Vyuziti spaceru pri reseni infektu totalni nahrady kycelniho a kolenniho kloubu.

There were several protocols proposed to solve the problem of deep infection of total hip and knee arthroplasty. These involve antibiotic therapy, debridement, irrigation drainage, resection arthroplasty, one stage or double-stage reimplantation, arthrodesis and as a last resort therapy amputation. Double-stage reimplantation with use of antibiotic loaded cement spacer is treatment of choice. Standard protocol in its first step involves removal of infected implants, debridement, use of antibiotic loaded cement spacer, irrigation drainage and parenteral antibiotic therapy and in second step implantation of new prosthesis, antibiotic therapy and rehabilitation. Spacer prevents excessive contraction of soft tissues around the joint, supports the extremity, allows partial weight bearing, improves bone quality and releases antibiotic. When planning reimplantation we need to consider each individual patients general health status, clinical findings and laboratory results. We propose the method of formation of canalized spacer that will allow irrigation drainage in marrow cavity of proximal femur or tibia. It also allows easier drain removal. Canalized spacer is financially affordable and its improved construction avoids disadvantages we experienced in past.Summary in EnglishAvailable from STL, Prague, CZ / NTK - National Technical LibrarySIGLECZCzech Republi