Spacer endoprosthesis for the treatment of infected total hip arthroplasty.

Abstract

We reviewed the treatment of infected total hip arthroplasty with a temporary spacer endoprosthesis. To fabricate the spacer, antibiotic-loaded cement was inserted into a specially designed mold. A central rod pin was superficially imbedded as an endoskeleton once the cement reached a doughy state. After polymerization, the final product was removed from the mold and inserted as an articulating spacer. Twenty patients were followed for an average of 38 months (range, 26-67 months). There were no recurrent or persistent infections. Eighteen patients underwent a successful 2-stage exchange. Two patients retained the spacer as a definitive treatment method. Complications with the spacer included 2 fractures and 2 dislocations. Overall, this cost-effective technique provided efficient local antibiotic delivery, early mobilization, facilitation of reimplantation, and improved patient satisfaction.