Category: Scientific Paper

Technique for hip spacer dislocation reduction

  • Publication date: 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.

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)

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