Treatment Of Infection After Hip Arthroplasty Using Antibiotic-impregnated Cement Spacer By Two-stage Exchange Arthroplasty

Objective To assess the effects of Antibiotic-impregnated cement spacer on the management of infection after hip arthroplasty.Methods Retrospectively analyzed 14 patients with infection after hip arthroplasty from January 2008 to October 2010. There were 8 males and 6 females with average age of 61 years old (range 45-78). Every patient had continuous hip pain and 2 cases with sinus tract.Abnormal erythrocyte sedimentation rate (ESR) and C-reactive protein was observed in 14 cases.Radiography findings, such as osteolysis ,loosening and periosteal reaction,were presented on 14 patients ;The replacemennt of the infected total hip arthroplasty in two stages was performed in 14 patients. In the first stage operation, The following steps were performed,complete debridement ,removal of infected prothesis,implantation of Vancomycin-impregnated cement spacer.After 3.6 months,antibiotic-loaded prothesis was implanted in the second stage. The hip functions before and after operation were evaluated by Harris score.Results After the first procedure,all the wounds closed smoothly and the mean follow-up after revision was 16 months. None of 14 patients had a recurrence of the infection. The mean postoperative Harris Hip Score averaged 81 points and increaesd about 42 points than preoperative score (P<0.05).Conclusion The success of infection after hip arthroplasty are complete debridement, using antimicrobial agents-loaded cement spacer in two-stage revision.