Background: A two-stage revision is a well-accepted method for the
treatment of a deep infection of a hip with a joint implant. In the present
study, the results associated with the interim use of antibiotic-loaded cement
beads were compared with those associated with the interim use of an
antibiotic-loaded cement prosthesis.
Methods: One hundred and twenty-eight consecutive patients who were
managed with a two-stage revision hip arthroplasty for the treatment of an
infection were followed clinically and radiographically for an average of 4.9
years. Cement beads were implanted following resection arthroplasty in the
first seventy hips, and a custom cement prosthesis was implanted in the
subsequent fifty-eight hips.
Results: There was no evidence of recurrent infection in 122
patients (95.3%); the infection-free rates in both groups were similar. The
use of a spacer prosthesis was associated with a higher hip score, a shorter
hospital stay, and better walking capacity in the interim period; a decreased
operative time, less blood loss, and a lower transfusion requirement at the
time of reimplantation; and fewer postoperative dislocations.
Conclusions: The present study supports the safety and efficacy of
the routine use of an antibiotic-loaded cement prosthesis in the interim
between the stages of a two-stage revision procedure for the treatment of an
infection at the site of a hip arthroplasty.
Level of Evidence: Therapeutic study, Level III-2
(retrospective cohort study). See Instructions to Authors for a complete
description of levels of evidence.