Custom made articulating hip spacer for staged revision in Birmingham hip resurfacing.

Abstract

Two-stage revisions of infected hip arthroplasties have achieved success rates of over 90%. We have devised a method for custom making an antibiotic impregnated bone cement spacer, which is implanted into the retained femoral neck after explantation of the prosthesis. This spacer preserves bone stock and abductor muscle length, allows weight bearing and is cheaper than off-the-shelf spacers. After explantation of the acetabular component, an acetabular trial device of the same size is lined with a sterile glove and used as a mould, into which bone cement is poured (Figs 1 and ​and2).2). Two Steinmann pins are inserted into the spacer before it sets (Fig 3). Figure 1 Antibiotic impregnated bone cement poured into sterile glove lined total hip replacement acetabular trial and Steinmann pins inserted in centre Figure 2 Lateral view of spacer in mould (glove removed) Figure 3 Radiograph showing implanted spacer in retained femoral neck, preserving abductor muscle tension and allowing weight bearing