Antibiotic joint spacers are temporary intra-articular devices with the main aim to control predominantly post-arthroplasty joint and bone infections via sustained, topical antibiotic release, whilst also ensuring reasonable joint function.
Antibiotic spacers are typically made of poly(methyl methacrylate) (PMMA) cement loaded with antibiotics, while also having a central metallic component to make them withstand the mechanical load. They are most commonly used after periprosthetic infection ensues, in order to achieve local, lasting high levels of antibiotics around the poorly vascularized infected bone. The antibiotic of choice used to be primarily gentamicin, however with the emergence of gentamicin resistant strains of bacteria such as S. epidermidis nowadays a drug combination (e.g. with vancomycin or tobramycin) became standard 1.
Radiographic features
The cement is highly radiopaque, and the internal metallic framework is also clearly depicted on both plain film and CT. It should be noted that these spacers are less resistant to mechanical stress, and are more prone to hardware failure under shear stress, or excess mechanical loading.
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