{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T17:55:42Z","timestamp":1790358942851,"version":"4.1.0"},"reference-count":23,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2020,9,28]],"date-time":"2020-09-28T00:00:00Z","timestamp":1601251200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["HIP International"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Peri-prosthetic joint infection (PJI) is a devastating complication after total hip arthroplasty (THA). The use of custom-made articulating spacers (CUMARS) has been described for use in the first of 2-stage treatment. We report our outcomes of managing PJI using CUMARS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patients undergoing 1st-stage revision using the Exeter standard stem, all-polyethylene acetabulum and antibiotic-loaded cement were identified. Medical records were assessed for demographics, microbiological and operative treatment, complications, eradication of infection and reoperations. No postoperative restrictions were enforced. 2nd-stage revision was undertaken in the presence of pain or subsidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>53 patients underwent 1st-stage revision using this technique. The average follow-up was 3.9 (range 0.5\u20137.2) years. Infection was eradicated in 47 (88.7%) patients. 2 patients had chronic infection managed with suppressive antibiotics, 2 patients died before eradication confirmed, 1 patient had raised inflammatory markers but no positive aspiration cultures, 1 patient was lost to follow-up. Complications occurred in 5 (9.4%) patients \u2013 4 dislocations and 1 infected haematoma. 4 patients required a repeated 1st stage. 2nd-stage revision was performed in 19 patients (35%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The CUMARS technique is an effective way of eradicating PJI after THA. It maintains function by providing a stable construct that permits weight-bearing. It delays or negates the need for 2nd-stage revision. Furthermore, it allows surgeons to choose between managing patients prospectively as a single-stage revision with the option of reverting to a 2nd stage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1120700020960669","type":"journal-article","created":{"date-parts":[[2020,9,28]],"date-time":"2020-09-28T03:26:32Z","timestamp":1601263592000},"page":"379-385","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["External validation study of hip peri-prosthetic joint infection with cemented custom-made articulating spacer (CUMARS)"],"prefix":"10.1177","volume":"32","author":[{"given":"Jonathan","family":"Quayle","sequence":"first","affiliation":[{"name":"Brighton and Sussex University Hospitals, Brighton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Barakat","sequence":"additional","affiliation":[{"name":"Brighton and Sussex University Hospitals, Brighton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0819-4706","authenticated-orcid":false,"given":"Antonio","family":"Klasan","sequence":"additional","affiliation":[{"name":"North Shore Hospital, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3332-2968","authenticated-orcid":false,"given":"Aaina","family":"Mittal","sequence":"additional","affiliation":[{"name":"Brighton and Sussex University Hospitals, Brighton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Stott","sequence":"additional","affiliation":[{"name":"Brighton and Sussex University Hospitals, Brighton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,9,28]]},"reference":[{"key":"bibr1-1120700020960669","author":"The National Joint Registry for England, Wales, Northern Ireland and the Isle of Man","year":"2018","journal-title":"NJR"},{"key":"bibr2-1120700020960669","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(18)30755-2"},{"key":"bibr3-1120700020960669","doi-asserted-by":"publisher","DOI":"10.3109\/17453670903506658"},{"key":"bibr4-1120700020960669","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61798-0"},{"key":"bibr5-1120700020960669","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2010.04.011"},{"key":"bibr6-1120700020960669","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2017.07.045"},{"key":"bibr7-1120700020960669","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2017.02.066"},{"key":"bibr8-1120700020960669","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.99B11.BJJ-2017-0088.R1"},{"key":"bibr9-1120700020960669","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2018.08.017"},{"key":"bibr10-1120700020960669","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2017.02.025"},{"key":"bibr11-1120700020960669","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.101B4.BJJ-2018-1109.R1"},{"key":"bibr12-1120700020960669","doi-asserted-by":"publisher","DOI":"10.1097\/CORR.0000000000000780"},{"key":"bibr13-1120700020960669","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-015-2833-4"},{"key":"bibr14-1120700020960669","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2018.08.016"},{"key":"bibr15-1120700020960669","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.91B11.22026"},{"key":"bibr16-1120700020960669","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2014.04.013"},{"key":"bibr17-1120700020960669","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2004.12.055"},{"key":"bibr18-1120700020960669","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.95B11.33135"},{"key":"bibr19-1120700020960669","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2017.03.018"},{"key":"bibr20-1120700020960669","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2017.11.016"},{"key":"bibr21-1120700020960669","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2019.02.012"},{"key":"bibr22-1120700020960669","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-018-9499-7"},{"key":"bibr23-1120700020960669","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-017-1499-z"}],"container-title":["HIP International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1120700020960669","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1120700020960669","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1120700020960669","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:21:57Z","timestamp":1777450917000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1120700020960669"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,28]]},"references-count":23,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,5]]}},"alternative-id":["10.1177\/1120700020960669"],"URL":"https:\/\/doi.org\/10.1177\/1120700020960669","relation":{},"ISSN":["1120-7000","1724-6067"],"issn-type":[{"value":"1120-7000","type":"print"},{"value":"1724-6067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,28]]}}}