AI Article Synopsis
- The study investigates the effectiveness of using large bone allografts in patients with infected total hip arthroplasties (THAs) through a two-stage protocol.
- In the first stage, infected prostheses and necrotic tissues were removed, followed by the placement of a gentamicin-infused mold in 17 out of 18 patients, while systemic antibiotics were administered during the recovery period.
- Outcomes showed a significant improvement in hip function (Harris Hip Score increased from 34 to 71), with 16 of 18 patients achieving successful results, although one experienced recurrent infection and another had a mechanical failure of the implant.
Article Abstract
Background: The use of massive bone allografts in cases of revision of failed total hip arthroplasties (THAs) due to infection is controversial.
Patients And Methods: 18 patients presented with infection at the site of a THA and were treated with a two-stage protocol. In the first stage, the prosthesis was removed together with all necrotic tissues and cement material if present. A custom-made mold of Palacos R cement containing 1 g of gentamicin was then inserted in 17 of the 18 patients. Systemic antibiotics were used during the interval period. In the second stage, the patients had either acetabular or femoral reconstruction using bulk allograft bone.
Results: Mean follow-up was 9 (5-14) years. 1 patient presented with recurrent infection and underwent a Girdlestone resection arthroplasty as definitive treatment. Another patient had a mechanical failure of the acetabular component, which was revised 10 years after the second stage of the reconstruction. The mean Harris Hip Score improved from 34 points preoperatively to 71 points at the last review. By our definition, 16/18 of the patients had a successful outcome.
Interpretation: Our results support the use of massive allografts in staged reconstructions of infected THAs complicated by considerable bone loss.
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| http://dx.doi.org/10.1080/17453670610045740 | DOI Listing |
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