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1、Construction of an articulating antibiotic-loaded cement spacer,与关节相连的带抗生素的结合剂假体,Options for management of infected total hip arthroplasties include suppressive antibiotic therapy, irrigation and debridement ,excision arthroplasty，single-stage exchange arthroplasty ,and 2-stage exchange arthroplasty
2、 . 选择处理感染髋关节的方法包括抑制抗生素疗法，冲洗，清创切除术，一种材料关节成形和二种材料关节成形。,Although selection of the most appropriate choice of management must be individualized to the patient ,2-stage exchange arthroplasty is a popular choice in north america because of the low recurrence of infection when this protocol is used . 尽管选择最
3、恰当方法必须对病人个体化，两种材料的关节成形在北美普遍选择因为使用这个 草案有较低的感染再发率,The interval insert of an antibiotic-loaded cement spacer is commonly used as part of a 2-stage exchange protocol to deliver a high local concentration of antibiotics and to prevent soft tissue contractures that may complicate the second stage procedur
4、e . 两种材料的关节成形普遍使用带抗生素的骨水泥以达到集中的高浓度的抗生素来阻止软组织感染和第二阶段恶化,The prosthesis of antibiotic-loaded acrylic cement ， an articulating cement spacer，has been described as a solution to the problems of limb-length discrepancy and decreased mobility during the interval period in 2-stage exchanges while maintainin
5、g a low rate of recurrent infection. 带有抗生素的丙烯酸材料的假体，形成一个与关节相连的结合剂间隙已经被认为是在使用两种材料关节成形时保持低的感染再发率 并解决肢体长度不一致和减少移动的一种方法。,prosthesis also allows soft tissue planes to be maintained , making surgical Two different types of the PROSTALAC implant have been proposed :one implant provides a cement-on-cement a
6、rticulation , and the other custom-made prosthesis provides a metal-on-polyethylene articulation . in addition to providing a vehicle for the delivery of a high dose of local antibiotic therapy ,these devices allow the patient to use crutches more easily with toe-touch weight bearing on the involved
7、 extremity. The continued mobilization of the extremity provided by the dissection at the time of reimplantation easier. 两种不同的带有抗生素的丙烯酸的假体已经被认为 ：一种提供了结合剂与结合剂的关节相连 ；另一种关节模型提供了一个金属与聚乙烯的关节相连。此外，提供了一种高剂量抗生素疗法的工具。这些这些装置可以使患者更容易使用拐杖负重。这个具有假体肢体的持续活动保持软组织面，使再植术的外科解解剖容易 。,We describe a simple method for the
8、intraoperative construction of an articulating antibioticloaded cement spacer in the design of a bipolar hemiarthroplasty for use in 2-stage exchange arthroplasty of the hip . 描述术中带有抗生素的结合剂间隙的假体装置的简单方法，这种装置是使用两种材料关节成形的设备，适用于双极半髋,Fig. 1. antibiotic-loaded cement is poured into the removed bulb of a s
9、yringe (arrow),and when it has reached a doughy consistency ,the femoral head of the prosthesis is inserted into it to form the metal-on cement articulation.,My Documents未标题-1.jpg,Fig. 2 . Appearance of the articulating spacer after removal of the bulb syringe to form a smooth surface that articulat
10、es with the acetabulum. The femoral component is coated with antibiotic-loaded cement before final insertion .,Fig .3. postoperative radiograph of the articulating antibiotic-loaded spacer in place.,Advantages of the articulating antibiotic-loaded cement spacer described include the use of materials
11、 already available in the operating room , the ease and speed in fashioning the spacer , a smooth cement-bone acetabular interface to minimize excessive bony wear ,and a constrained metal-on-cement articulation to minimize the risk of femoral head dislocation. The use of an articulating spacer allow
12、s for immediate limited weight bearing on the involved extremity ,an articulating hip joint with improved range of motion ,a vehicle for augmenting parenteral antibiotic therapy ,and maintenance of limb length. 带有抗生素的与关节相连的间隙的优点包括：所用的材料在手术市是可用的，形成间隙是容易和迅速的，一个光滑的骨与结合剂髋臼表面减少多余的骨磨损，一个拘束的金属和结合剂的关节相连减少股骨头的脱臼。与关节相连的间隙的作用允许相关肢体立即有限的负重，与髋关节相连的关节被证明有一定范围活动，也是增加肠外抗生素治疗和维持肢体长度的工具。,See you next time !thank you,
