What does this research mean for the field?

A commercially available articulating high-dose antibiotic cement spacer used in two-stage revision total hip arthroplasty for infection achieves an 89% five-year reinfection-free survival rate, though spacer dislocation strongly predicts dislocation after reimplantation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate five-year implant survival, complications, and functional outcomes associated with a partially intraoperatively fabricated articulating high-dose antibiotic cement spacer in two-stage revision total hip arthroplasty for infection.

September 2, 2026The Bone & Joint Journal

Five-year survival and complications of more than 300 articulating high-dose antibiotic spacers in two-stage revision total hip arthroplasties for infection

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Authors

MWMatthew T. WeintraubRush University Medical Center WMWilliam R. MidthunMayo Clinic in Arizona MPMark W. PagnanoMayo Clinic

Discussion

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Overview

Cohort study reveals an 89% five-year reinfection-free survival with articulating antibiotic spacers in revision hip arthroplasty, indicating that spacer dislocation predicts subsequent instability.

Key Points

To evaluate five-year implant survival, complications, and functional outcomes associated with a partially intraoperatively fabricated articulating high-dose antibiotic cement spacer in two-stage revision total hip arthroplasty for infection.
Analyzed 298 patients (302 total hip arthroplasties) undergoing two-stage exchange arthroplasty with an articulating antibiotic spacer between August 2005 and May 2022.
Excluded patients with prior failed two-stage exchanges, tracking outcomes over a mean follow-up of six years (range 2 to 16).
At five years post-reimplantation, survival free of reinfection was 89% (95% CI 85.2 to 93.1), aseptic rerevision was 93% (95% CI 89.3 to 96.1), any rerevision was 86% (95% CI 81.3 to 90.3), and any reoperation was 80% (95% CI 74.7 to 84.9).
Reinfection risk was significantly higher in McPherson host C (HR 3.7, 95% CI 1.4 to 9.6; p = 0.007) and limb grade 3 patients (HR 3.3, 95% CI 1.0 to 11.1; p = 0.049).
Dislocation of the temporary spacer occurred in approximately 5% of patients and strongly predicted dislocation of the final prosthesis after reimplantation (HR 6.2, 95% CI 2.3 to 16.9; p < 0.001).

Cite This Study

Weintraub et al. (2026) studied this question.

synapsesocial.com/papers/6a97e2eac562ede874ec74ed https://doi.org/10.1302/0301-620x.108b9.bjj-2026-0551.r1

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September 2, 2026The Bone & Joint Journal

Five-year survival and complications of more than 300 articulating high-dose antibiotic spacers in two-stage revision total hip arthroplasties for infection

View Full Paper

Ask AI

Bookmark

Authors

MWMatthew T. WeintraubRush University Medical Center WMWilliam R. MidthunMayo Clinic in Arizona MPMark W. PagnanoMayo Clinic

Discussion

Member takes

Overview

Cohort study reveals an 89% five-year reinfection-free survival with articulating antibiotic spacers in revision hip arthroplasty, indicating that spacer dislocation predicts subsequent instability.

Key Points

To evaluate five-year implant survival, complications, and functional outcomes associated with a partially intraoperatively fabricated articulating high-dose antibiotic cement spacer in two-stage revision total hip arthroplasty for infection.
Analyzed 298 patients (302 total hip arthroplasties) undergoing two-stage exchange arthroplasty with an articulating antibiotic spacer between August 2005 and May 2022.
Excluded patients with prior failed two-stage exchanges, tracking outcomes over a mean follow-up of six years (range 2 to 16).
At five years post-reimplantation, survival free of reinfection was 89% (95% CI 85.2 to 93.1), aseptic rerevision was 93% (95% CI 89.3 to 96.1), any rerevision was 86% (95% CI 81.3 to 90.3), and any reoperation was 80% (95% CI 74.7 to 84.9).
Reinfection risk was significantly higher in McPherson host C (HR 3.7, 95% CI 1.4 to 9.6; p = 0.007) and limb grade 3 patients (HR 3.3, 95% CI 1.0 to 11.1; p = 0.049).
Dislocation of the temporary spacer occurred in approximately 5% of patients and strongly predicted dislocation of the final prosthesis after reimplantation (HR 6.2, 95% CI 2.3 to 16.9; p < 0.001).

Cite This Study

Weintraub et al. (2026) studied this question.

synapsesocial.com/papers/6a97e2eac562ede874ec74ed https://doi.org/10.1302/0301-620x.108b9.bjj-2026-0551.r1

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