Management of the infected arthroplasty using antibiotic-loaded hydroxyapatite blocks combined with cement spacer

摘要

The treatment and management of the infected arthroplasty is extremely difficult. In case of infection with MRSA, vancomycin often will be first choice, but the surgeons have to pay attention to handle it, since it is very delicate for heat. The choice of bone cement with low polymerization heat, or another method using HAb as a career of the powder of the drugs should be needed. We performed the two-stage reconstruction using antibiotic-loaded HAb combined with cement spacer. The advantages of our method are to avoid loss of efficacy of the antibiotic from polymerization heat of bone cement, to place HAb with cement spacer in a portion to anticipate the effect of an antibiotic, and to fill the void space. Our data showed satisfactory results For hip cases, but approximately half cases underwent resection arthroplasty in knee cases. The infected knees are more intractable, probably because the thickness of subcutaneous tissue as a barrier for micro-organisms compared to hip cases.