Antibiotic spacers in THA yields infection eradication, improved clinical function
Data published in The Journal of Arthroplasty showed infection eradication and improved clinical function when an articulating antibiotic spacer was inserted during a two-stage revision total hip arthroplasty for periprosthetic joint infection.
Kevin I. Perry, MD, orthopedic surgeon at Mayo Clinic and assistant professor of orthopedics at Mayo Clinic College of Medicine and Science, and colleagues identified 135 hips in 131 patients undergoing a two-stage revision total hip arthroplasty for periprosthetic joint infection with Prostalac acetabular and femoral components (DePuy) and classified infections according to Musculoskeletal Infection Society criteria.
Results showed patients had a survivorship free of any infection after reimplantation of 92% at 2 years and 88% at 5 years postoperatively. Researchers noted a significant risk factor for poorer infection-free survivorship after reimplantation included patients with a host-extremity grade of C3 compared with all patients with a host grade of A. Researchers also found improvements in Harris Hip Scores from a mean of 58 points to a mean of 71 points in the spacer phase and to a mean of 81 points post-reimplantation. After reimplantation, 10% of patients experienced dislocation, of whom 7% required re-revision, according to results. Significant risk factors for post-reimplantation dislocation included trochanteric deficiency, dislocation of the articulating spacer prior to reimplantation and female sex, according to researchers.
“Insertion of an articulating antibiotic spacer during a two-stage revision THA for [periprosthetic joint infection] PJI demonstrates reliable infection eradication and improvement in clinical function, including during the spacer phase,” Perry told Healio.com/Orthopedics. “Nevertheless, patients with trochanteric deficiency or spacer dislocation are at high risk of post-reimplantation dislocation.” – by Casey Tingle
Disclosures: Perry reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.