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DOS Kongressen 2016 ·
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Treatment of infected Exeter prosthesis with two
stage revisions and cement in cement implantation
Arnar Oskar Bjarnison, Leif Broeng
Department of Orthopaedics, Zealand University hospital; Department of
Orthopaedics, Zealand University hospital
Background:
The standard treatment of chronic PJI in THA is removal of the
alloplastic material together with the cement.
Purpose / Aim of Study:
The purpose of this study was to examine the post-
operative outcome of 8 patients, treated from 2012 until 2016, which had
prosthetic joint infection(PJI) from their primary cemented THA with Exeter
prosthesis, were 2 stage revisions were performed and the cement mantle in
the femoral canal conserved. A positive diagnosis of late PJI was considered
when 2 or more biopsies revealed a positive bacterial count.
Materials and Methods:
Clinical and operative data were evaluated retrospec-
tively. Age, sex, time from primary hip to revision, time from 1st to 2nd stage
revision, followup and results of microbiological cultures was registered. The
median age at the firsts tage revision procedure was 74(68 to 78). The median
followup period was 14 months(12 to 40). At followup a radiological evalua-
tion together with a clinical evaluation of pain and ability to walk, hip disability
and osteoarthritis outcome score was obtained. Complications concerning soft
tissue and antibiotic treatment was also registered. After the 1st stage revision
antibiotics were administrated. The 1st 2 weeks intravenously followed by at
least 4 weeks of per oral treatment. Patients had to be infection free before the
2nd stage revision for 4 to 6 weeks.
Findings / Results:
From the 8 patients treated from 2012 until 2016, 7 were
treated with successful eradication of the PJI, 1 required one soft tissue revision
followed by 5 weeks of antibiotic treatment after the 2nd stage revision and
one died from cardiac failure after the 1st stage revision.
Conclusions:
2stage revision with retention of femoral cement mantle in treat-
ment of infected THA is an effective methood of treating infected cementet
THA that show promising results.
No conflicts of interest reported
136.