Managing The Interval in 2-Stage Revision for Prosthetic Joint Infection in Total Hip Replacement: Choice of Articulating Spacer?

Description

This transcript captures a presentation by James Coleman, a foundation-year doctor from Wales, discussing a case series on the interval management of prosthetic joint infections (PJI). He highlights the severe implications of PJI, including a high mortality rate that exceeds that of common cancers. Coleman explains different spacer options in two-stage revisions, noting complications tied to non-articulating and articulating designs. He reports findings from a study of 68 two-stage revisions performed between 2005 and 2018, where complications were recorded, with a focus on the differences in complication rates between constrained and non-constrained spacers. He also addresses the impact of interval length on complication occurrences and stresses the importance of optimizing patient health for better second-stage outcomes. Moreover, Coleman discusses his evolving practice with constrained liner spacers which can reduce dislocation risks, preserving soft-tissue tension and minimizing complications during surgery. In the Q&A session following his presentation, Coleman responds thoughtfully to audience inquiries about bone loss complications and the potential for shifting surgical strategies based on his findings.

DOI: 10.1302/3114-221674

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