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REVIEW  HIP PERIPROSTHETIC JOINT INFECTIONS: PREVENTION, DIAGNOSIS AND TREATMENT 

Minerva Orthopedics 2022 August;73(4):389-99

DOI: 10.23736/S2784-8469.21.04200-0

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Salvage strategies in reconstruction after hip periprosthetic joint infections: the implant. How to choose the correct implant to restore the bone loss and the soft tissue disruption after periprosthetic joint infections

Loris PERTICARINI 1 , Stefano M. ROSSI 1, Fabio MANCINO 2, Rudy SANGALETTI 3, Francesco BENAZZO 1, 3

1 Section of Robotic Prosthetic Surgery, Unit of Sports Traumatology, Department of Orthopedics and Traumatology, Poliambulanza Foundation, Brescia, Italy; 2 IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy; 3 University of Pavia, Pavia, Italy



Revision total hip arthroplasty in the setting of femoral and acetabular bone loss is a challenging procedure and requires a solid understanding of the current salvage procedure. Despite major developments in implants and materials available for managing the bone defects, their reconstruction remains a major problem in order to achieve primary stability and durable fixation without sacrificing additional bone stock. Although multiple classifications have been reported for femoral and acetabular side, the Paprosky system is the most commonly used to describe the defects and guide treatment strategy. Multiple femoral options are currently available to manage severe bone loss including impaction bone grafting with cemented stem, megaprosthesis, cortical strut grafts or segmented allografts as a prosthetic composite. In addition, variable alternatives have been proposed also for the acetabular side including impaction bone grafting with metal mesh, reinforcement rings and antiprotrusio cage, highly porous metal augments, cup-cage constructs, and custom- made triflange cups. However, considering the lack of high-quality long-term outcomes studies, there remains no consensus on which technique provides better outcomes for each side. The purpose of this study was to review the current literature and provide a comprehensive understanding of the available options for salvage reconstruction procedure after massive bone loss in periprosthetic joint infection.


KEY WORDS: Reoperation; Hip prosthesis; Infections

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