Antibiotic-laden Arthroplasty with a Novel Design of Cement Mould and Metallic Endoskeleton for Treatment of Hip Infection, an Inexpensive Alternative: A Preliminary Report of Two Cases
- Author:
William Cch, Mbbs, Simmrat S, Ms Orth, Suhaeb Am, Msurgery
- Publication Type:Case Report
- Keywords:
antibiotic-impregnated, cement spacer, hip cement mould, metallic endoskeleton, hip arthroplasty infection
- From:Malaysian Orthopaedic Journal
2017;11(2):78-81
- CountryMalaysia
- Language:English
-
Abstract:
Infection of the hip after implant fixation is an uncommon
yet devastating complication that results in poor long-term
outcome. The gold standard treatment for chronic infection
after hip arthroplasty is a two-stage protocol: eradication of
infection, follow by re-implantation arthroplasty. The use of
interim antibiotic-laden cement spacer has become a popular
procedure to maintain hip joint function and provide
antibiotic elution simultaneously before re-implantation.
However, antibiotic cement spacer is mechanically weak and
breaks if overloaded. Therefore, we designed a cement
mould with metallic endoskeleton with the aim of creating a
stronger, inexpensive, antibiotic-impregnated spacer
resembling a unipolar arthroplasty. We report two cases of
severe hip joint infection after implant fixation (bipolar
hemiarthroplasty, screw fixation neck of femur). Both
patients had undergone first stage surgery of debridement
and articulating antibiotic cement insertion using our design.
Although the second stage surgery was planned for these
patients, both patients delayed the operation in view of good
functional status after a year walking with the antibiotic
cement spacer. These cases showed that the mechanical
property of the new antibiotic cement spacer was promising
but further mechanical studies upon this new endoskeleton
design are required.
