Acta Scientific Orthopaedics (ISSN: 2581-8635)

Research Article Volume 5 Issue 7

Modern Technologies in the First Stage Treatment of Deep Periprosthetic Hip Joint Infection

Valeriy Murylev1,2*, Grigoriy Kukovenko1,2, Pavel Elizarov1,2, Alexey Muzychenkov1,2, Alexander Zhuchkov2, Semen Alekseev2, Ivan Chizh1, Michail Elizarov1, Nursultan Stambekov1, Alexander Rudnev1 and Nikolay Erochin1,2

1Sechenov University: Pervyj Moskovskij Gosudarstvennyj Medicinskij Universitet Imeni I M Secenova. I.M.Sechenov First Moscow State Medical University Moscow. Russian Federation
2Municipal Clinical Hospital SP Botkin: Gorodskaia Klinicheskaia Bol'nitsa Imeni SP Botkina. (S. P. Botkin Moscow City Clinical Hospital.) Moscow. Russian Federation

*Corresponding Author: Valeriy Murylev, Sechenov University: Pervyj Moskovskij Gosudarstvennyj Medicinskij Universitet Imeni I M Secenova. I. M. Sechenov First Moscow State Medical University Moscow. Russian Federation.

Received: April 18, 2022; Published: June 17, 2022


Purpose: To evaluate the functional results of using 3D spacers for IIIA and IIIB defects according to the classification system described by W.G. Paprosky during the first stage of deep hip periprosthetic joint infection (PJI) treatment.

Patients and methods: From 2017 to 2020, 24 patients with hip PJI and IIIA and IIIB acetabular bone defects according to the W.G. Paprosky classification underwent first-stage revision arthroplasty. The patients were divided into 2 groups: group 1 received articulating spacers, and group 2 received 3D custom-made spacers. Function was evaluated by the Harris hip score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analogue scale (VAS). Statistical analyses were performed using IBM SPSS Statistics version 22.0 for Windows. Student's t-test, Wilcoxon's signed-rank test (to compare parameters before and after surgery) and the Mann-Whitney rank-sum test were used.

Results: In the first group, the average VAS score, HHS, and WOMAC score were 3.3 (± 1.4), 51.3 (± 9.4), and 42.9 (± 5.9), respectively; in the second group, the average VAS score, HHS, and WOMAC score were 1.3 (± 0.9), 69.7 (± 3.6), and 30.1 (± 2.4), respectively. The rating scale data showed a statistically significant improvement in the function of patients in the second group (p < 0.05).

Conclusion: Custom-made 3D spacers used during the first stage of treatment for deep periprosthetic hip infections yielded larger improvements in function and quality of life than articulating spacers.

Keywords: Revision Arthroplasty; Two-Stage Revision Arthroplasty; Hip Joint; Periprosthetic Infection; 3d Spacer; Custom-Made Spacer


  1. Pabinger C., et al. “Projections of hip arthroplasty in OECD countries up to 2050”. HIP International 5 (2018): 498-506.
  2. Kovochich M., et al. “Understanding outcomes and toxicological aspects of second-generation metal-on-metal hip implants: a state-of-theart review”. Critical Reviews in Toxicology 10 (2018): 853-901.
  3. Shubnyakov II., et al. “What Has Changed in the Structure of Revision Hip Arthroplasty?” Traumatology and Orthopedics of Russia4 (2019): 9-27.
  4. Yoon PW., et al. “Epidemiology of hip replacements in Korea from 2007 to 2011”. Journal of Korean Medical Science 6 (2014): 852-858.
  5. Tikhilov RM., et al. “Classifications of Acetabular Defects: Do They Provide an Objective Evidence for Complexity of Revision Hip Joint Arthroplasty? (Critical Literature Review and Own Cases)”. Traumatology and Orthopedics of Russia1 (2019): 122-141.
  6. Surendra Senthi., et al. “Infection in total hip replacement: meta-analysis”. International Orthopaedics 35 (2011): 253-260.
  7. Kukovenko GA., et al. “Importance of the Algorithm for Diagnosis of Late Deep Periprosthetic Hip Infection”. Traumatology and Orthopedics of Russia4 (2019): 75-87.
  8. Wiesel SW. “Essentials of Orthopedic Surgery Third Edition”. Springer. - N.Y. -USA (2007): 93-114.
  9. Burastero G., et al. “Acetabular spacers in 2-stage hip revision: is it worth it? A single-centre retrospective study”. Hip International (2016).
  10. Murylev VYu., et al. “Periprosthetic infection in hip arthroplasty”. Vrach (Doctor)3 (2018): 17-22.
  11. Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR). Hip, Knee and Shoulder Arthroplasty: 2018. Annual Report. Adelaide: AOA, (2018).
  12. Swedish Hip Arthroplasty Register Annual Report (2017).
  13. Akgün D., et al. “Outcome of hip and knee periprosthetic joint infections caused by pathogens resistant to biofilm-active antibiotics: results from a prospective cohort study”. Archives of Orthopaedic and Trauma Surgery 5 (2018): 635-642.
  14. CCH William., et al. “Antibiotic-laden Arthroplasty with a Novel Design of Cement Mould and Metallic Endoskeleton for Treatment of Hip Infection, an Inexpensive Alternative: A Preliminary Report of Two Cases”. Malaysian Orthopaedic Journal 2 (2017): 78-81.
  15. Paprosky WG., et al. “Acetabular defect classification and surgical reconstruction in evision arthroplasty. A 6-year follow-up evaluation”. The Journal of Arthroplasty 1 (1994): 33-44.
  16. Tsukayama DT., et al. “Infection after total hip arthroplasty A study of the treatment of one hundred and six infections”. The Journal of Bone and Joint Surgery 4 (1996): 512-523.
  17. Nishimura S., et al. “Chronic renal failure due to amyloid nephropathy caused by chronic infection after hip replacement”. CEN Case Reports2 (2014): 217-222.
  18. Eka A. “Patient-related medical risk factors for periprosthetic joint infection of the hip and knee”. Annals of Translational Medicine 16 (2015): 233.
  19. Brian P., et al. “Two-Stage Revision Total Hip Arthroplasty with a Specific Articulating Antibiotic Spacer Design: Reliable Periprosthetic Joint Infection Eradication and Functional Improvement”. The Journal of Arthroplasty 12 (2018): 3746-3753.
  20. Dall’Ava L., et al. “Comparative analysis of current 3D printed acetabular titanium implants”. 3D Printing in Medicine 1 (2019): 15.
  21. Bejon P. “Two-stage revision for prosthetic joint infection: predictors of outcome and the role of reimplantation microbiology”. Journal of Antimicrobial Chemotherapy 65 (2017): 569-575.
  22. Tikhilov R., et al. “Risk factors and a prognostic model of hip periprosthetic infection recurrence after surgical treatment using articulating and non-articulating spacers”. International Orthopaedics7 (2016): 1381-1387.
  23. Fu-Shine Yang., et al. “Mechanical failure of articulating polymethylmethacrylate (PMMA) spacers in two-stage revision hip arthroplasty: the risk factors and the impact on interim function”. BMC Musculoskeletal Disorders 20 (2019): 372.
  24. Jung J., et al. “Complications after spacer implantation in the treatment of hip joint infections”. International Journal of Medical Sciences 5 (2009): 265-273.
  25. Faschingbauer M., et al. “Mechanical complications with one hundred and thirty-eight (antibiotic-laden) cementspacers in the treatment of periprosthetic infection after total hip arthroplasty”. International Orthopaedics 5 (2015): 989-994.
  26. Hughes AJ., et al. “3D Printing Aids Acetabular Reconstruction in Complex Revision Hip Arthroplasty”. Hindawi Advances in Orthopedics (2017): 7.
  27. C Hurson., et al. “Rapid prototyping in the assessment, classification and preoperative planning of acetabular fractures”. Injury 10 (2007): 1158-1162.
  28. Bagaria V and Chaudhary K. “A paradigm shift in surgical planning and simulation 3Dgraphy: experience of first 50 surgeries done using 3D-printed biomodels”. Injury11 (2017): 2501-2508.


Citation: Valeriy Murylev., et al. “Modern Technologies in the First Stage Treatment of Deep Periprosthetic Hip Joint Infection".Acta Scientific Orthopaedics 5.7 (2022): 89-96.


Copyright: © 2022 Valeriy Murylev., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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