Lausmann Christian, Citak Mustafa, Hessling Udo, Wolff Matthias, Gehrke Thorsten, Suero Eduardo M, Zahar Akos
Prosthetic Joint Infection Centre, Helios ENDO-Klinik Hamburg, Holstenstraße 2, 22767, Hamburg, Germany.
Arch Orthop Trauma Surg. 2018 Nov;138(11):1617-1622. doi: 10.1007/s00402-018-3038-2. Epub 2018 Sep 18.
Mechanical failure due to dislocation, fracture and acetabular wear is a major complication associated with the use of spacers in the management of periprosthetic joint infection (PJI). We have developed a novel custom-made spacer in the setting of two-stage septic revision hip arthroplasty and present the preliminary results of our technique.
Between May 2015 and November 2017, 30 patients underwent hip revision using the ENDO spacer technique in the setting of a two-stage septic exchange arthroplasty. The technique involves the dual mobility liner and the downsized stainless cemented straight stem in combination with antibiotic-loaded PMMA bone cement. The primary outcome measure was the overall spacer complication rate, particularly spacer dislocation. Furthermore, functional outcome using the Harris Hip Score (HHS) before spacer implantation and prior re-implantation was evaluated.
The mean age of the patients was 69.8 years (range from 45 to 85; SD = 9.9 years). No microorganisms were preoperatively found in 23 (76.7%) cases. Successful re-implantation was performed in all patients after a mean spacer duration time of 53.6 days (range 14-288 days; SD = 48.2). Spacer-related complications occurred in only two patients (6.7%). The HHS significantly improved from 34.0 (range 3-62; SD = 15.1) to 48.1 (range 11-73; SD = 15.7) (p = 0.0008).
The ENDO spacer surgical technique is a feasible option in the treatment of periprosthetic joint infection (PJI), with a low dislocation rate. Furthermore, it allows early mobilization with the possibility of full-weight bearing.
脱位、骨折和髋臼磨损导致的机械故障是人工关节周围感染（PJI）治疗中使用间隔器的主要并发症。我们在两期感染性髋关节翻修术中开发了一种新型定制间隔器，并展示了我们技术的初步结果。
2015年5月至2017年11月期间，30例患者在两期感染性置换关节成形术中采用ENDO间隔器技术进行髋关节翻修。该技术包括双动衬垫和尺寸缩小的不锈钢骨水泥直柄，与含抗生素的聚甲基丙烯酸甲酯（PMMA）骨水泥联合使用。主要观察指标是间隔器的总体并发症发生率，尤其是间隔器脱位。此外，还评估了间隔器植入前和再次植入前使用Harris髋关节评分（HHS）的功能结果。
患者的平均年龄为69.8岁（范围45至85岁；标准差=9.9岁）。23例（76.7%）患者术前未发现微生物。所有患者在平均间隔器使用时间53.6天（范围14至288天；标准差=48.2）后成功进行了再次植入。仅2例患者（6.7%）出现与间隔器相关的并发症。HHS评分从34.0（范围3至62；标准差=15.1）显著提高到48.1（范围11至73；标准差=15.7）（p=0.0008）。
ENDO间隔器手术技术是治疗人工关节周围感染（PJI）的一种可行选择，脱位率低。此外，它允许早期活动并有可能完全负重。
