• Andrea Sambri, Michele Fiore, Claudia Rondinella, Lorenzo Morante, Azzurra Paolucci, Claudio Giannini, Calogero Alfonso, and Massimiliano De Paolis.
• IRCCS Azienda Ospedaliera Universitaria di Bologna, Via Massarenti 9, 40138, Bologna, Italy. andrea_sambri@libero.it.
• Arch Orthop Trauma Surg. 2023 May 1; 143 (5): 234123532341-2353.

IntroductionTemporary spacers used in the staged revision of a hip prosthetic joint infection (PJI) have been associated with several mechanical complications with very variable reported general complications rates up to 73%. The aim of this systematic review was to assess the mechanical complications associated with hip antibiotic-loaded spacers when treating periprosthetic hip PJI.MethodsThrough an electronic systematic search of PubMed, articles reporting mechanical complications of spacers used in the treatment of hip PJI were reviewed. Dislocations, spacer fracture, femoral fractures, and acetabular lysis rates were evaluated.ResultsForty studies were included. Standardized molded spacers had a significantly higher weighted mean of total mechanical complication rates (37.2%) when compared to standardized preformed spacers (13.8%, p = 0.039), while no significant difference was found between molded spacers and manually shaped spacers. Spacer dislocation was the most frequent complication. No significant difference in mechanical complication rate was found between spacers with and without any metallic component.ConclusionsSpacer placement in chronic PJI of the hip with bone and soft-tissue defects is challenging and bears a high risk of mechanical failures and progressive bone loss during the interim period. A careful patient selection for spacer implantation is mandatory.© 2022. The Author(s).

28 keywords...

hide…