Short term results of using teicoplanin and gentamicin combination added spacer after infected hip prosthesis

AIM: In this study, we aimed to evaluate the short time effects of teicoplanin and gentamicin combination loaded antibiotic spacers, in the treatment of hip periprosthetic joint infections (PJI). MATERIAL-METHOD: We retrospectively evaluated the 38 PJI patiens, whom were treated at our clinic. Patients with a minimum of one year follow-up, after eradication of the infection and total cure were included. Between February 2011 and November 2015, all of the patients had a surgical treatment with teicoplanin and gentamicin combination loaded antibiotic spacers, and intravenous antibiotic infusion under control of Infectious Diseases Department. Age, sex, side, type of infection, laboratory parameters, infectious agent, duration of spacer, duration of iv antibiotic infusion, postoperative complications and follow up periods were noted. Patients with lost of follow-up, postopertive exitus and shorter follow-up periods were excluded. FINDINGS: Of the 38 patients, 11 patients had hemi, 19 had total and 8 had revision arthroplasties at the time of PJI diagnosis. 14 patient which were operated recently and not finished the follow-up period, 3 patients with lost of follow up and 4 of postoperative exitus were excluded. 17 patients with a minimum of one year follow-up, after eradication of the infection and total cure were included. Of the 17 patients, 3 patients had hemi, 8 had total and 6 had revision arthroplasties before spacer application. Mean age of patient group was 65,94 (min.25-max.89) years, and mean follow-up period was noted as 952 (min.365-max.1684) days. Four were male and remaining 13 were female. Eight were right and 9 were left sided PJI cases. Persistent fistül tract at the surgical site was detected 9 of the patients. Tsukuyama classification was used to classify the cases. Nine were type 2, 6 were type 3 and 2 were type 4 PJI according to Tsukuyama. No recurrence were detected at the last follow-up. Revision hip arthroplasty procedure was done to 11 of these patients. 3 patients had a girdlestone procedure and the remaining 3 didn't give a consent to a new surgery and living with spacers. DISCUSSION-RESULTS: In our clinic, we recorded effective treatment of hip PJI cases with a success of 100%, in coordination with Infectious Diseases Clinic and in the light of current literature, with a minimum follow-up of one year