The Surgical Treatment of Patients With Periprosthetic Infection After Arthroplasty of a Hip Joint With the Use of Personified Articulating Spacers, Created With a 3d Printing

Abstract

The purpose of the investigation is to assess the results of the surgical treatment with the use of personified articulating hip joint spacers. The results of treatment of 67 patients with periprosthetic infection after hip joint arthroplasty, who was receiving therapy at the purulent surgery department of FSBEI HE PRMU MOH Russia, were analyzed. The patients were classified into 2 groups:33 patients (23 men and 10 women) were included into the 1st (comparative group). Their treatment was carried out in 2015-2016 years according to the standard algorithms of the two-step hip joint revision arthroplasty methodology. 34 patients (24 men and 10 women) were included into the 2d (basic) group. Two-step hip joint revision arthroplasty methodology with the use of personified approach in the space production was used in their treatment since 2016 year. Hip joint re-surgery with the change of the spacer after the revision was performed to 2 patients (6,7 %) from the basic group and 4 patients (13,3 %) from the comparative group (p>0,05). The functional state of the patients of the basic group 3 months after the first step of re-arthroplasty about peri-implant infection is characterized by better functional results on the Harris scale in comparison with patients who were treated with standard approaches. The developed methodology of the articulating spacer installation, using an individual acetabular component, allowed to provide stability and articulation without the involvement of a bone in the area of the installed spacer. The full articulation and the retention of active movements in the installed spacer area is the recipe for success of the 2d step of arthroplasty. The frecuency analysis of re-surgery on the joint with the spacer replacement after the revision showed a statistically significant decrease in the recurrence of suppuration after hip joint arthroplasty.