Retained Functional Antibiotic Hip Spacers Have High Rates of Stem Loosening, Subsidence, and Reoperation.
J Arthroplasty
; 38(7 Suppl 2): S405-S411, 2023 07.
Article
en En
| MEDLINE
| ID: mdl-37257789
ABSTRACT
BACKGROUND:
Functional antibiotic hip spacers for treatment of periprosthetic joint infection may be retained in patients deemed too sick for reimplantation, or who elect to forego additional surgery. Our aim was to characterize reoperations, modes of failure, and function outcomes in patients who have retained hip spacers.METHODS:
We performed a retrospective review of 43 hips that underwent placement of an articulating hip spacer between January 1, 2014 and November 30, 2021. There were 28 hips that completed 2-stage exchange (TS group) and were reimplanted at mean 4 months (range, 2 to 10). The other 15 hips underwent planned spacer retention (RS group). Mean follow-up was 2.9 years (range, 1 to 6.1 years). The RS group was older (74 versus 66 years, P = .005) and had a higher age-adjusted Charlson Comorbidity Index (4.4 versus 3.3, P = .04) compared with the TS group.RESULTS:
Overall survivorship free of reinfection was 91% at 1 year and 86% at 5 years. There were 6 RS hips that underwent reimplantation for spacer failure at a mean of 23 months (range, 6 to 71 months) and 8 had radiographic stem loosening/subsidence. Patients who had a retained spacer at final follow-up were more likely to require a walker (P = .005) or wheelchair (P = .049) compared with patients who underwent reimplantation.CONCLUSIONS:
Retained hip spacers can decrease overall surgical burden, but are associated with high rates of stem loosening, subsidence, and unplanned reoperation. Planned spacer retention should be undertaken with caution in patients healthy enough to undergo reimplantation.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Artritis Infecciosa
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Infecciones Relacionadas con Prótesis
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Artroplastia de Reemplazo de Cadera
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Prótesis de Cadera
Tipo de estudio:
Etiology_studies
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Observational_studies
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Risk_factors_studies
Límite:
Humans
Idioma:
En
Año:
2023
Tipo del documento:
Article