{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:34:26Z","timestamp":1760060066988,"version":"build-2065373602"},"reference-count":18,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Spacer dislocation is among the most frequent mechanical complications after revision total hip arthroplasty for periprosthetic hip infection. Spacer dislocations may be managed conservatively, but there are no guidelines on the rehabilitation of these patients, and the restriction of weight bearing is still under debate. Methods: We first report the case of a patient with hip spacer cranial dislocation, judged unfit to be surgically treated once more for a medium period, who started a rehabilitation program with partial weight bearing. Results: After two weeks of inpatient rehabilitation, the patient started to maintain the standing position with partial weight bearing on the affected side. Following hospital discharge we continued rehabilitation in the outpatient clinic. Despite the finding of the denervation of the ipsilateral quadriceps, three months after admission, she was able to walk for short distances using a walker, initially with the help of a therapist and then with supervision. About one year later, she was able to undergo the reimplantation of the definitive prosthesis. Conclusions: Despite the spacer dislocation, walking short distances is a feasible goal, even with assistance, wearing a brace and using a walker. Future research is needed to confirm and expand upon this observation and to understand the mechanisms underlying the development of neurological complications to implement effective prevention strategies.<\/jats:p>","DOI":"10.3390\/jcm14155316","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T10:51:14Z","timestamp":1753699874000},"page":"5316","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Gait Training with a Dislocated Hip Spacer: A Case Study and Literature Review"],"prefix":"10.3390","volume":"14","author":[{"given":"Stefano","family":"Salvaderi","sequence":"first","affiliation":[{"name":"Physical and Rehabilitation Medicine Unit, Scientific Institute of Lissone, Istituti Clinici Scientifici Maugeri, 20851 Lissone, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Liquori","sequence":"additional","affiliation":[{"name":"Physical and Rehabilitation Medicine Unit, Scientific Institute of Tradate, Istituti Clinici Scientifici Maugeri IRCCS, 21049 Tradate, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Zatti","sequence":"additional","affiliation":[{"name":"Orthopaedic Department, San Gerardo Hospital, University of Milano-Bicocca, 20900 Monza, Italy"},{"name":"Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgio","family":"Ferriero","sequence":"additional","affiliation":[{"name":"Physical and Rehabilitation Medicine Unit, Scientific Institute of Tradate, Istituti Clinici Scientifici Maugeri IRCCS, 21049 Tradate, Italy"},{"name":"Department of Biotechnology and Life Sciences, University of Insubria, 21100 Varese, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Negrini","sequence":"additional","affiliation":[{"name":"Physical and Rehabilitation Medicine Unit, Scientific Institute of Tradate, Istituti Clinici Scientifici Maugeri IRCCS, 21049 Tradate, Italy"},{"name":"Department of Biotechnology and Life Sciences, University of Insubria, 21100 Varese, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5573-2693","authenticated-orcid":false,"given":"Calogero","family":"Malfitano","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences for Health, University \u201cLa Statale\u201d, 20133 Milan, Italy"},{"name":"Azienda di Servizi alla Persona Istituti Milanesi Martinitt e Stelline e Pio Albergo Trivulzio, 20146 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ludovit","family":"Salgovic","sequence":"additional","affiliation":[{"name":"Department of Clinical Disciplines, Institute of Physiotherapy, Balneology and Medical Rehabilitation, University of Ss. Cyril and Methodius, 91701 Trnava, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola Emilia","family":"Ferrara","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Orthopedics and Rheumatology, Fondazione Policlinico Universitario \u201cAgostino Gemelli\u201d IRCCS, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"128","DOI":"10.2106\/JBJS.H.00155","article-title":"The epidemiology of revision total hip arthroplasty in the United States","volume":"91","author":"Bozic","year":"2009","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2107","DOI":"10.1016\/j.arth.2019.04.051","article-title":"Impact of hip antibiotic spacer dislocation on final implant position and outcomes","volume":"34","author":"Garceau","year":"2019","journal-title":"J. Arthroplast."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1007\/s00064-007-1196-4","article-title":"Two-stage reimplantation with an application spacer and combined with delivery of antibiotics in the management of prosthetic joint infection","volume":"19","author":"Thabe","year":"2007","journal-title":"Oper. Orthop. Traumatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"166","DOI":"10.5435\/JAAOS-D-19-00116","article-title":"Addressing antibiotic hip spacer instability via hybrid screw-cement fixation of a constrained liner and cement-rebar interface techniques: A technical narrative","volume":"28","author":"Patel","year":"2020","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1016\/j.arth.2013.10.014","article-title":"Dislocation of preformed antibiotic-loaded cement spacers (Spacer-G): Etiological factors and clinical prognosis","volume":"29","author":"Bori","year":"2014","journal-title":"J. Arthroplast."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1177\/11207000221126135","article-title":"What is the outcome after a Girdlestone resection arthroplasty following a hip fracture?","volume":"33","author":"Shah","year":"2023","journal-title":"Hip Int."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.5312\/wjo.v15.i12.1175","article-title":"Femoral nerve palsy following Girdlestone resection arthroplasty: An observational cadaveric study","volume":"15","author":"Spuehler","year":"2024","journal-title":"World J. Orthop."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"106861","DOI":"10.1016\/j.ijscr.2022.106861","article-title":"A 5-year follow-up of Girdlestone resection arthroplasty in hip infection continued by total hip replacement: A case report","volume":"93","author":"Solichin","year":"2022","journal-title":"Int. J. Surg. Case Rep."},{"key":"ref_9","first-page":"516","article-title":"Clinical results and complications of a two-stage proce-242 dure in hip infection using preformed antibiotic-loaded cement spacers","volume":"85","author":"Garcia","year":"2019","journal-title":"Acta Orthop. Belg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1046\/j.1445-5994.2001.00007.x","article-title":"Quadriceps muscle wasting persists 5 months after total hip arthroplasty for osteoarthritis of the hip: A pilot study","volume":"31","author":"Reardon","year":"2001","journal-title":"Intern. Med. J."},{"key":"ref_11","first-page":"184","article-title":"Sarcopenia, osteoporosis and the burden of prevalent vertebral fractures: A cross-sectional study of 350 women with hip fracture","volume":"56","author":"Castiglioni","year":"2020","journal-title":"Eur. J. Phys. Rehabil. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1177\/112070001002000104","article-title":"Long-stem versus short-stem preformed antibiotic-loaded cement spacers for two-stage revision of infected total hip arthroplasty","volume":"20","author":"Logoluso","year":"2010","journal-title":"Hip Int."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1007\/s00264-010-1172-8","article-title":"Preformed gentamicin spacers in two-stage revision hip arthroplasty: Functional results and complications","volume":"35","author":"Pattyn","year":"2011","journal-title":"Int. Orthop."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.otsr.2017.11.016","article-title":"Complications with cement spacers in 2-stage treatment of periprosthetic joint infection on total hip replacement","volume":"104","author":"Erivan","year":"2018","journal-title":"Orthop. Traumatol. Surg. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"10","DOI":"10.7150\/jbji.28390","article-title":"Quality of life and health status after Girdlestone resection arthroplasty in patients with an infected total hip prosthesis","volume":"4","author":"Vincenten","year":"2019","journal-title":"J. Bone Jt. Infect."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1016\/j.injury.2019.11.028","article-title":"Orthopedic treatment and early weight-bearing for bimalleolar ankle fractures in elderly patients: Quality of life and complications","volume":"51","author":"Lorente","year":"2020","journal-title":"Injury"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1007\/s00402-019-03317-1","article-title":"The direct anterior approach: Treating periprosthetic joint infection of the hip using two-stage revision arthroplasty","volume":"140","author":"Thaler","year":"2020","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Artzner, T., Clere-Jehl, R., Schenck, M., Greget, M., Merdji, H., De Marini, P., Tuzin, N., Helms, J., and Meziani, F. (2019). Spontaneous ilio-psoas hematomas complicating intensive care unit hospitalizations. 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