Long Cephalomedullary Nails Can Be a Cheap and Effective Interval Revision Prosthesis in Infected Hip Replacements That Require Proximal Femoral Replacement: A Small Case Series
Hip prosthetic joint infection management is complex and expensive, especially in severe bone loss. Reducing the price of interval prosthesis when performing staged revision could minimize costs without compromising outcomes. We present 2 similar techniques developed independently that use an antibi...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-10-01
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| Series: | Arthroplasty Today |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344123001231 |
| _version_ | 1797653947114061824 |
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| author | Boopalan Ramasamy, MS, FRACS Aaron Scott Hammat, BHMS (Hons) Renjy Nelson, MD, FRACP Stuart Adam Callary, BAppSc, PhD Ping Keung Chan, MBBS, FRCSEd (Orthopaedic Surgery) Lucian Bogdan Solomon, MD, PhD, FRACS |
| author_facet | Boopalan Ramasamy, MS, FRACS Aaron Scott Hammat, BHMS (Hons) Renjy Nelson, MD, FRACP Stuart Adam Callary, BAppSc, PhD Ping Keung Chan, MBBS, FRCSEd (Orthopaedic Surgery) Lucian Bogdan Solomon, MD, PhD, FRACS |
| author_sort | Boopalan Ramasamy, MS, FRACS |
| collection | DOAJ |
| description | Hip prosthetic joint infection management is complex and expensive, especially in severe bone loss. Reducing the price of interval prosthesis when performing staged revision could minimize costs without compromising outcomes. We present 2 similar techniques developed independently that use an antibiotic-coated cephalomedullary nail with a total hip arthroplasty bearing (head and cemented acetabular component) attached to it as an interval proximal femoral replacement prosthesis. Using this technique, the femoral implant cost was reduced up to 10-fold. All patients have recovered well with resolution of infection and functional recovery similar to patients undergoing proximal femoral replacement. In one case, the lag screw (femoral neck) fractured at 5 months prompting the second-stage revision. This complication should be considered when deciding the timing of second-stage revisions in these cases. |
| first_indexed | 2024-03-11T16:52:14Z |
| format | Article |
| id | doaj.art-3a7d4880361d4fc79997273f6d3dfa25 |
| institution | Directory Open Access Journal |
| issn | 2352-3441 |
| language | English |
| last_indexed | 2024-03-11T16:52:14Z |
| publishDate | 2023-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj.art-3a7d4880361d4fc79997273f6d3dfa252023-10-21T04:22:51ZengElsevierArthroplasty Today2352-34412023-10-0123101218Long Cephalomedullary Nails Can Be a Cheap and Effective Interval Revision Prosthesis in Infected Hip Replacements That Require Proximal Femoral Replacement: A Small Case SeriesBoopalan Ramasamy, MS, FRACS0Aaron Scott Hammat, BHMS (Hons)1Renjy Nelson, MD, FRACP2Stuart Adam Callary, BAppSc, PhD3Ping Keung Chan, MBBS, FRCSEd (Orthopaedic Surgery)4Lucian Bogdan Solomon, MD, PhD, FRACS5Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, South Australia, Australia; Centre for Orthopaedic and Trauma Research, The University of Adelaide, Adelaide, South Australia, Australia; Corresponding author. Royal Adelaide Hospital, 1 Port Road, Adelaide, South Australia 5000, Australia. Tel.: +61870741997.Centre for Orthopaedic and Trauma Research, The University of Adelaide, Adelaide, South Australia, AustraliaDepartment of Infectious Diseases, Royal Adelaide Hospital, Adelaide, South Australia, AustraliaDepartment of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, South Australia, Australia; Centre for Orthopaedic and Trauma Research, The University of Adelaide, Adelaide, South Australia, AustraliaDepartment of Orthopaedics and Traumatology, Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong KongDepartment of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, South Australia, Australia; Centre for Orthopaedic and Trauma Research, The University of Adelaide, Adelaide, South Australia, AustraliaHip prosthetic joint infection management is complex and expensive, especially in severe bone loss. Reducing the price of interval prosthesis when performing staged revision could minimize costs without compromising outcomes. We present 2 similar techniques developed independently that use an antibiotic-coated cephalomedullary nail with a total hip arthroplasty bearing (head and cemented acetabular component) attached to it as an interval proximal femoral replacement prosthesis. Using this technique, the femoral implant cost was reduced up to 10-fold. All patients have recovered well with resolution of infection and functional recovery similar to patients undergoing proximal femoral replacement. In one case, the lag screw (femoral neck) fractured at 5 months prompting the second-stage revision. This complication should be considered when deciding the timing of second-stage revisions in these cases.http://www.sciencedirect.com/science/article/pii/S2352344123001231Gamma nailFirst stage revisionPJITemporary spacerInfected arthroplastyCephallomedullary nail |
| spellingShingle | Boopalan Ramasamy, MS, FRACS Aaron Scott Hammat, BHMS (Hons) Renjy Nelson, MD, FRACP Stuart Adam Callary, BAppSc, PhD Ping Keung Chan, MBBS, FRCSEd (Orthopaedic Surgery) Lucian Bogdan Solomon, MD, PhD, FRACS Long Cephalomedullary Nails Can Be a Cheap and Effective Interval Revision Prosthesis in Infected Hip Replacements That Require Proximal Femoral Replacement: A Small Case Series Arthroplasty Today Gamma nail First stage revision PJI Temporary spacer Infected arthroplasty Cephallomedullary nail |
| title | Long Cephalomedullary Nails Can Be a Cheap and Effective Interval Revision Prosthesis in Infected Hip Replacements That Require Proximal Femoral Replacement: A Small Case Series |
| title_full | Long Cephalomedullary Nails Can Be a Cheap and Effective Interval Revision Prosthesis in Infected Hip Replacements That Require Proximal Femoral Replacement: A Small Case Series |
| title_fullStr | Long Cephalomedullary Nails Can Be a Cheap and Effective Interval Revision Prosthesis in Infected Hip Replacements That Require Proximal Femoral Replacement: A Small Case Series |
| title_full_unstemmed | Long Cephalomedullary Nails Can Be a Cheap and Effective Interval Revision Prosthesis in Infected Hip Replacements That Require Proximal Femoral Replacement: A Small Case Series |
| title_short | Long Cephalomedullary Nails Can Be a Cheap and Effective Interval Revision Prosthesis in Infected Hip Replacements That Require Proximal Femoral Replacement: A Small Case Series |
| title_sort | long cephalomedullary nails can be a cheap and effective interval revision prosthesis in infected hip replacements that require proximal femoral replacement a small case series |
| topic | Gamma nail First stage revision PJI Temporary spacer Infected arthroplasty Cephallomedullary nail |
| url | http://www.sciencedirect.com/science/article/pii/S2352344123001231 |
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