The Use of Antibiotic Impregnated Cement Spacers in the Treatment of Infected Total Joint Replacement: Challenges and Achievements

Abstract

Two stage total hip arthroplasty revision surgery includes foreign material debridment, insertion of antibiotic impregnated<br />cement spacer, and finally, reimplantation of the prosthesis. This review has aimed to evaluate the efficacy of antibiotic<br />impregnated cement spacers in infection control and eradication in arthroplasties.<br />A total of 85 articles on total hip arthroplasty were used in this narrative literature review.<br />High concentrations of the antibiotic in targeted drug delivery by means of using antibiotic impregnated cement<br />spacers is effective against infections while reduces the side effects of systemic antibiotic therapy. This results in<br />prevention of bone and muscle atrophy as well as size discrepancy. Also, antibiotic impregnated cement spacers<br />reduce dead space and help stabilize the limb in total hip arthroplasty. Despite all reported drawbacks, antibiotic<br />impregnated cement spacers seem effective in eradicationg infections, although a consensus has not been yet<br />achieved.<br />Level of evidence: I