Experience of local exposure to septic foci in destructive coxitis

The article presents an overview of modern experimental studies devoted to the problem of the treatment of deep surgical infection of the hip joint, as well as an analysis of existing materials used for the manufacture of implants (spacers) of large joints. Purulent inflammation of the hip joint (coxitis) occupies a leading place in the structure of orthopedic diseases. Such inflammation may be the result of iatrogenic infection, complicated fractures, arthritis. There are several classifications of purulent coxitis, which characterize the degree and depth of development of purulent inflammation. Anamnesis and clinical manifestations are the primary criteria for suspected infection in the joint, further diagnosis should be confirmed with the help of basic and secondary diagnostic indicators. Isolation of the pathogen and obtaining a detailed antibiogram together with surgical treatment (arthrotomy with spacer implantation) are crucial for determining a comprehensive strategy for antibiotic therapy of a sick animal. According to most authors, the successful outcome of coxitis is the installation of a temporary implant with an antibiotic. Spacer is a device based on biocompatible materials, such as metal, polymethylmethacrylate, polyethylene, with the inclusion of antimicrobial agents, which is used to temporarily fill the joint cavity. A spacer with an antibiotic helps to fill the space formed after resection, and provides a high local concentration of antimicrobial agents. The advantages of the spacer are a higher elution of antibiotics from the implant surface, the ability to replace a fragment of missing bone in the proximal femur / acetabulum. The use of spacer is considered as an etiotropic and pathogenetic treatment before subsequent endoprosthetics. In the studied literature, only isolated cases of the use of hip joint spacers in animals with purulent coxitis are described.