Volume 9, 2023
|Number of page(s)||6|
|Published online||08 November 2023|
Simple and cost-effective way to make mobile antibiotic cement spacer: hand-made silicone mold
Department of Orthopedic Surgery, Tam Anh Hospital, Ha Noi, Vietnam
2 Orthopedic and Trauma Department, Dong Nai General Hospital, Dong Nai, Vietnam
3 Orthopedic and Trauma Department, Da Nang Hospital, Da Nang, Vietnam
4 Orthopedic and Trauma Department, Cho Ray Hospital, Ho Chi Minh City, Vietnam
* Corresponding author: email@example.com
Accepted: 13 October 2023
Background: Two-stage exchange arthroplasty is considered the most common approach for the management of prosthetic joint infections. There has been plentiful evidence to support the superiority of the mobile spacers over the static ones. Unfortunately, articulating options are not available in our low-resource environment, which motivated us to come up with an affordable way to create a mobile cement spacer. After experimenting with a variety of materials and producing methods, we realized that silicone is a favorable material for mold building and established a simple process of making a handmade silicone mold. We demonstrate the clinical outcomes of three prosthetic joint infections by using these spacers in the hope of spreading the idea to our colleagues who work in the circumstances of a developing country. Construction of the spacer molds: The molds, consisting of two parts, were shaped by using high viscosity addition silicone (elite HD+ putty soft, Zhermack SpA, Italy) as material, and previously removed implants as template. They were sterilized using ethylene oxide treatment before being ready for casting antibiotic-loaded bone cement spacer. Case report: Three cases of prosthetic infection were treated with two-stage revision, using antibiotic-impregnated cement spacer cast in hand-made silicone molds. We sought to determine intraoperative complications, postoperative range of motion, and functional scores. All the patients were regularly followed up to identify fractures or dislocation of the spacer, and reinfection. Results: At the end of the follow-up, all three patients had the infection eradicated. The three patients could sit comfortably with bent knees, walk with partial weight-bearing, and achieve 75–80 degrees of knee flexion in the first week after surgery. Follow-up X-rays revealed no fractures or dislocation in any of the spacers. Conclusion: Silicone molds offer a simple and cost-effective alternative to costly commercial products in producing articulating spacers. Treating infected joints arthroplasty with these spacers allows for early motion and partial weight bearing and improves patient satisfaction and life quality before reimplantation without significant complications.
Key words: Prosthetic joint infection / Articulating spacer / Two-stage revision / Silicone mold
© The Authors, published by EDP Sciences, 2023
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Current usage metrics show cumulative count of Article Views (full-text article views including HTML views, PDF and ePub downloads, according to the available data) and Abstracts Views on Vision4Press platform.
Data correspond to usage on the plateform after 2015. The current usage metrics is available 48-96 hours after online publication and is updated daily on week days.
Initial download of the metrics may take a while.