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Review
. 2017 Jan 1;2(1):29-37.
doi: 10.7150/jbji.16067. eCollection 2017.

Therapeutic Use of Antibiotic-loaded Bone Cement in the Treatment of Hip and Knee Joint Infections

Konstantinos Anagnostakos  1
Affiliations
Review

Therapeutic Use of Antibiotic-loaded Bone Cement in the Treatment of Hip and Knee Joint Infections

Konstantinos Anagnostakos. J Bone Jt Infect. .

Abstract

The use of antibiotic-loaded cement spacers is an established method in the management of periprosthetic hip and knee joint infections. Despite inconsistencies among published studies, data shows that infection control rates exceed 90% with two-stage exchange arthroplasty. The present work reviews the current literature about antibiotic-loaded cement spacers and concentrates on the indications for spacer implantation, spacer production details, antibiotic impregnation, pharmacokinetic properties, clinical success, mechanical complications, and systemic safety.

Keywords: antibiotic-loaded bone cement.; hip infection; hip spacer; knee infection; knee spacer.

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Conflict of interest statement

Competing Interests: The author has declared that no competing interest exists.

Figures

Figure 1
Figure 1
Criteria for differentiation between spacer implantation and Girdlestone arthroplasty for the management of late implant-associated hip joint infections.
Figure 2
Figure 2
Anteroposterior X-ray of the left hip joint showing an antibiotic-loaded cement hip spacer with a titanium endoskeleton acting as a hemiarthroplasty.
Figure 3
Figure 3
Criteria for knee spacer implantation.
Figure 4
Figure 4
Anteroposterior and lateral radiographs of a static knee spacer in situ.
Figure 5
Figure 5
X-rays of the left knee of a 52-year female patient showing a septic loosening of the femoral component two years after implantation of a tumor prosthesis.
Figure 6
Figure 6
Treatment of the infected tumor prosthesis from Figure 5, consisting of prosthesis explantation and spacer implantation. Due to the large bone defect, an overbridge to maintain leg length and stability was required. Here, an antibiotic-loaded cement-coated nail was implanted with a cement spacer in the leg to solve this problem.
Figure 7
Figure 7
Lateral radiographs of a left knee joint showing a fracture with subsequent dislocation of a static spacer one week after implantation.
See this image and copyright information in PMC

References

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