Gil Gonzalez Sergi, Marqués López Fernando, Rigol Ramon Pau, Mestre Cortadellas Carlos, Cáceres Palou Enric, León García Alfonso
Orthopaedic Surgery Department, Hospitales del Imas, Mar y Esperanza, Universitat Autónoma de Barcelona, Barcelona, Spain.
Hip Int. 2010;20 Suppl 7:S128-34. doi: 10.1177/11207000100200s721. Epub 2010 May 27.
Two-stage revision hip arthroplasty for infection using an antibiotic-loaded cement spacer has been used frequently with good results. However, spacer instability is also frequent. Proximal cementation of the spacer could avoid spacer dislocation. We retrospectively assessed 35 patients in whom a 2-stage revision hip arthroplasty for infection was carried out using an antibiotic-loaded cement spacer with gentamicin (Spacer-G) in which the spacer was proximally cemented in 16 patients. The mean follow-up was 32 months. We assessed spacer stability and infection elimination. There were 8 spacer dislocations (22.9%), 5 in hips without proximal cementation and 2 in hips with proximal cementation (p>0.05). There was no fracture in any hip. Reinfection occurred in 5 hips (14.3%), in 3 with the same microorganism, while 2 had a different microorganism. Our results indicate that the proximal cementation of the spacer prevents its dislocation. Infection was eliminated in 86% of the hips.
使用含抗生素骨水泥间隔物的两阶段翻修髋关节置换术治疗感染已被频繁应用且效果良好。然而,间隔物不稳定也很常见。间隔物近端骨水泥固定可避免间隔物脱位。我们回顾性评估了35例行两阶段翻修髋关节置换术治疗感染的患者,这些患者使用了含庆大霉素的抗生素骨水泥间隔物(Spacer-G),其中16例患者的间隔物进行了近端骨水泥固定。平均随访时间为32个月。我们评估了间隔物稳定性和感染清除情况。发生了8例间隔物脱位(22.9%),其中5例发生在未进行近端骨水泥固定的髋关节,2例发生在进行了近端骨水泥固定的髋关节(p>0.05)。所有髋关节均未发生骨折。5例髋关节(14.3%)发生再感染,其中3例为同一微生物感染,2例为不同微生物感染。我们的结果表明,间隔物近端骨水泥固定可防止其脱位。86%的髋关节感染得到清除。