Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 14 2 2026 04 01 Clinical Outcomes of Antibiotic-Impregnated Cement Spacers in the Treatment of Infected Total Hip Arthroplasty: A Pilot Randomized Clinical Trial 1 11 118620 10.30483/rjm.2026.254685.1455 EN Ismaeil Garivani Assistant Professor, Department of Orthopedic Surgery, School of Medicine, North Khorasan University of Medical Sciences Reza Ganji Associated Professor, Department of Orthopedic Surgery, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran 0000-0002-4063-5962 Mohamad Amin Younessi Heravi Assistant Professor, Department of Medical Physics and Radiology, School of Allied Medical Sciences, North Khorasan University of Medical Sciences, Bojnurd, Iran 0000-0002-7960-3095 Journal Article 2025 11 13 Background: Two-stage revision arthroplasty remains the gold standard for managing periprosthetic joint infection (PJI) following total hip arthroplasty (THA) and involves temporary implantation of an antibiotic-loaded cement spacer. Objective: This pilot randomized clinical trial aimed to compare silicone mold–based articulating spacers with commercially prefabricated spacers regarding infection eradication and functional outcomes in patients with infected THA. Methods: Fourteen patients diagnosed with infected THA were randomly assigned to receive either a prefabricated spacer (control group) or a silicone mold–based spacer (intervention group). Clinical outcomes were assessed using the Hip Osteoarthritis Outcome Score (HOOS) before spacer implantation and six weeks after the first-stage revision. Functional improvement was evaluated using gain score analysis. Statistical analyses were performed using SPSS, with p < 0.05 considered statistically significant. Results: Infection eradication was achieved in all patients in both groups. In both groups, after surgery, there were significant differences in HOOS (p < 0.001) compared with before surgery. Mean HOOS improved significantly after surgery in the control group (from 49.60 ± 9.79 to 71.60 ± 4.72) and in the intervention group (from 48.52 ± 8.64 to 69.67 ± 3.77). Gain score analysis showed no statistically significant difference between groups (p = 0.77). Conclusion: Silicone mold–based spacers demonstrated clinical and infection-control outcomes comparable to those of prefabricated spacers. Given their lower cost and ease of fabrication, silicone mold–based spacers may serve as a practical and cost-effective alternative, particularly in resource-limited settings.

https://journal.razavihospital.ir/article_118620_3cb2f8f7e34d047fe24047216cecd1fe.pdf