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18.05.2017 | Original Paper | Ausgabe 11/2017 Open Access

International Orthopaedics 11/2017

Two stage revision hip arthroplasty in periprosthetic joint infection. Comparison study: with or without the use of a spacer

International Orthopaedics > Ausgabe 11/2017
Dariusz Marczak, Marek Synder, Marcin Sibiński, Michał Polguj, Julian Dudka, Jacek Kowalczewski
Wichtige Hinweise
The protocol of the study was accepted by the Bioethics Committee of our institution (resolution RNN/43/13/KE dated 12 March 2013).



The aim of this study was to compare two methods of two-stage surgery for PJI (periprosthetic joint infection) after THA (total hip arthroplasty): one with and one without the use of an antibiotic-loaded cement spacer.


This retrospective study was performed on 99 consecutive patients (99 hips) with a minimum follow-up of 24 months. Patients were divided into two groups: (1) in whom the operation was performed using a spacer, and (2) for whom a spacer was not used.


For the whole cohort, the results improved between pre-operative and final follow-up. Recurrence of infection was found in nine out of 98 patients (9.2%) and was not significantly different between the two groups. Patients treated with a spacer had better functional improvement in the interim period, but the VAS score was better in the non-spacer group. The improvement in final function was better in the spacer group with regard to HHS, but not according to WOMAC score or VAS at final follow-up.


The resection arthroplasty should be awarded particular consideration in cases of poor soft tissue quality, bone stock deficiency, when complications related to spacer use are expected or chances of new hip endoprosthesis implantation are low.

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