The Use of a Supra-Acetabular Antibiotic loaded Cement shelf to Improve Hip Stability in first-Stage Infected Total Hip Arthroplasty

Background: Antibiotic-loaded cement spacers in first-stage revision total hip arthroplasty (THA) for managing infection are associated with high dislocation and fracture rates. The aim of this study is to report the use of an antibiotic loaded cemented supra-acetabular roof augmentation to reinforce hip stability after cement spacer insertion for first-stage total hip revision in the treatment of infected THA.

Methods: We retrospective reviewed a consecutive series of 50 THA`s involving 47 patients with an infected hip requiring staged revisions THA. We documented dislocation, reinfection, time for revision and outcome.

Results: There were no cases of hip dislocation, cement fractures or any other technical complications associated with the use of the roof augmentation lip. Thirteen cases (26%) had a cemented spacer for longer than 120 days. Seven (14%) cases had recurrent infection after staged revision THA.

Conclusion: The antibiotic loaded cemented supra-acetabular roof augment improved femoral head spacer coverage for patients requiring a staged revision THA for infection.