Preformed gentamicin spacers in two-stage revision hip arthroplasty: functional results and complications

Abstract

Two-stage revisions with antibiotic-loaded spacers have gained popularity for treating infected hip-joint arthroplasties. The aim of this prospective study was to assess patient functionality between stages and treatment impact on duration of hospital stay and to describe related complications. Sixty-one consecutive patients with infected hip arthroplasties underwent two-stage revision with preformed spacer implantation. Mean Harris Hip and Merle d'Aubigné scores between the two stages were 39.9 and 7.6, respectively. Forty-six patients (75.4%) were able to leave hospital between stages. Spacer dislocation occurred in 16.4%. No cases of spacer breakage were noted. Preformed cement spacers provide acceptable functional outcome between revision hip arthroplasty stages and facilitate the surgical procedure without increasing mechanical complication rates.

Fig. 1

Preformed Spacer G is available in six versions

Fig. 2

Long version of Spacer G used in combination with femoral osteotomy

Fig. 3

Limited cementation of the proximal femur enhances rotational stability of the spacer

Fig. 4

Dislocated spacer. Patient was put on a restricted weightbearing regimen

Fig. 5

Diaphyseal fracture occurred 4 weeks after spacer implantation