Convened under the auspicious of esteemed endorsers - ISTA

polymerization, the outer mold is pealed from around the cemented stem; D. combinedfemoral stem with its cement mantle that match the femoral canal diameter.The final construct is cemented in place with antibiotic-impregnated polymethylmethacrylateand inserted during the late stages of polymerization to minimize osseous interdigitation tofacilitate later removal in the second stage. As regards the femoral component, cementation islimited to the proximal 3cm of the femoral canal. Modular head that achieves stability is thenapplied. Extramedullary rod formed of K-wire with antibiotic-impregnatedpolymethylmethacrylate cured around is inserted sub-muscular to provide elution of antibioticextramedullary, followed by closure in layers (Fig 5)Fig 5 A. acetabular component after cementation; B. Femoral component insertion withcementation limited to the proximal 3 cm of the femoral canal; C. extramedullary K-wirewith antibiotic-impregnated polymethylmethacrylate investing itIn septic hip arthritis the same technique is used after osteotomy of the neck and debridement ofthe infected and devitalized tissues.In the first stage, all necrotic and devitalised tissues are removed, and the functional temporaryprosthesis is inserted using the technique described. Tissue biopsy (5-6 specimens fromacetabulum and femur) are collected and sent for culture. Extended cultures for 2 weeks is ourprotocol to approve the results of culture with infection best predicted when three or more of theintraoperative cultures show growth of a consistent microorganism [3]. Even if we thought thatthe positive growth on culture was a contaminant, as is the case when only one of five culturespecimens is positive, we counted the case as a confirmed infection. This approach was taken toensure the safety of the procedure.During the interval period between the two stages: patient is allowed to mobilize and ambulatepartial weight-bearing with frame the day after surgery, intravenous antibiotics are administeredfor a minimum of 6 weeks, combined with oral rifampicin. The patient is followed clinicallyand radiologically; provided wound healing and inflammatory mediators (ESR and C-RP)levels are satisfactory, antibiotics discontinued and second stage performed. Numerousintraoperative samples are obtained for microbiological analysis during the second stage. Afile:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]