Impregnation of vancomycin, gentamicin, and cefotaxime in a cement spacer for two-stage cementless reconstruction in infected total hip arthroplasty

Twenty-two patients with infected total hip arthroplasty were treated with 2-stage arthroplasty, using a cement spacer impregnated with a combination of 3 thermostable antibiotics (vancomycin, gentamicin, and cefotaxime). Ini tially, implants were removed, and a spacer was inserted. Six to 12 weeks l ater, the spacer was removed, and the patients underwent reconstruction usi ng cementless components. The patients were followed for an average of 41 m onths. One patient had a recurrence of infection and was treated with resec tion arthroplasty. The remaining 21 patients (95%) had no evidence of infec tion at the final follow-up. We recommend using the combination of these 3 antibiotics in the cement spacer for 2-stage reconstruction in infected hip arthroplasty when the causative organism is not identified in the culture of preoperative aspiration.