Patient-specific articulating spacer for two-stage shoulder arthroplasty exchange.

OBJECTIVE

Two-stage exchange with an antibiotic-loaded polymethylmethacrylate (PMMA) spacer is standard treatment for chronic periprosthetic joint infection of the shoulder. We present a safe and simple technique for patient-specific spacer implants.

INDICATION: (Chronic) periprosthetic joint infection of the shoulder.

RELATIVE CONTRAINDICATIONS: Known allergy against components of PMMA bone cements. Inadequate compliance for two-stage exchange. Patient is unfit to undergo two-stage exchange.

SURGICAL TECHNIQUE: Hardware removal, histologic and microbiologic samples, and debridement. Preparation of targeted or calculated antibiotic-loaded PMMA. Tailoring of patient-specific spacer. Spacer implantation.

POSTOPERATIVE MANAGEMENT: Rehabilitation protocol. Antibiotic treatment. Reimplantation after successful eradication of infection.