Retaining well-fixed cementless stem in the treatment of infected hip arthroplasty

Open Access This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the source is credited. DOI 10.3109/17453674.2013.814013 Sir—I have read the Acta article: Retaining well-fixed cementless stem in the treatment of infected hip arthroplasty” by Lee et al. (2013). The authors present outcome in 19 patients with infected hip arthroplasties and a well-fixed cementless stem intraoperatively tested by a stem retractor. Treatment consisted of removal of the acetabular cup, liner and head, and implantation of a cup of a cement spacer. At a mean follow-up of 4 years 15 of 17 patients had no recurrence of infection. The authors stated that there have been no results of stem-retaining 2-staged revision in the literature. However, we have published a similar study reporting on 13 patients with infected hip arthroplasties and well-fixed stems (Anagnostakos et al. 2010). In all cases a preoperative bone scintigraphy excluded involvement of the stem. Intraoperatively, the stem fixation was also tested by a stem retractor. Treatment consisted of removal of the acetabular cup, liner and head, and implantation of an antibiotic-loaded cement spacer head. At a mean follow-up of 5 years the infection was healed in 11 of 12 cases.