[Individual Megaspacers in Two-stage Revision of Infected Total Hip Arthroplasty-clinical and Functional Results After 2 Years : Individual Metal-endoskeleton Cement Spacer (iMECS)]

Overview

Journal Orthopadie (Heidelb)

Specialty Orthopedics

Date 2021 Oct 31

PMID 34718833

Authors

Martin Ellenrieder

Bastian Surmann

Andreas Enz

Soren Henning Toch

Robert Lenz

Wolfram Mittelmeier

Affiliations

Soon will be listed here.

Abstract

Background: Large femoral defects in late periprosthetic infection (PPI) after total hip arthroplasty (THA) often require the use of large, individual metal endoskeleton-reinforced cement spacers (iMECS).

Objectives: The aim was to record the clinical, radiological and functional results (Harris Hip Score HHS) up to the 2 years after treatment of a PPI using an iMECS. Major patient-specific parameters were to be evaluated with regard to the treatment outcome.

Materials And Methods: The collective of this single-center retrospective cohort study comprised 29 patients. The mean follow-up was 24.4 months (range: 23.0 to 27.6 months). The absence of infection after endoprosthetic hip joint reconstruction was rated as successful treatment. The two patient groups (successful (S)/not successful (nS)) were compared with regard to gender distribution, the Charlson comorbidity index (CCI), the number of previous septic changes, and the rate of polymicrobial and difficult-to-treat infections.

Results: The average CCI in the total collective was 6.4 points. Joint reconstruction was possible in 23 of 29 patients (79%); 2 years after PPI treatment 4 patients were not available for a follow-up examination (2 deceased, 2 unable to participate). At the time of the follow-up, 17 of the 29 patients had received a joint reconstruction and were free of infection, with an average HHS of 75 points. There were no iMECS-associated complications requiring revision. Only the initial CCI (S: 4.1 points; nS: 9.7 points) differed significantly between the patient groups (p < 0.05).

Conclusions: In the case of large femoral defects, iMECS provide secure temporary stabilization. The chance of a successful joint reconstruction is closely related to the individual comorbidities profile.

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