Staged Custom, Intramedullary Antibiotic Spacers for Severe Segmental Bone Loss in Infected Total Hip Arthroplasty
Introduction. Total hip arthroplasty (THA) infections with severe bone loss pose significant reconstructive challenges. We present our experience with two-stage hip reimplantation using an intramedullary, antibiotic-impregnated nail. Methods. Three patients with infected THA with severe proximal fem...
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| Format: | Article |
| Language: | English |
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Wiley
2011-01-01
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| Series: | Advances in Orthopedics |
| Online Access: | http://dx.doi.org/10.4061/2011/398954 |
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| author | Atul F. Kamath Okechukwu Anakwenze Gwo-Chin Lee Charles L. Nelson |
| author_facet | Atul F. Kamath Okechukwu Anakwenze Gwo-Chin Lee Charles L. Nelson |
| author_sort | Atul F. Kamath |
| collection | DOAJ |
| description | Introduction. Total hip arthroplasty (THA) infections with severe bone loss pose significant reconstructive challenges. We present our experience with two-stage hip reimplantation using an intramedullary, antibiotic-impregnated nail. Methods. Three patients with infected THA with severe proximal femoral bone loss (Mallory type IIIB or greater) were treated using a custom antibiotic spacer. Clinical outcomes and any complications were recorded. Average followup was 49 months from final reimplantation. Results. Mean age at spacer placement (stage 1) was 53 years. The mean Harris Hip Score at final followup was 80. Two patients had asymptomatic heterotopic ossification, and one patient had a 2 cm leg-length discrepancy. Conclusions. A custom intramedullary nail antibiotic spacer is a reliable option in the staged management of the infected THA with severe proximal femoral bone loss. Benefits of this technique include limb salvage with maintenance of leg length, soft tissue tension, and functional status. |
| format | Article |
| id | doaj-art-1099f84a8a7446f3abd9af4d3d3b139f |
| institution | Kabale University |
| issn | 2090-3472 |
| language | English |
| publishDate | 2011-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Advances in Orthopedics |
| spelling | doaj-art-1099f84a8a7446f3abd9af4d3d3b139f2025-02-03T06:12:15ZengWileyAdvances in Orthopedics2090-34722011-01-01201110.4061/2011/398954398954Staged Custom, Intramedullary Antibiotic Spacers for Severe Segmental Bone Loss in Infected Total Hip ArthroplastyAtul F. Kamath0Okechukwu Anakwenze1Gwo-Chin Lee2Charles L. Nelson3Department of Orthopaedic Surgery, University of Pennsylvania, 3400 Spruce Street, 2 Silverstein, Philadelphia, PA 19104, USADepartment of Orthopaedic Surgery, University of Pennsylvania, 3400 Spruce Street, 2 Silverstein, Philadelphia, PA 19104, USADepartment of Orthopaedic Surgery, Penn Presbyterian Medical Center, Cupp 1, 39th and Market Streets, Philadelphia, PA 19104, USADepartment of Orthopaedic Surgery, Geisinger Medical Center, Danville, PA 17822, USAIntroduction. Total hip arthroplasty (THA) infections with severe bone loss pose significant reconstructive challenges. We present our experience with two-stage hip reimplantation using an intramedullary, antibiotic-impregnated nail. Methods. Three patients with infected THA with severe proximal femoral bone loss (Mallory type IIIB or greater) were treated using a custom antibiotic spacer. Clinical outcomes and any complications were recorded. Average followup was 49 months from final reimplantation. Results. Mean age at spacer placement (stage 1) was 53 years. The mean Harris Hip Score at final followup was 80. Two patients had asymptomatic heterotopic ossification, and one patient had a 2 cm leg-length discrepancy. Conclusions. A custom intramedullary nail antibiotic spacer is a reliable option in the staged management of the infected THA with severe proximal femoral bone loss. Benefits of this technique include limb salvage with maintenance of leg length, soft tissue tension, and functional status.http://dx.doi.org/10.4061/2011/398954 |
| spellingShingle | Atul F. Kamath Okechukwu Anakwenze Gwo-Chin Lee Charles L. Nelson Staged Custom, Intramedullary Antibiotic Spacers for Severe Segmental Bone Loss in Infected Total Hip Arthroplasty Advances in Orthopedics |
| title | Staged Custom, Intramedullary Antibiotic Spacers for Severe Segmental Bone Loss in Infected Total Hip Arthroplasty |
| title_full | Staged Custom, Intramedullary Antibiotic Spacers for Severe Segmental Bone Loss in Infected Total Hip Arthroplasty |
| title_fullStr | Staged Custom, Intramedullary Antibiotic Spacers for Severe Segmental Bone Loss in Infected Total Hip Arthroplasty |
| title_full_unstemmed | Staged Custom, Intramedullary Antibiotic Spacers for Severe Segmental Bone Loss in Infected Total Hip Arthroplasty |
| title_short | Staged Custom, Intramedullary Antibiotic Spacers for Severe Segmental Bone Loss in Infected Total Hip Arthroplasty |
| title_sort | staged custom intramedullary antibiotic spacers for severe segmental bone loss in infected total hip arthroplasty |
| url | http://dx.doi.org/10.4061/2011/398954 |
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