Advantages of PROSTALAC Prepared by Modified Cement-coating Method / 대한정형외과학회잡지

ABSTRACT

PURPOSE: To report the clinical advantage and effect of our modified cement-coating method of PROSTALAC for the treatment of infected hip arthroplasty. MATERIALS AND METHODS: Twenty seven patients (mean age, 57), who had been treated with PROSTALAC after an infected hip arthroplasty, were enrolled in this study. Before surgery, the femoral stem was sterilized with gamma-radiation. During the operation, the stem was coated with antibiotics-impregnated cement and introduced into the femoral canal by several repeats of an insertion and removal procedure, just like a piston movement, to fit the stem into the intramedullary canal space. A bipolar hemiarthroplastic polyethylene liner was used for acetabular cup cement-fixation. A periodic hematologic test, such as ESR and CRP, the ability of early ambulation, leg length discrepancy and hip flexion, were checked for the clinical evaluation. RESULTS: CRP was normalized by an average of 4.2 weeks after the PROSTALAC operation. Partial weight bearing was possible 2 weeks after surgery, and mean leg length discrepancy and flexion of hip was 1.4 cm and 63.5degrees, respectively. PROSTALAC was still retained in 5 cases with satisfactory function. Reinfection after final reimplantation (22 cases) was noted in 4 cases (18.2%). Neither dislocation nor periprosthetic fracture occurred after reimplantation. CONCLUSION: The 2 phase treatment with PROSTALAC is an effective method for infected hip arthroplasty. PROSTALAC has considerable benefit for providing daily acting ability before the final reimplantation provided the appropriate surgical technique and strict sterilization of the inserted implements are combined.