Efficacy Of Retaining Antibiotic Bone Cement Spacers In The Treatment Of Periprosthetic Joint Infection

Objective:The purpose of this study was to analyze and evaluate the efficacy of Antibiotic-loaded bone cement(ALBC)retention therapy in patients with periprosthetic joint infection(PJI)by reviewing the clinical efficacy of Antibiotic-loaded bone cement(ALBC)retention.Methods:26 patients who received antibiotic bone cement spacers from the Department of Arthritis Surgery,Second Hospital of Shanxi Medical University from January2013 to January 2020 were retrospectively selected.All patients were initially scheduled for second revision,but the spacers were retained.Two patients were followed up for at least one year and included in the study: 13 in the hip group and9 in the knee group.The mean age of the hip joint group was 66.8±9.2(51-85 years)years,5 males and 8 females,with a BMI24.2±3.4kg/m~2(18.8-31.2 kg/m~2).In the knee joint group,the mean age was 67.2±8.8 years(49-76 years),including 4males and 5 females,with a mean BMI24.1±2.7kg/m~2(19.6-28.8 kg/m~2).Evaluation of functional outcomes in the hip group included the hip Harris score.In the knee joint group,the American Knee Association score(KSS),visual analog scale(VAS),range of motion of knee joint(ROM)and imaging were used to evaluate the clinical effect,and the microbi al culture results and infection outcome of patients were counted.Results:In the hip group,the average follow-up was 39.3±21.5 months,and the Harris score was significantly improved from 42.92±9.21 before surgery to 78.67±5.63 in the last follow-up.In the knee group,the average follow-up was 31.6±12.0 years,and the postoperative KSS score,VAS score and range of motion of knee joint(ROM)were significantly improved.The differences were statistically significant(P<0.05).Conclusion:Patients who retained the antibiotic bone cement spacer had significant pain relief and improved range of motion compared to those before revision surgery,significantly improving their quality of life,and still had satisfactory clinical outcomes during long-term follow-up.When a patient is unable to tolerate surgery,the clinician may use a one-stage spacer as the final treatment option and design an antibiotic cement spacer that is more suitable for the patient before surgery.