An Articulating Antibiotic Spacer Controls Infection and Improves Pain and Function in a Degenerative Septic Hip

Abstract

Background Treating septic arthritis of the hip with coexisting advanced degenerative disease is challenging.

Spacers

“…The majority of the reports comparing the mid‐term outcome of surgical treatment for PJI revealed a better functional outcome (as measured by the HHS) for patients who received articulating spacers compared to non‐articulating spacers. The average reported HHS for all patients receiving articulating spacers (898 cases) after an average follow‐up of 50 months was 83 (range 68–98 points; SD = 8.2), compared to the HHS of 81 points (range, 78–83 points; SD = 2.3) for those receiving non‐articulating spacers (63 patients) after an average follow up of 61 months …”

“…A few studies that evaluated patient function between stages for resection arthroplasty and reimplantation detected a superior outcome for patients receiving articulating spacers compared to those with non‐articulating spacers …”

“…There were no level 1 studies that examined the success of surgical treatment with regard to infection control. There were 5 level 2 studies, 11 level 3 studies, and 43 level 4 studies …”

Place de l’infection comme étiologie de reprise des prothèses totales de hanche de première intention et ses facteurs prédictifs

“…Garvin et Hanssen [13] rapportent des taux d'éradications supérieurs à 90 %, mais la tendance à la séquence chirurgicale courte est confirmée par la littérature plus récente avec des résultats très satisfaisants [14][15][16][17]. Le registre norvégien indique un risque diminué de re-révision lors des chirurgies en deux temps des prothèses infectées mais sans significativité statistique, et l'utilisation d'un espaceur en ciment peut améliorer la fonction pendant l'intervalle [18,19].…”

Functional outcome in patients with infection after total joint arthroplasty

“…Fleck et al 6 used an articulating spacer to treat osteoarthritis with concomitant or recent (within 1 year) septic arthritis. Fourteen patients were treated with debridement and insertion of a prosthesis with antibiotic-loaded acrylic cement (PROSTALAC; DePuy Orthopaedics, Warsaw, IN) articulating spacer as a primary device.…”