Clinical Application Of Antibiotic Loaded Cement Spacer Prepared By 3D Printing Technology In Two-stage Revision Following Hip Arthroplasty

Objective:To investigate clinical effectiveness of application antibiotic loaded cement spacer prepared by 3D printing technology and hand fabricated in two-stage revision following hip arthroplasty.Methods: Retrospectively analyse of 37 patients(37 hips)underwent two-stage revision hip arthroplasty using 3D printing technology preparation and hand fabricated intra-operatively antibiotic loaded bone cement spacer from January 2010 to March 2018.With an average age of(59.2±11.3)years(the range from 30 to 82 years old).According to implantation different of antibiotic loaded cement spacer the patients were divided into 2groups: group A(n=20)implantation of antibiotic loaded cement spacer prepared by 3D printing technology;group B(n=17)implantation of hand fabricated articulating antibiotic loaded cement spacer.Comparison within the two groups of the spacer preparation?stage one operation time,stage one and stage two(reimplantation of THA)harris scores evaluation of clinical effect.Results: All the patients were followed up,group A followed up with an average of(23.5±10.4)months(the range from 12 to 48 months),group B followed up with an average of(35.7±8.9)months(the range from 25 to 56 months).Group A during the inter-stage period 1(5%)case occurred spacer fracture and 1(5%)case occurred dislocation.Group B2(11.8%)cases occurred spacer fracture.There was no significant difference in age,preoperatively harris scores and time to revision.Group B was statistically significant longer in spacer preparation and stage one operation time.Group A harris scores improved was significant difference with group B during the inter-stage period and following hip arthroplasty reimplantation at the 3 months and 6 months.While there was no significant difference between the groups in terms of at 1 year.Showed no recurrence during the follow-up period.Conclusion: Application of antibiotic loaded cement spacer prepared by 3D printing technology in two-stage revision following hip arthroplasty could shorten operation time,hip function improved significantly during early follow-up.