Abstract
The experience that we gathered using uncemented stems for revisions with diaphyseal anchorage gave us satisfactory outcomes both for survival curve
(94% of cases – 15 yrs follow-up) and for clinical results in the aseptic mobilisations.
Thus, we extended this technique in the re-implant of septic prostheses.
We treated 43 cases of septic hip prostheses from 2003 to 2006. The treatment of choice has been the two-stage revision with the implant of temporary spacer, utilising the one-stage treatment just in few cases selected from needle-aspiration positive culture. The technique foresees the utilisation of Wagner uncemented revision stems in 98% of cases and 2% using a first implant prosthesis. Accompaniment antibiotic protocol has been protracted for 3 – 6 months till the negativity of the inflammation index.
Average follow-up of 26 months shows good clinical and radiographical results with percentage of a new revision of the two-stage in 2.32% (1 case).
The uncemented components are confirmed to be the best presidia for the implant stability retrieval in the immediate and long-term either, the two-stage strategy appears sure enough for the re-infections control especially associated with an adequate antibiotic treatment. Therefore, the choice strategy proposed by us favours the uncemented implants in combination with the two-stage.
Correspondence should be addressed to Vasiliki Boukouvala at Department of Orthopaedic Surgery & Traumatology, University Hospital of Larissa, 110 Mezourlo, Larissa, GREECE. Tel: +30 2410 682722, Fax: +30 2410 670107, Email: malizos@med.uth.gr
