Background: Infection is the most feared complication in every aspect of bone surgery. Antibiotic impregnated cement spacers and cement beads are widely used since 1972 for treating prosthetic infection. The delivery of a high concentration of antibiotics in a localized area is thought to be safer than systemic administration of intravenous antibiotics in such doses.
Materials and methods: Our clinic has more than 10 years of experience in using preformed and manufactured spacers, mostly hand made. A new method developed by us puts the designing in the preoperative planning phase. Antibiotics are chosen based on the antibiogramm the cement is chemically “configured”. 3D design based on the previous implant or on the bony structure is done; negative molds are manufactured with CNC mill the manufacturing kit is sterilized with ethylene oxide. Intraoperatively the spacer is molded and implanted.
Results and Conclusions: We consider that our method meets almost all the conditions proposed by us. Problems were found with the inconsistent mechanical behavior. More studies are required regarding the mechanical properties of the bone cement in function of antibiotic concentrations and preparation methods.