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Medullary-Sparing Antibiotic Cement Articulating Spacer Reduces the Rate of Mechanical Complications in Advanced Septic Hip Arthritis: A Retrospective Cohort Study.
Chen, Chun-Yen; Lin, Chin-Ping; Tsai, Chun-Hao; Chen, Hui-Yi; Chen, Hsien-Te; Lin, Tsung-Li.
Afiliación
  • Chen CY; Department of Orthopedics, China Medical University Hospital, Taichung 40447, Taiwan.
  • Lin CP; Department of Orthopedics, China Medical University Hospital, Taichung 40447, Taiwan.
  • Tsai CH; Department of Orthopedics, China Medical University Hospital, Taichung 40447, Taiwan.
  • Chen HY; Department of Sports Medicine, College of Health Care, China Medical University, Taichung 406040, Taiwan.
  • Chen HT; Department of Radiology, China Medical University Hospital, Taichung 40447, Taiwan.
  • Lin TL; Department of Orthopedics, China Medical University Hospital, Taichung 40447, Taiwan.
J Pers Med ; 14(2)2024 Jan 31.
Article en En | MEDLINE | ID: mdl-38392594
ABSTRACT
Antibiotic cement articulating spacers eradicate infection during a two-stage revision for advanced septic hip arthritis (ASHA); however, mechanical complications have been reported. We hypothesized that the rate of mechanical complications would be lower in medullary-sparing (MS) than in non-medullary-sparing (n-MS) articulating spacers. A retrospective study of ASHA using n-MS or MS spacers was conducted between 1999 and 2019. The rate of mechanical complications and reoperation and risk factors for mechanical complications were analyzed. The cohort included 71 n-MS and 36 MS spacers. All patients were followed up for 2 years. The rate of spacer dislocation was lower in MS (0%) than in n-MS spacers (14.1%; p = 0.014). The reoperation rate for mechanical complications was lower in MS (0%) than in n-MS spacers (12.7%; p = 0.019). The rate of a diaphyseal stem during reimplantation was lower in MS (0%) than in n-MS spacers (19.4%; p = 0.002). The identified risk factors for n-MS spacer dislocation were postoperative under-restored femoral head diameter ≥3 mm, femoral offset ≥3 mm, and surgical volume (≤6 resection arthroplasties per year). Both spacers controlled infection. However, MS spacers had a lower spacer dislocation and reoperation rate and avoided the diaphyseal stem during reimplantation. We recommend using MS spacers to restore native femoral head diameter and femoral offset when ASHA is treated by surgeons with lower surgical volumes.
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Texto completo: 1 Banco de datos: MEDLINE Idioma: En Revista: J Pers Med Año: 2024 Tipo del documento: Article País de afiliación: Taiwán

Texto completo: 1 Banco de datos: MEDLINE Idioma: En Revista: J Pers Med Año: 2024 Tipo del documento: Article País de afiliación: Taiwán