Assessment of Functional Outcomes of Custom-made Articulating Spacers in Two Stage Arthroplasty for Treatment of Infected Hip Joint

Assessment of Functional Outcomes of Custom-made Articulating Spacers in Two Stage Arthroplasty for Treatment of Infected Hip Joint

The goal of this prospective observational study is to evaluate whether the use of a Custom-Made Articulating Spacer (CUMARS) can achieve satisfactory functional outcomes and effective infection control in patients undergoing two-stage revision for infected hip joints.

The main questions it aims to answer are:

Does the use of CUMARS provide acceptable functional outcomes during the interim period and after definitive reimplantation?

Does CUMARS result in effective infection eradication with acceptable perioperative parameters and complication rates?

Participants will:

Undergo first-stage removal of the infected hip prosthesis and implantation of a Custom-Made Articulating Spacer

Receive targeted systemic antibiotic therapy based on culture results

Be followed up clinically and radiologically to assess function, complications, and infection status

Undergo second-stage definitive hip reimplantation after confirmation of infection eradication

Purpose: This prospective study aimed to evaluate the functional outcomes, perioperative parameters, complication rates, and infection eradication achieved with the use of Custom-Made Articulating Spacer (CUMARS) in two-stage revision of infected hip joints.

Methods: This prospective single-arm study was conducted at a tertiary referral center and included 25 patients with chronic hip joint infections . All patients underwent two-stage revision with implantation of a CUMARS construct at the first stage. Functional outcomes were assessed using the Modified Harris Hip Score (mHHS) and Visual Analogue Scale (VAS) for pain. Perioperative parameters, complication rates, and infection eradication were also evaluated during the 2 stage procedure . Minimum follow-up after reimplantation was 24 months.

Inclusion Criteria:

• Age from 20-80 years old
• Patients with PJI after hip arthroplasty according to MSIS criteria 2018 OR ICM 2018.
• PJI > 4 weeks post operative
• Patients with chronic septic hip arthritis (either native or on top of infected proximal femur implant)

Exclusion Criteria:

• Age less than 20 years
• Early postoperative PJI
• Acute Hematogenous PJI
• Fungal infection
• Acute septic hip
• gouty arthritis