Usefulness of Prosthesis Made of Antibiotic-Loaded Acrylic Cement as an Alternative Implant in Older Patients With Medical Problems and Periprosthetic Hip Infections: A 2- to 10-Year Follow-Up Study

The purpose of this study was to compare the clinical outcomes after 2-stage revision with those following single-stage revision in patients who developed periprosthetic joint infection after primary hip arthroplasty.

Between January 2004 and January 2013, we retrospectively reviewed patients who developed periprosthetic joint infection after primary hip arthroplasty and who underwent surgery for placement of a prosthesis made of antibiotic-loaded acrylic cement (PROSTALAC). Patients were divided into 2 groups based on the stages of revision. Group A was made up of patients who had undergone 2-stage revision using PROSTALAC as an interim prosthesis. Group B was made up of patients who had been compelled to undergo single-stage revision using PROSTALAC as an alternative implant because of older age and/or medical problems. Clinical outcomes were evaluated using a visual analog scale to score pain by calculating the Harris Hip Score and by determining the patient’s walking ability.

There were 20 patients in group A and 19 patients in group B. The mean follow-up period after final surgery was 68.8 months (range, 24-114 months). The infection resolution rate after initial PROSTALAC placement was 92.3%, and the final resolution rate was 94.9%. The visual analog scale and Harris Hip Score of group A were significantly better than those of group B. However, no significant difference in walking ability was found between the 2 groups.

Although the clinical outcomes in patients with PROSTALAC implants were not as good as those who underwent 2-stage revision, PROSTALAC can be a useful alternative implant in selected patients who are debilitated because of older age and/or who have critical medical problems.