Treatment of deep infection of the hip associated with massive bone loss
Open Access
- 1 June 2005
- journal article
- Published by British Editorial Society of Bone & Joint Surgery in The Journal of Bone and Joint Surgery. British volume
- Vol. 87 (6), 770-775
- https://doi.org/10.1302/0301-620x.87b6.15411
Abstract
We have carried out in 24 patients, a two-stage revision arthroplasty of the hip for infection with massive bone loss. We used a custom-made, antibiotic-loaded cement prosthesis as an interim spacer. Fifteen patients had acetabular deficiencies, eight had segmental femoral bone loss and one had a combined defect. There was no recurrence of infection at a mean follow-up of 4.2 years (2 to 7). A total of 21 patients remained mobile in the interim period. The mean Merle D’Aubigné and Postel hip score improved from 7.3 points before operation to 13.2 between stages and to 15.8 at the final follow-up. The allograft appeared to have incorporated into the host bone in all patients. Complications included two fractures and one dislocation of the cement prosthesis. The use of a temporary spacer maintains the function of the joint between stages even when there is extensive loss of bone. Allograft used in revision surgery after septic conditions restores bone stock without the risk of recurrent infection.Keywords
This publication has 18 references indexed in Scilit:
- Complications Associated With Reimplantation After Girdlestone ArthroplastyPublished by Wolters Kluwer Health ,2003
- Two-stage uncemented revision hip arthroplasty for infectionThe Journal of Bone and Joint Surgery. British volume, 2000
- A cement spacer for two-stage revision of infected implants of the hip jointInternational Orthopaedics, 1998
- Long-term elution of antibiotics from bone-cement: An in vivo study using the prosthesis of antibiotic-loaded acrylic cement (PROSTALAC) systemThe Journal of Arthroplasty, 1998
- An intramedullary cement spacer in total hip arthroplastyThe Journal of Arthroplasty, 1998
- Treatment of Infection Associated with Segmental Bone Loss in the Proximal Part of the Femur in Two Stages with Use of an Antibiotic-Loaded Interval Prosthesis*The Journal of Bone & Joint Surgery, 1998
- The use of porous prostheses in delayed reconstruction of total hip replacements that have failed because of infection.The Journal of Bone & Joint Surgery, 1994
- Revision of infected hip replacement: Two-stage procedure with a temporary gentamicin spacerActa Orthopaedica, 1994
- Surgical Treatment of the Infected Hip ImplantClinical Orthopaedics and Related Research, 1994
- Classification and Management of Acetabular Abnormalities in Total Hip ArthroplastyClinical Orthopaedics and Related Research, 1989