Similar Rate of Infection Eradication for Functional Articulating, Prefabricated and Custom-Made Spacers in 2-Stage Revision of the Infected Total Hip: A Literature Review. Issue 4 (25th July 2016)

• Record Type: Journal Article
• Authors: Veltman, Ewout S.; Moojen, Dirk Jan F; Glehr, Mathias; Poolman, Rudolf W.
• Is Part Of: Hip international. Volume 26:Issue 4(2016)
• Page Start: 319
• Page End: 326
• Publication Date: 2016-07-25
• Subjects: Antibiotic-loaded spacer -- Functional articulating spacer -- Periprosthetic joint infection -- Total hip arthroplasty -- 2-stage revision; Hip joint -- Pathophysiology -- Periodicals; Hip joint -- Diseases -- Periodicals; Hip joint -- Surgery -- Periodicals; 617.581005
• DOI: 10.5301/hipint.5000400
• Languages: English
• ISSNs: 1120-7000

Abstract

Background: 2-stage revision with the use of an antibiotic-loaded interval spacer is therapy of choice in late periprosthetic joint infection for most surgeons. For the spacer, either a prefabricated, functional articulating or custom-made spacer can be used. Little is known about which type of spacer provides optimal outcome after 2-stage revision. The aim of this study was to determine which type of spacer provides the best results, when used in 2-stage revision of an infected THA. Methods: We performed a systematic review of the literature to analyse which type of interval spacer provides highest infection eradication rate and best functional outcome after a minimum 2 year follow-up. Exclusion criteria were follow-up of less than 2 years, single-stage revision, or 2-stage revision without use of a spacer. Results: 25 studies were included. Infection eradication rate was similar with rates of 96%, 93% and 95% for the prefabricated-, functional articulating- and custom-made spacers respectively. Functional outcome was scarcely described. Postoperative HHS was 81, 90 and 83 respectively. Conclusions: Functional articulating spacers achieve a comparable rate of infection eradication in the treatment of periprosthetic hip joint infections as compared to preformed or custom-made antibiotic-loaded spacers. There is insufficient evidence concerning rehabilitation and functional outcome after 2-stage revision hip arthroplasty to advocate or discourage the use of either kind of interval spacer.