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Current Issue - July 2017, Volume 11, Issue No. 2

Official Journal of Malaysian Orthopaedic Association and ASEAN Orthopaedic Association

Antibiotic-laden Arthroplasty with a Novel Design of Cement Mould and Metallic Endoskeleton for Treatment of Hip Infection, an Inexpensive Alternative: A Preliminary Report of Two Cases


Infection of the hip after implant fixation is an uncommon yet devastating complication that results in poor long-term outcome. The gold standard treatment for chronic infection after hip arthroplasty is a two-stage protocol: eradication of infection, follow by re-implantation arthroplasty. The use of interim antibiotic-laden cement spacer has become a popular procedure to maintain hip joint function and provide antibiotic elution simultaneously before re-implantation. However, antibiotic cement spacer is mechanically weak and breaks if overloaded. Therefore, we designed a cement mould with metallic endoskeleton with the aim of creating a stronger, inexpensive, antibiotic-impregnated spacer resembling a unipolar arthroplasty. We report two cases of severe hip joint infection after implant fixation (bipolar hemiarthroplasty, screw fixation neck of femur). Both patients had undergone first stage surgery of debridement and articulating antibiotic cement insertion using our design. Although the second stage surgery was planned for these patients, both patients delayed the operation in view of good functional status after a year walking with the antibiotic cement spacer. These cases showed that the mechanical property of the new antibiotic cement spacer was promising but further mechanical studies upon this new endoskeleton design are required.

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The Malaysian Orthopaedic Journal is a peer-reviewed journal that is published three times a year in both print and electronic online version. The purpose of this journal is to publish original research studies, evaluation of current practices and case reports in various subspecialties of orthopaedics and traumatology, as well as associated fields like basic science, biomedical engineering, rehabilitation medicine and nursing.

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