Low-dose vancomycin-loaded cement spacer for two-stage revision of infected total hip arthroplasty
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Date
2020Author
Caglar, Omur
Tokgozoglu, Mazhar
Akgun, Rahmi C.
Atilla, Bulent
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Objectives: This study aims to evaluate the success rate in terms of eradication of infection and long-term outcomes of two-stage revision arthroplasty with spacers loaded with low-dose vancomycin alone for the treatment of an infected hip arthroplasty.
Patients and methods: The records of 42 two-stage exchange arthroplasty patients (16 males. 26 females; mean age 61 years: range, 30 to 80 years) treated between January 1999 and January 2009 were included in this retrospective study. In the first stage. following removal of the prosthesis and debridement, a spacer consisting of 1 g of vancomycin per 40 g of cement was placed in the infected joint space. Patients received six weeks of intravenous antibiotics according to intraoperative cultures. After cessation of systemic antibiotic treatment, with normal C-reactive protein and erythrocyte sedimentation rate levels, second stage surgery with cementless components was performed.
Results: The mean follow-up duration was seven (range, 3 to 13) years. Two patients (4.7%) developed re-infection after two-stage reimplantation and one patient underwent a resection arthroplasty after repeated debridements. Five years of survival was 92.9% with Kaplan-Meier survival analysis.
Conclusion: For chronic infected total hip revisions, two-stage revision arthroplasty with low-dose vancomycin impregnated cement spacers have comparable re-infection and success rates. Low-dose vancomycin promotes effective infection control and reduces antibiotic toxicity.
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https://apps.webofknowledge.com/full_record.do?product=WOS&search_mode=GeneralSearch&qid=1&SID=E3V5riSPiJ4L6X6DkYx&page=7&doc=323http://hdl.handle.net/11727/5817
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