Prosthetic Infection

Patient-Specific Antibiotic Spacer for the Treatment of Complex Prostethic Infection

Joint replacement surgeries rarely result in infection when performed under ideal operating room conditions and with proper technique. However, roughly 3% of all joint replacement cases result in prosthetic infections. Prosthetic infection is a challenging process that often requires multiple-stage surgeries, including the removal of the installed prosthesis.

 An infection that emerges after the first four weeks of the surgery generally shows deep penetration to bone tissue and thus is considered a chronic prosthetic infection. It is often not possible to treat this condition solely with antibiotics. Therefore, as mentioned above, prosthesis removal is frequently a prerequisite for cleaning the bone from infection. After the prosthesis is removed, a temporary antibiotic-loaded cement spacer is implanted in its place. The spacer, made from antibiotic-laden cement, releases a high concentration of antibiotics at the application site, killing the infection source bacteria embedded in the bone tissue and playing a crucial role in treating prosthesis infection.

Commercial ready-made spacers produced in standard shapes and various sizes are often preferred due to their ease of use. However, in some cases, gaps and deficiencies in bone anatomy can hinder the placement or stability of ready-made spacers, potentially disrupting the treatment. Additionally, ready-made spacers contain only one type of antibiotic in relatively low doses. Therefore, they may often be inadequate in treating prosthetic infections caused by bacteria exhibiting multiple antibiotic resistances. 

Patient-specific antibiotic-loaded spacer applications have two significant features that increase the chances of treatment success compared to commercial spacers. The first feature is marked by its anatomy-specific design philosophy and the second is marked by its flexibility in application to include any antibiotic in its composition. A patient-specific spacer is designed in a 3D computer environment considering the patient’s deficient and distorted bone anatomy aiming for best fit and superior stability. Subsequently, this personalized spacer design is transformed into a mold model and produced using a 3D printer. Finally, antibiotics of choice in ideal doses are mixed with bone cement and poured into the mold to make the patient-specific antibiotic-loaded spacer with the best possible antibiotic coverage.


In conclusion, for patients with multiple antibiotic resistance and bone anatomy hindering the use of ready-made spacers due to repeated surgeries, personalized joint spacers are an effective and crucial step in achieving high success rates in treating prosthesis infections.


Please contact us to learn more about personalized antibiotic-loaded cement spacers and their possible impact on your prosthetic infection treatment.

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