Patient-specific articulating spacer for two-stage shoulder arthroplasty exchange. 2023

Kilian List, and Laura Elisa Streck, and Chiara Gaal, and Leonard Achenbach, and David Dines, and Maximilian Rudert
Department of Orthopedic Surgery, Koenig-Ludwig-Haus, University of Wuerzburg, Brettreichstraße 11, 97074, Wuerzburg, Germany. kilian.rueckl@gmail.com.

OBJECTIVE Two-stage exchange with an antibiotic-loaded polymethylmethacrylate (PMMA) spacer is standard treatment for chronic periprosthetic joint infection of the shoulder. We present a safe and simple technique for patient-specific spacer implants. METHODS (Chronic) periprosthetic joint infection of the shoulder. Known allergy against components of PMMA bone cements. Inadequate compliance for two-stage exchange. Patient is unfit to undergo two-stage exchange. METHODS Hardware removal, histologic and microbiologic samples, and debridement. Preparation of targeted or calculated antibiotic-loaded PMMA. Tailoring of patient-specific spacer. Spacer implantation. METHODS Rehabilitation protocol. Antibiotic treatment. Reimplantation after successful eradication of infection.

UI MeSH Term Description Entries
D012086 Reoperation A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery. Revision, Joint,Revision, Surgical,Surgery, Repeat,Surgical Revision,Repeat Surgery,Revision Surgery,Joint Revision,Revision Surgeries,Surgery, Revision
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000072228 Arthroplasty, Replacement, Shoulder Replacement of the SHOULDER JOINT. Shoulder Replacement Arthroplasty,Total Shoulder Replacement,Arthroplasties, Shoulder Replacement,Arthroplasty, Shoulder Replacement,Replacement Arthroplasties, Shoulder,Replacement Arthroplasty, Shoulder,Replacement, Total Shoulder,Replacements, Total Shoulder,Shoulder Replacement Arthroplasties,Shoulder Replacement, Total,Shoulder Replacements, Total,Total Shoulder Replacements
D000900 Anti-Bacterial Agents Substances that inhibit the growth or reproduction of BACTERIA. Anti-Bacterial Agent,Anti-Bacterial Compound,Anti-Mycobacterial Agent,Antibacterial Agent,Antibiotics,Antimycobacterial Agent,Bacteriocidal Agent,Bacteriocide,Anti-Bacterial Compounds,Anti-Mycobacterial Agents,Antibacterial Agents,Antibiotic,Antimycobacterial Agents,Bacteriocidal Agents,Bacteriocides,Agent, Anti-Bacterial,Agent, Anti-Mycobacterial,Agent, Antibacterial,Agent, Antimycobacterial,Agent, Bacteriocidal,Agents, Anti-Bacterial,Agents, Anti-Mycobacterial,Agents, Antibacterial,Agents, Antimycobacterial,Agents, Bacteriocidal,Anti Bacterial Agent,Anti Bacterial Agents,Anti Bacterial Compound,Anti Bacterial Compounds,Anti Mycobacterial Agent,Anti Mycobacterial Agents,Compound, Anti-Bacterial,Compounds, Anti-Bacterial
D001170 Arthritis, Infectious Arthritis caused by BACTERIA; RICKETTSIA; MYCOPLASMA; VIRUSES; FUNGI; or PARASITES. Arthritis, Bacterial,Arthritis, Septic,Arthritis, Viral,Arthritides, Bacterial,Arthritis, Suppurative,Bacterial Arthritides,Bacterial Arthritis,Infectious Arthritis,Suppurative Arthritis,Septic Arthritis,Viral Arthritis
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D016459 Prosthesis-Related Infections Infections resulting from the implantation of prosthetic devices. The infections may be acquired from intraoperative contamination (early) or hematogenously acquired from other sites (late). Prosthesis Related Infection,Prosthesis-Related Infection,Infections, Prosthesis-Related,Infection, Prosthesis Related,Prosthesis Related Infections,Related Infection, Prosthesis,Related Infections, Prosthesis
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D019904 Polymethyl Methacrylate Polymerized methyl methacrylate monomers which are used as sheets, moulding, extrusion powders, surface coating resins, emulsion polymers, fibers, inks, and films (From International Labor Organization, 1983). This material is also used in tooth implants, bone cements, and hard corneal contact lenses. PMMA,Polymethylmethacrylate,Acron,Acrylic Bone Cement,CMW Bone Cement,Implast,Kallocryl K,Lucite,Methyl Acrylic Plastic,Palacos R,Palavit,Perspex,Plexiglas,Plexiglass,Poly(methyl methacrylate),Polymethyl Methacrylate, Isostatic,Polymethyl Methacrylate, Simplex Opaque,Polymethyl Methacrylate, Surgical Simplex Bone Cement, Ammonium Salt,Polymethyl Methacrylate, Surgical Simplex P,Polymethyl Methacrylate, Syndiostatic,Polymethylmetacrylate,Sol,Superacryl,Isostatic Polymethyl Methacrylate,Methacrylate, Polymethyl,Methacrylate, Syndiostatic Polymethyl,Syndiostatic Polymethyl Methacrylate

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