Antibiotic cement spacer for isolated medial wall acetabular deficiency in the setting of infected hip arthroplasty

Abstract

Periprosthetic joint infections remain challenging for orthopaedic surgeons. These are typically treated with 2-stage revision with an antibiotic spacer and arthroplasty reimplantation after infection eradication. We report a novel technique to create an antibiotic cement spacer construct in the setting of significant acetabular medial wall destruction due to osteolysis and infection. The medial wall of the acetabulum was reconstructed using antibiotic cement with 2 screws acting as a rebar. An acetabular liner was then cemented into place forming a cement construct similar to a reconstruction cage in function. This technique created a firm acetabular construct that allowed for the placement of a stable articulating spacer. The spacer allowed for infection eradication and was successfully converted into a revision total hip arthroplasty. Keywords: Periprosthetic joint infection, Antibiotic spacer, Total hip arthroplasty, Acetabular bone loss