Technique for hip spacer dislocation reduction

Categoria: Scientific Paper

Technique for hip spacer dislocation reduction

Data di pubblicazione: 16/07/24

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Acetabular spacers in 2-stage hip revision: is it worth it? A single-centre retrospective study.

Authors

Burastero G, Basso M, Carrega G, Cavagnaro L, Chiarlone F, Salomone C, Papa G, Felli L.

Institute

Infectious Diseases and Septic Orthopaedics, Hospital St. Mary of Mercy, Albenga - Italy.
Orthopaedic Clinic - IRCCS University Hospital San Martino IST, Genova - Italy.

Journal

Hip Int. 2017 Mar 31;27(2):187-192.

Take Home message

A simple surgical technique to create an acetabular spacer can:
reduce hip spacer dislocation;
improve hip biomechanics;
simplify and shorten the second stage.

Study details		Score	Range
Subject	Clinical	-	-
Type	Retrospective study	2	1 - 5
Journal	J Bone Joint Inf	1	1 - 3

Summary

71 patients affected by hip PJI underwent two-stage revision with preformed GV spacers. 31 patients were treated with an OR-made acetabular spacer, while 40 did not.

Sample characteristics

71 pts (36 M, 35 F) with a mean age of 68Y (32 – 83)
31 pts with acetabular spacer, 40 pts without

Spacer implantation (range)

3M (with) vs 5M (without)

FU (range)

33M (8-44) vs 45M (10-52)

Study results

Infection eradication

96.8% (30/31) vs 92.5% (37/40)

Operation time

1st stage: 148 vs 142 mins
2nd stage: 83 vs 109 mins

Leg length discrepancy Offset

1.1mm vs 2.8mm (p = 0.03)
53mm vs 53mm (unaffected hip); 62mm vs 57 mm (affected hip)

Dislocation

3.2% (1/31) vs 10% (4/40)

Key points

Dislocation and leg length discrepancy can be reduced with the help of an acetabular spacer by improving biomechanics.
Offset can be restored or lateralised with a good abductor lever arm recovery with or without acetabular spacer.
A significant reduction in the operatory time of the second stage is achieved due to a better preservation of the bone stock when an acetabular spacer is applied.

Read on PubMed Find out more about Spacer for hip

Score

Study value	Description
*	Retrospective study
* *	Retrospective comparative Retrospective Register study
* * *	Prospective study Systematic review Meta-analysis
* * * *	Randomized controlled trial (RCT)
* * * * *	Systematic review of RCT

Journal value	Description
*	Low impact factor (<1.500)
* *	Medium impact factor (>1.500 – <2.500)
* * *	High impact factor (> 2.500)