Abstract
An articulating or nonarticulating antibiotic hip spacer can be placed following the
first stage implant removal of a periprosthetic hip joint infection. Antibiotic spacers
help fill in the dead space created at the time of resection and provide a high local
concentration of antibiotics. Theoretical advantages of a static spacer include a
higher elution of antibiotics because of the increased surface area, the ability to
protect deficient bone in the proximal femur/acetabulum, and the ability to immobilize
the periarticular soft tissues. Advantages of an articulating spacer include improved
ambulation and easier motion for the patient, maintenance of soft tissue tension,
and an easier surgical reconstruction at the time of the second stage. Additionally,
an articulating antibiotic spacer may minimize the risk of dislocation following the
second stage reconstruction. The choice of articulating or nonarticulating is currently
one of surgeon preference yet it is advised that surgeons consider an articulating
spacer for all patients except those with severe femoral/acetabular bone loss or deficient
abductors.
Keywords
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References
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Article info
Publication history
Accepted:
November 6,
2019
Received in revised form:
November 5,
2019
Received:
September 30,
2019
Footnotes
This article is published as part of a supplement supported by an educational grant from OsteoRemedies, LLC.
One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to https://doi.org/10.1016/j.arth.2019.11.007.
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© 2019 Elsevier Inc. All rights reserved.
