PMID- 33362995
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201229
IS  - 2218-5836 (Print)
IS  - 2218-5836 (Electronic)
IS  - 2218-5836 (Linking)
VI  - 11
IP  - 12
DP  - 2020 Dec 18
TI  - Improved patient reported outcomes with functional articulating spacers in 
      two-stage revision of the infected hip.
PG  - 595-605
LID - 10.5312/wjo.v11.i12.595 [doi]
AB  - BACKGROUND: Two-stage revision arthroplasty with an antibiotic-loaded spacer is 
      the treatment of choice in chronically infected total hip arthroplasties. 
      Interval spacers can be functional articulating or prefabricated. Functional 
      results of these spacers have scarcely been reported. AIM: To compare 
      retrospectively the patient reported outcome and infection eradication rate after 
      two-stage revision arthroplasty of the hip with the use of a functional 
      articulating or prefabricated spacer. METHODS: All patients with two-stage 
      revision of a hip prosthesis at our hospital between 2003 and 2016 were included 
      in this retrospective cohort study. Patients were divided into two groups; 
      patients treated with a functional articulating spacer or with a prefabricated 
      spacer. Patients completed the Hip Osteoarthritis Outcome Score and the EQ-5D-3L 
      (EQ-5D) and the EQ-5D quality of life thermometer (EQ-VAS) scores. Primary 
      outcomes were patient reported outcome and infection eradication after two-stage 
      revision. The results of both groups were compared to the patient acceptable 
      symptom state for primary arthroplasty of the hip. Secondary outcomes were 
      complications during spacer treatment and at final follow-up. Descriptive 
      statistics, mean and range are used to represent the demographics of the 
      patients. For numerical variables, students' t-tests were used to assess the 
      level of significance for differences between the groups, with 95% confidence 
      intervals; for binary outcome, we used Fisher's exact test. RESULTS: We 
      consecutively treated 55 patients with a prefabricated spacer and 15 patients 
      with a functional articulating spacer of the hip. The infection eradication rates 
      for functional articulating and prefabricated spacers were 93% and 78%, 
      respectively (P > 0.05). With respect to the functional outcome, the Hip 
      Osteoarthritis Outcome Score (HOOS) and its subscores (all P < 0.01), the EQ-5D 
      (P < 0.01) and the EQ-VAS scores (P < 0.05) were all significantly better for 
      patients successfully treated with a functional articulating spacer. More 
      patients in the functional articulating spacer group reached the patient 
      acceptable symptom state for the HOOS pain, HOOS quality of life and EQ-VAS. The 
      number of patients with a spacer dislocation was not significantly different for 
      the functional articulating or prefabricated spacer group (P > 0.05). However, 
      the number of dislocations per patient experiencing a dislocation was 
      significantly higher for patients with a prefabricated spacer (P < 0.01). 
      CONCLUSION: Functional articulating spacers lead to improved patient reported 
      functional outcome and less perioperative complications after two-stage revision 
      arthroplasty of an infected total hip prosthesis, while maintaining a similar 
      infection eradication rate compared to prefabricated spacers.
CI  - (c)The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights 
      reserved.
FAU - Veltman, Ewout S
AU  - Veltman ES
AD  - Department of Orthopaedic and Trauma Surgery, OLVG, Amsterdam 1091AC, 
      Netherlands. wout.veltman@gmail.com.
FAU - Moojen, Dirk Jan F
AU  - Moojen DJF
AD  - Orthopaedic and Trauma Surgery, OLVG, Amsterdam 1091AC, Netherlands.
FAU - Poolman, Rudolf W
AU  - Poolman RW
AD  - Department of Orthopaedic Surgery and Joint Research, OLVG, Amsterdam 1091AC, 
      Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20201218
PL  - United States
TA  - World J Orthop
JT  - World journal of orthopedics
JID - 101576349
PMC - PMC7745492
OTO - NOTNLM
OT  - Functional articulating spacer
OT  - Hip arthroplasty
OT  - Patient reported outcome
OT  - Periprosthetic joint infection
OT  - Prefabricated spacer
OT  - Two-stage revision
COIS- Conflict-of-interest statement: The authors have no conflict of interest to 
      mention.
EDAT- 2020/12/29 06:00
MHDA- 2020/12/29 06:01
PMCR- 2020/12/18
CRDT- 2020/12/28 11:57
PHST- 2020/04/11 00:00 [received]
PHST- 2020/10/09 00:00 [revised]
PHST- 2020/10/26 00:00 [accepted]
PHST- 2020/12/28 11:57 [entrez]
PHST- 2020/12/29 06:00 [pubmed]
PHST- 2020/12/29 06:01 [medline]
PHST- 2020/12/18 00:00 [pmc-release]
AID - 10.5312/wjo.v11.i12.595 [doi]
PST - epublish
SO  - World J Orthop. 2020 Dec 18;11(12):595-605. doi: 10.5312/wjo.v11.i12.595. 
      eCollection 2020 Dec 18.