Table 1.
Results of two-stage cementless revision of periprosthetic infection of the hip
| Study | Number | Study type | Followup | Spacer/beads | Local antibiotics | Duration of intravenous antibiotics | Interval until reimplantation | Antibiotics after implantation | Implants | Eradication rate | Aseptic loosening | HHS |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Wilson and Dorr [67] | 22/13* | Retrospective | ≥ 3 years, 48 months | Resection arthroplasty | No | 3 weeks parenteral | 6–12 weeks | 3 days parenteral | Different, nm stems | 91%/100% cementless | 7.6% stem loose | 75 |
| Nestor et al. [51] | 34 | Retrospective | 47 (24–72) mo | Resection arthroplasty | No | ≥ 4 weeks parenteral | 8 (3–19) months | Different | Different, nm stems | 82% | 18% stem loose | |
| Fehring et al. [16] | 25 | Retrospective | 41 (24–98) months | Beads | Tobramycin in 16 cases | 6 weeks parenteral | 4.8 months | Different, nm stems + modular with pf | 92% | 0% | 81 (30–100) | |
| Haddad et al. [30] | 50 | Retrospective | 5.8 (2–8.7) years | Beads + cement ball | Gentamicin | 5 days parenteral and then oral | 3 weeks | ≥ 3 months | Different, nm stems | 92% | 8% stem subsidence | 78 (54–92) |
| Koo et al. [40] | 22 | Prospective, includes acute and late periprosthetic infections | 41 (24–78) months | Spacer, beads | Vancomycin, gentamicin, cefotaxime | 6 weeks | 6–12 weeks | Different, nm stems | 95% | 5% cup loose, 30% stem subsidence | ||
| Hofmann et al. [35] | 27 | Retrospective | 76 (28–148) months | Old stem and new polyethylene cup | Tobramycin | 6 weeks parenteral, in 17 cases additional oral for 6 weeks | Different, nm stems | 94% | 0% | 53 (36–68) | ||
| Kraay et al. [41] | 33 | Retrospective | ≥ 2 years | Spacer in 16 cases | Tobramycin in 16 cases | ≥ 6 weeks parenteral | 7.4 (3–37) months | Different, nm + modular stems | 92% | 9% cup, 0% stem | ||
| Masri et al. [45] | 29 | Retrospective | ≥ 2 years | PROSTALAC® spacer | Tobramycin, vancomycin, cefuroxime, penicillin† | 6 weeks parenteral or in combination with oral | 12 weeks | 5 days intravenous | Different, nm stems, 2 strut grafts | 90% | 0% | 70 (42–100) |
| Current study | 36 | Prospective | ≥ 2 years 35 (24–60) months | Spacer | Specific: gentamicin, clindamycin, vancomycin, ampicillin, ofloxacin | 2 weeks parenteral, 4 weeks oral | 6 weeks | 2 weeks parenteral, 4 weeks oral | One modular stem with distal fixation | 100% | 6% stem subsidence, 0% loosening | 90 (60–100) |
* 13 of 22 reimplantations without cement; †combination of another local antibiotic with tobramycin; HHS = Harris hip score; nm = nonmodular; pf = proximal fixation.