Abstract
Two-stage reconstructive technique has been proved to be a safe and effective method in the treatment of deep infection of hip joint implants. Between stages, however, the patients may be uncomfortable with limited mobility and activity because the joint function is severely restricted by the removal of the infected prosthesis and a thorough debridement. Furthermore, the delayed reimplantation procedure after a Girdlestone-like surgery is often complicated by shortening, bone loss, and dislocation due to scar formation, disuse osteoporosis, and distorted tissue planes.
We reported the technical details of a new method to make a cement-on-cement prosthesis as a temporary spacer for the period between resection and reimplantion. The doughy cement, mixed with antibiotics, was introduced into a metal mold made with the shape of a unipolar prosthesis to form the femoral component. Several large K-wires were placed in the mold in advance to act as strut support in order to prevent late fracture of the cement prosthesis. The remained cement was put into the acetabular cavity and molded into a hemispherical shape with a retrieved unipolar prosthesis of identical femoral head size. After consolidation of the cement, the femoral component was taken out from the metal mold and implanted into the femoral canal with fixation by antibiotic-loaded cement on the proximal portion.
Between the year 1999 and 2000, we have treated 42 infected hip implants by this technique with few complications. This new molding method has been a routine procedure in our practice. We believe it to be a simple, safe, and inexpensive way to eradicate local infection and provide comfort and mobility for the patient and an easier reimplantation procedure for the surgeon.
The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.
