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component as their permanent prosthesis. The case with persistent infection after the first stagehad successful second stage debridement and successful implantation of permanent prosthesis atthird stage 6 months later. Two patients did not have a second-stage operation for implantationof the permanent prosthesis and retained the temporary prosthesis. Following the definition forsuccessful treatment outcomes, 11of 12 patients were treated successfully, with an overallsuccess rate of 91.6%. No patient had clinical, laboratory, or radiographic evidence of infectionat the final follow-up. Nine of eleven patients (81.81%) had an improvement of Harris hip scoreof at least 30 points.DiscussionMany surgical strategies have been described in an attempt to treat infected hip arthroplasty andend stage septic arthritis of the hip, with two-stage arthroplasty considered to be the treatmentof choice and more widely practiced than one-stage arthroplasty in most centres. After removalof prosthetic components and thorough debridement carried in the first stage, the surgeon is leftwith choice between leaving the joint space empty, or, much better, inserting antibiotic-loadedspacer whether static or functional .Static spacers, like antibiotic impregnated cement-coated rush pin or intramedullary nail,antibiotic-impregnated cement beads have the theoretical advantage of increased antibioticelution due to their large surface area, yet these spacers have the disadvantages of: skeletaltraction being required for 2-3 weeks postoperatively till muscle scaring takes place, withresulting muscle shortening; pain; joint instability; limited mobility; bone surface degradationthrough bone-on-bone contact or by toggling and abrasion by the static cement spacer [4].On the contrary, functional articulating spacers have the advantages of maintaining soft tissuetension, providing sufficient stability, preventing muscle contracture, and allowing the patient toambulate partial weight-bearing the day after surgery. Many varieties have been described, likePROSTALAC device available in a single size (42mm outer diameter, 32mm inner diameterwith a snap-fit design) and femoral component with several molds differing in size, femoraloffset, neck length, and stem length [5]; spacer G (TECRES S.P.A.) which is constructedentirely from gentamicin-loaded cement available in 3 sizes.In this study, we presented a modified technique to form a custom-made articulating spacerwith antibiotic elution through the antibiotic-impregnated cement used in both components ofthe construct. The technique gives versatility in forming a construct with different sizes that canmatch different sizes of acetabula and femoral canals to a great extent. This match between thespacer and bone anatomy is of ultimate importance to prevent toggling of the spacer withinbone and consequently decrease bone resorption during the interval period, and at the same timefile:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]