Kh. Koo et al., Impregnation of vancomycin, gentamicin, and cefotaxime in a cement spacer for two-stage cementless reconstruction in infected total hip arthroplasty, J ARTHROPLA, 16(7), 2001, pp. 882-892
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.