Retaining well-fixed cementless stem in the treatment of infected hip arthroplasty

Abstract

Sir—I have read the Acta article: Retaining well-fixed cementless stem in the treatment of infected hip arthroplasty” by Lee et al. (2013). The authors present outcome in 19 patients with infected hip arthroplasties and a well-fixed cementless stem intraoperatively tested by a stem retractor. Treatment consisted of removal of the acetabular cup, liner and head, and implantation of a cup of a cement spacer. At a mean follow-up of 4 years 15 of 17 patients had no recurrence of infection. The authors stated that there have been no results of stem-retaining 2-staged revision in the literature. However, we have published a similar study reporting on 13 patients with infected hip arthroplasties and well-fixed stems (Anagnostakos et al. 2010). In all cases a preoperative bone scintigraphy excluded involvement of the stem. Intraoperatively, the stem fixation was also tested by a stem retractor. Treatment consisted of removal of the acetabular cup, liner and head, and implantation of an antibiotic-loaded cement spacer head. At a mean follow-up of 5 years the infection was healed in 11 of 12 cases.