A spacer to be used with femoral hip prostheses
We reviewed the treatment of infected total hip arthroplasty with a temporary spacer endoprosthesis
Collared hip prosthesis with revision spacer - …
Once the decision is made that a hip is infected, the surgical plan is typically as follows involving a two-stage technique. An infected joint routinely requires the removal of all parts of the hip replacement from the bone so that the infection can be cleared. The space occupied by the removed hip prosthesis is filled with an antibiotic laden cement spacer shaped like a hip prosthesis. This spacer serves to keep the soft tissues stretched out to proper length and provides antibiotic which leaches out of the cement spacer directly to the infected area over time. In addition, 6-12 weeks of IV antibiotics are given, depending upon the infecting organism. Once this treatment is completed, it is commonly possible, through a second operation, to implant a new hip replacement into the now sterilized hip area.
12. Hsieh PH, Shih CH, Chang YH, Lee MD, Shih HN, Yang WE. Two-stage revision hip arthroplasty for infection: comparison between the interim use of antibiotic-loaded cement beads and a spacer prosthesis. 2004;86:1989-1997
Complications after spacer implantation in the …
Antibiotic-loaded cement spacers are an efficient method in the treatment of hip joint infections. However, during treatment several complications might occur that might endanger the infection eradication as well as the functional outcome after prosthesis reimplantation. Our data demonstrate that > 50 % of patients suffering from hip joint infections and treated with a two-stage protocol will have some kind of complications besides reinfection or infection persistence, mostly consisting of mechanical ones (spacer fracture, -dislocation, femoral fracture, prosthesis dislocations), systemic side effects (acute renal failure, allergic reactions), and general complications (draining sinus, pneumonia, etc.). Despite the retrospective design of our study and the limited possibility of interpreting these findings and their causes, this rate indicates that these patients are prone to have some kind of complication. Orthopedic surgeons should be aware of these complications and their treatment options and concentrate on the early diagnosis for prevention of further complications. Between stages, an interdisciplinary cooperation with other facilities (internal medicine, microbiologists) should be aimed for patients with several comorbidities for optimizing their general medical condition.
Since each failed hip replacement has a different reason for its failure, preparing for the revision hip replacement is also going to be unique. Specialized CAT scans or MRI tests may be needed to evaluate bone loss around the current implant or position of the prosthesis relative to the normal anatomy. Various laboratory or nuclear scans to check for infection may be indicated such as CBC, CRP, Sed. Rate or Bone Scan. An aspiration of the hip joint may yield fluid that can be analyzed by cell count and culture. Finally, consultations with other medical or surgical specialists may be required to evaluate the medical condition or special circumstances of the patient prior to surgery to optimize the outcome.
Anyone had a staph infection in hip prosthesis
Nevertheless, as a cause leading to revision hip replacement, infection is the third most common. In several studies which assess the causes of primary hip replacement failure, infection of the joint is the most challenging and potentially devastating cause with 15% of all revision hip replacement procedures being done for this reason . If an artificial joint becomes infected, the pain is typically more constant than with a loose, but non-infected joint, but symptoms greatly vary with the type of infecting organism. Along with pain, symptoms include a stiffening of the joint, making movement quite difficult. On rare occasion, a prosthetic joint infection can make the patient systemically ill with fever, chills, weight loss, and lethargy.
Once the implant is separated from the bone on both sides of the joint, samples of the biologic material that has developed in the defects of the bone may be sent off to the hospital lab for immediate analysis, especially if an infection is suspected. Sometimes, even when preoperative lab studies to assess for infection are negative, presentation at surgery may lead the surgeon to have concern that a low-grade infection is present. The material that is harvested from the area directly between the implant and the bone is often the best and only way that these occult infections can be found. If there is evidence that such a low-grade infection exists, the surgeon will not proceed with the re-implantation of a new, revision hip replacement at that time. Rather, an antibiotic spacer will be left in the hip temporarily, the operation ended and treatment will proceed to clear the infection.
Reporting for Placement of a Non-biodegradable …
How to cite this article: Sukeik M, Haddad FS
The spacer is placed under a existing collar of a femoral hip prosthesis and cemented or tied in place or both
Revision Hip Replacement - Zehr Center Orthopaedics
Two-stage procedure in the treatment of late chronic hip infections - spacer implantation
Total Hip Replacement -OrthoInfo - AAOS
Revision Total Hip Replacement -OrthoInfo - AAOS
Coding for Hip Replacement Surgery - For The Record …
42. Yamamoto K, Miyagawa N, Masaoka T, Katori Y, Shishido T, Imakiire A. Clinical effectiveness of antibiotic-impregnated cement spacers for the treatment of infected implants of the hip joint. 2003;8:823-8
Prosthetic Joint Infection - Recon - Orthobullets
41. Durbhakula SM, Czajka J, Fuchs MD, Uhl RL. Spacer endoprosthesis for the treatment of infected total hip arthroplasty. 2004;19:760-7
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A reinfection and/or infection persistence are the most feared complications after hip spacer implantation because they can be both associated with subsequent surgical revisions and higher morbidity and mortality rates, respectively. However, several other complications might also occur during a two-stage treatment protocol for late hip joint infections which can also lead to prolonged treatment courses and endanger the functional outcome. Although these complications are frequently not mentioned or insufficiently documented in the literature, they are surely of no minor value compared with an infection persistence or reinfections.
2018 ICD-10-CM Diagnosis Code Z47.33: Aftercare …
In conclusion, treatment of late chronic hip joint infections after THA is a challenging problem. The gold standard remains a two-stage revision arthroplasty using antibiotic-impregnated cement spacers which achieves an infection control rate over 90%. Articulating spacers provide the advantages of maintaining limb length and joint mobility, minimising soft-tissue contracture and scarring, and facilitating second-stage reimplantation and therefore, should be used as the first option of treatment for late chronic hip joint infections.
THA Revision - Recon - Orthobullets
Primary surgical indications and antibiotic impregnation of the bone cement at the site of spacer implantation in the treatment of hip joint infections.
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