients followed up for >6 months (mean, 48.6 months). Ten of these 31 hips (32.3%) became reinfected. No possible predictor examined differed significantly between the reinfection-positive and reinfection-negative groups. However, spacers consisting of PMMA cement alone were associated with the highest risk of reinfection. Therefore, α-TCP-containing antibiotic-impregnated hip cement spacers might decrease the reinfection rate in patients undergoing re-implantation.
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spelling pubmed-38714982013-12-31 Two-Stage Revision Total Hip Arthroplasty for Periprosthetic Infections Using Antibiotic-Impregnated Cement Spacers of Various Types and Materials Uchiyama, Katsufumi Takahira, Naonobu Fukushima, Kensuke Moriya, Mitsutoshi Yamamoto, Takeaki Minegishi, Yojiro Sakai, Rina Itoman, Moritoshi Takaso, Masashi ScientificWorldJournal Clinical Study Antibiotic-impregnated hip cement spacers of various types and materials have been used in the treatment of periprosthetic hip infections. We developed a handmade spacer by using polymethylmethacrylate (PMMA) and/or α-tricalcium phosphate (α-TCP). In this study, we retrospectively reviewed the surgical outcomes in 36 consecutive patients treated with 2-stage revision total hip arthroplasty by using our antibiotic-impregnated hip cement spacers. We aimed to analyze the infection control and reinfection rates after revision surgery. Moreover, we analyzed the possible predictors of postoperative reinfection. After exclusion of 1 patient who died immediately after the first-stage surgery, infection was controlled in 33 of the 36 hips (success rate, 91.7%). Two of these 33 hips underwent resection arthroplasty. Of the 36 hips that had been treated with the antibiotic-cement spacer, 31 hips (86.1%) were eligible for the second-stage prosthesis re-implantation. The 31 protocol hip joints of patients followed up for >6 months (mean, 48.6 months). Ten of these 31 hips (32.3%) became reinfected. No possible predictor examined differed significantly between the reinfection-positive and reinfection-negative groups. However, spacers consisting of PMMA cement alone were associated with the highest risk of reinfection. Therefore, α-TCP-containing antibiotic-impregnated hip cement spacers might decrease the reinfection rate in patients undergoing re-implantation. Hindawi Publishing Corporation 2013-12-07 /pmc/articles/PMC3871498/ /pubmed/24381509 http://dx.doi.org/10.1155/2013/147248 Text en Copyright © 2013 Katsufumi Uchiyama et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Uchiyama, Katsufumi
Takahira, Naonobu
Fukushima, Kensuke
Moriya, Mitsutoshi
Yamamoto, Takeaki
Minegishi, Yojiro
Sakai, Rina
Itoman, Moritoshi
Takaso, Masashi
Two-Stage Revision Total Hip Arthroplasty for Periprosthetic Infections Using Antibiotic-Impregnated Cement Spacers of Various Types and Materials
title Two-Stage Revision Total Hip Arthroplasty for Periprosthetic Infections Using Antibiotic-Impregnated Cement Spacers of Various Types and Materials
title_full Two-Stage Revision Total Hip Arthroplasty for Periprosthetic Infections Using Antibiotic-Impregnated Cement Spacers of Various Types and Materials
title_fullStr Two-Stage Revision Total Hip Arthroplasty for Periprosthetic Infections Using Antibiotic-Impregnated Cement Spacers of Various Types and Materials
title_full_unstemmed Two-Stage Revision Total Hip Arthroplasty for Periprosthetic Infections Using Antibiotic-Impregnated Cement Spacers of Various Types and Materials
title_short Two-Stage Revision Total Hip Arthroplasty for Periprosthetic Infections Using Antibiotic-Impregnated Cement Spacers of Various Types and Materials
title_sort two-stage revision total hip arthroplasty for periprosthetic infections using antibiotic-impregnated cement spacers of various types and materials
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3871498/
https://www.ncbi.nlm.nih.gov/pubmed/24381509
http://dx.doi.org/10.1155/2013/147248
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