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KMID : 0361620140490050355
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Journal of the Korean Orthopaedic Association
2014 Volume.49 No. 5 p.355 ~ p.365
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Long-Term Clinical Outcome of Two Stage Revision Surgery for Infected Hip Arthroplasty Using Cement Spacer
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Kang Joon-Soon
Moon Kyoung-Ho
Lee Tong-Joo
Kim Young-Tae
Ryu Dong-Jin
Choi Jae-Hwang
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Abstract
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Purpose : We retrospectively analyzed long-term clinical results after two-stage revision arthroplasty using an antibiotic-impregnated cement spacer for infected total hip arthroplasty.
Materials and Methods : Twenty-six hips (group 1: cup exchanged, group 2: cup and stem exchanged) were enrolled in this study. The mean follow-up period was 7.4 years (5 to 11 years). We analyzed the laboratory findings, the time interval between antibiotic-impregnated cement spacer insertion and revision arthroplasty, Harris hip score, Oxford hip score, radiologic changes, and recurrence of infection.
Results : Revision hip arthroplasty was performed at 7.5 weeks on average (group 1: 7.2 weeks, group 2: 7.7 weeks) after implant removal and cement spacer insertion. In group 1, Harris hip score was 51.1 points preoperatively, 84.4 points at six months, 89.3 points in at one year, 91.8 points at three years, and 89.8 points at five years. In group 2, the Harris hip score was 49.8 points preoperatively, 78.1 points at six months, 83.7 points at one year, 90.3 points at three years, and 88.7 points at five years. Recurrence of infection developed in one hip in each group.
Conclusion : Ninety-two percent of infected hips were eradicated with two-stage revision arthroplasty using an antibiotic-impregnated cement spacer for infected hip arthroplasty at minimum five-year follow-up. When the infection was limited to the hip joint and the stem was fixed well, two-stage revision with stem retained could be a good treatment option.
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KEYWORD
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hip arthroplasty, infection, revision, spacer
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