• Clinics in Shoulder and Elbow
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• v.25 no.3
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• pp.202-209
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• 2022

Background: The purpose of our study was to investigate short-term outcomes of two-stage reverse total shoulder arthroplasty (RTSA) with an antibiotic-loaded cement spacer for shoulder infection. Methods: Eleven patients with shoulder infection were treated by two-stage RTSA following temporary antibiotic-loaded cement spacer. Of the 11 shoulders, nine had pyogenic arthritis combined with complex conditions such as recurrent infection, extensive osteomyelitis, osteoarthritis, or massive rotator cuff tear and two had periprosthetic joint infection (PJI). The mean follow-up period was 29.9 months (range, 12-48 months) after RTSA. Clinical and radiographic outcomes were evaluated using the visual analog scale (VAS) score for pain, American Shoulder and Elbow Surgeons (ASES) score, subjective shoulder value (SSV), and serial plain radiographs. Results: The mean time from antibiotic-loaded cement spacer to RTSA was 9.2 months (range, 1-35 months). All patients had no clinical and radiographic signs of recurrent infection at final follow-up. The mean final VAS score, ASES score, and SSV were significantly improved from 4.5, 38.6, and 29.1% before RTSA to 1.7, 75.1, and 75.9% at final follow-up, respectively. The mean forward flexion, abduction, external rotation, and internal rotation were improved from 50.0°, 50.9°, 17.7°, and sacrum level before RTSA to 127.3°, 110.0°, 51.8°, and L2 level at final follow-up, respectively. Conclusions: Two-stage RTSA with antibiotic-loaded cement spacer yields satisfactory short-term clinical and radiographic outcomes. In patients with pyogenic arthritis combined with complex conditions or PJI, two-stage RTSA with an antibiotic-loaded cement spacer would be a successful approach to eradicate infection and to improve function with pain relief.

• Restorative Dentistry and Endodontics
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• v.20 no.1
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• pp.152-163
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• 1995

This experiment was performed to observe the adhesion pattern and microleakage in the gingival margin according to variation in the resin cement thickness which results from thickness of Die spacer. which is considered to effect the adaptability of the composite resin inlays. Clearfil CR inlays were fabricated on stone models with CR Sep applicated once and Nice fit twice, 4 times, and 6 times each. After 2nd curing within the CRC-100 oven, CR inlays were cemented with CR inlay cement. Dye(2% methylene blue) penetration and adhesion pattern were evaluated after sectioning of gingival margin into :3 pieces. The results were as follows ; 1. The thickness of resin cement showed unevenchanging pattern with that of die spacer, namely, it was increased until 4 times' application of Nice-Fit but was decreased with 6 times' application of that. 2. The degree of dye penetration wasn't affected by cement thickness within a limited value. 3. Most of dye penetration was shown through the interface between cement and enamel rather than the interface between cement and CR inlay. This shows that the affinity of resin cement for CR inlay was superior to the adhesive strength with tooth structure. 4. No gap was found at the interface between enamel and cement but some showed separation between dentin and cement. It is concidered that the contraction force of cement was less than the bond strength with the enamel. 5. Lots of voids were found in the CR inlay and resin cement. There was a pooling tendency of bonding agent and cement in the axiogingival line angle portion. 6. In some specimens, cracks were shown in enamel margin. From this it could be considered that cavity preparation and surface treatment weakened the tooth structure.

• Journal of the Korea institute for structural maintenance and inspection
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• v.18 no.4
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• pp.92-98
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• 2014

Spacer is a construction material for maintaining cover depth and steel installation, however several problems like staining, leakage, and cracking are currently issued due to performance degradation and unsatisfactory dimensional stability of spacer. Plastic composite is widely used for prevention of brittle failure in cement based material, which yields improvement of crack resistance and ductile failure. This study is for development and applicability evaluation of high strength spacer with slag cement for environmental load reduction and plastic composite like polypropylene fiber, nylon fiber, and glass fiber. For this work, unit weight of 4 different plastic fibers are evaluated through preliminary tests. Physical tests including compressive, flexural, and tensile strength and durability tests including absorption, permeability, length change, crack resistance, carbonation, and freezing and thawing are performed. Through various tests, optimum plastic fiber is selected and manufacturing system for high strength spacer with the selected fiber is developed. Dimensional stability of the developed spacer is evaluated through field applicability evaluation.

• Cement Symposium
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• no.29
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• pp.123-130
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• 2002

• Clinics in Shoulder and Elbow
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• v.20 no.1
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• pp.46-48
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• 2017

There are many methods of making cement spacer in patients who require a two-staged operation for humeral head osteomyelitis. However, limitation of motion after the first surgery-due to inadequate size and insufficient intra-articular space for second surgery-remain to be an issue. To mitigate this issue, we made a cement spacer with the same size and shape of the patient humeral head. Four patients with humeral head osteomyelitis were enrolled in this study. To make the cement spacer, we used the Mimics program, and designed the molding box by a reverse engineering technique. We evaluated the range of motion and pain using a Constant score. The mean abduction was $50^{\circ}$($40^{\circ}-60^{\circ}$), forward flexion was $50^{\circ}$ ($30^{\circ}-70^{\circ}$), and average Constant score was 47.75 (44-52). Three-dimensional printed molding technique is one of the effective methods for humeral head osteomyelitis allowing for daily activities prior to the second surgery.

• Hip & pelvis
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• v.35 no.1
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• pp.32-39
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• 2023

Purpose: A staged revision with placement of a temporary antibiotic-loaded cement spacer after removal of the implant is the "gold standard" for treatment of chronic prosthetic joint infection (PJI). It enables local delivery of antibiotics, maintenance of limb-length and mobility, easier reimplantation. However, bacterial colonization of spacers and mechanical complications can also occur. The aim of this study is to evaluate functional results and infection control in two-stage treatment of total hip arthroplasty (THA) PJI with and without a spacer. Materials and Methods: A retrospective review of 64 consecutive patients was conducted: 34 underwent two-stage revision using a cement spacer (group A), 30 underwent two-stage revision without a spacer (group B). At the final follow-up, functional evaluation of patients with a THA in site, without PJI recurrence, was performed using the Harris hip score (HHS). Measurement of limb-length and off-set discrepancies was performed using anteroposterior pelvic X-rays. Results: Most patients in group B were older with more comorbidities preoperatively. Thirty-three patients (97.1%) in group A underwent THA reimplantation versus 22 patients (73.3%) in group B (P<0.001). No significant differences in limb-length and off-set were observed. The results of functional evaluation performed during the final follow-up (mean, 41 months) showed better function in patients in group A (mean HHS, 76.3 vs. 55.9; P<0.001). Conclusion: The use of antibiotic-loaded cement spacer seems superior in terms of functional outcomes and reimplantation rate. Resection arthroplasty might be reserved as a first-stage procedure in patients who are unfit, who might benefit from a definitive procedure.

• Journal of Korean Foot and Ankle Society
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• v.16 no.2
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• pp.135-139
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• 2012

The interphalangeal joint (IPJ) of the hallux has received little attention compared with the first metatarsophalangeal joint. But, the hallucal IPJ has several disorders such intra-articular fractures, dorsal dislocation, alignment disorder, and inflammatory or degenerative arthritis. Among these disorders septic arthritis of the IPJ of the hallux is rare. We report a case of sepsis of the hallucal IPJ and adjacent underlying osteomyelitis without neuropathic problem and was performed through infected soft tissue and osseous debridement, temporary antibiotic-impregnated cement spacer, and delayed intercalary allogenic fibular bone graft with K-wire fixation.

• Journal of the Korean institute of surface engineering
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• v.40 no.4
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• pp.197-202
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• 2007

Fit of the restoration and its cementation procedure is crucial to both its short and long term prognosis. Marginal fit is affected by many variables during the fabrication process. These variables, being intrinsic properties of the materials or the clinical technique used, can cause changes in the size and shape of the definitive restoration. Even if all variables are controlled carefully, the seating of a restoration can still be affected due to insufficient space for the luting agent. The use of die spacer can reduce the elevation of a cast restoration of a prepared tooth, decreased seating time, improve the outflow of excess cement, and lower the seating forces. The purpose of this study was to evaluate the marginal fidelity according to die spacer application times and measurement site. Casting alloys were prepared and fabricated using non-precious metal at $950^{\circ}C$. Specimens are divided into four groups: I(die spacer painted casting for wax pattern), II(die spacer non painted casting for wax pattern). The specimens were cut and polished for marginal gap observation. The marginal gap was observed using scanning electron microscopy (SEM).

• Journal of the Korean Society of Safety
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• v.13 no.3
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• pp.45-50
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• 1998

The low grade domestic kaoline, such as pink-C and white-D, was converted to metakaoline, which has pozzolanic reactivity by heat treatment in the temperature range of $600^{\circ}C$ to 100$0^{\circ}C$ for preparing the spacer. The spacer was used for supporting the reinforced steel rod during construction to improve the safety of architecture. Pink-C and white-D were completely dehydroxylated when burnt at 80$0^{\circ}C$ for 1 hour and converted to metakaoline. The compressive strengths of specimens added calcined pink-C were lower than those of press molding mortar products inspite of calcining conditions. When white-D with calcined 80$0^{\circ}C$ and 100$0^{\circ}C$ for 1 hour was mixed 30% in the weight ratio of cement, the specimens cured 28 days had 338 $kg/cm^2$ and 347 $kg/cm^2$ of compressive strengths, respectively.

• 대한족부족관절학회:학술대회논문집
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• 2009.04a
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• pp.15-15
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• 2009