The treatment of the infected hip arthroplasty is difficult and its cost-effectiveness is low. Although many methods have been reported to manage this intractable disease, for example, resection arthroplasty, continuous irrigation, the use of cement beads and the cement spacer which contained antibiotics, and hydroxyapatite blocks which filled with antibiotics, each therapy has limitation or disadvantage for clinical application. Some authors recently reported better results of the infection of the hip arthroplasty using cement beads and the cement spacer, but the loss of efficacy of the antibiotics by polymerization heat is problem when it is used with bone cement. Hydroxyapatite blocks filled with antibiotics seemed to be one of the better choices, but it is difficult to place the blocks to desirable location and maintain it during treatment period. Additionally, it is also difficult to fill the space after the infected implants are removed by hydroxyapatite blocks alone. In the present study, we report the clinical results of the antibiotic-loaded hydroxyl-apatite blocks (HAb) combined with cement spacer. Our method provides the surgeon to avoid polymerization heat for antibiotics, to place HAb with cement spacer to where the surgeon anticipates the effect of an antibiotic, and also to fill the void space with preservation of the affected leg length.
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