Pizzo Richard A, Patel Jay N, Viola Anthony, Keller David M, Yoon Richard S, Liporace Frank A
Department of Orthopaedic Surgery, Jersey City Medical Center, Jersey City, NJ, USA.
Hip Pelvis. 2020 Dec;32(4):207-213. doi: 10.5371/hp.2020.32.4.207. Epub 2020 Dec 3.
Infection following total hip arthroplasty is a challenging and devastating complication. In two-stage revision arthroplasty, antibiotic spacers, although efficacious, can be associated with an unacceptable rate of mechanical complications (e.g., fracture, dislocation). This series describes 15 patients with infected total hip prostheses treated with hybrid cement-screw fixation constrained liner antibiotic spacers to enhance stability and minimize mechanical complications.
All patients with an infected hip prosthesis undergoing two-stage revision arthroplasty at a single academic medical center were identified and screened for inclusion. Clinical and radiographic data including patient demographics and outcome measures were collected and retrospectively analyzed.
Two patients died of unrelated causes at an average of 6-week postoperatively. Infections in the remaining thirteen patients (100%) were successfully eradicated; all underwent uncomplicated revision arthroplasty at a mean duration of 99.5 days after the placement of the antibiotic spacer. No dislocations, fractures, or other mechanical failures of any spacer were observed in this series.
The hybrid cement-screw fixation technique for constrained liner antibiotic spacers is a reliable and effective treatment method for eradicating prosthetic joint infections without mechanical complications.
全髋关节置换术后感染是一种具有挑战性且极具破坏性的并发症。在两阶段翻修关节成形术中，抗生素骨水泥间隔物虽然有效，但可能会出现不可接受的机械并发症发生率（如骨折、脱位）。本系列描述了15例感染性全髋关节假体患者，采用混合骨水泥 - 螺钉固定的限制性衬垫抗生素骨水泥间隔物进行治疗，以提高稳定性并尽量减少机械并发症。
在单一学术医学中心对所有接受两阶段翻修关节成形术的感染性髋关节假体患者进行识别和筛选以纳入研究。收集包括患者人口统计学和结局指标在内的临床和影像学数据，并进行回顾性分析。
两名患者在术后平均6周时死于无关原因。其余13名患者（100%）的感染均成功根除；所有患者在放置抗生素骨水泥间隔物后平均99.5天接受了无并发症的翻修关节成形术。本系列中未观察到任何骨水泥间隔物出现脱位、骨折或其他机械故障。
用于限制性衬垫抗生素骨水泥间隔物的混合骨水泥 - 螺钉固定技术是一种可靠且有效的治疗方法，可根除假体关节感染且无机械并发症。
