The experience of surgical treatment of tuberculosis and non-specific arthritis with two-stage arthroplasty using articulating cement spacers saturated with antibiotics

Abstract

The objective: to analyze the results of surgical treatment of tuberculosis and non-specific arthritis of large joints of extremities by two-stage endoprosthesis replacement using cement articulating spacers saturated with antibiotics. Subjects and methods. The prospective single-center cohort trial included 36 clinical cases in 35 patients with purulent destructive arthritis of the hip, knee, and shoulder joints, who underwent two-stage surgery from 2010 to 2018. This method implied using cement articulating spacers at the first stage of surgery followed by replacement with a prosthetic implant. Joint tuberculosis was diagnosed in 7 (20.0%) patients, all other cases were non-specific arthritis. Results. In all 36 cases, patients underwent a full cycle of two-stage endoprosthesis replacement of joints affected by tuberculosis or non-specific infection resulting in pronounced destructive changes. In 33 clinical cases of the patients (91.67%), a positive outcome was observed with restoration of joint and extremity function in general with persistent eradication of the infection. An unfavorable outcome was obtained in 3 patients due to development of periprosthetic infection and loosening of the implant, 2 of them had tuberculous arthritis.

Keywords

• туберкулезный и неспецифический артрит
• артикулирующие цементные спейсеры
• метилметакриловый цемент
• насыщенный антибиотиками
• двухэтапное эндопротезирование суставов