The spacer interval is treated as a waiting period. It is also the only prospective test you get of how stable that hip will be, and the information it produces is routinely lost between the two operations.
So record it explicitly: did the spacer dislocate, did it fracture, how did the patient mobilise. Put it in the note that the surgeon planning the second stage will read, not in a nursing entry. A spacer that dislocated is telling you something about abductor function and soft tissue tension that no preoperative imaging will.
The same applies to perispacer fracture. Both were common enough in a large series — around 5% each — that most units will see them, and most units will not be capturing them in a form that reaches the second-stage decision.
- Document spacer dislocation or fracture in the surgical record, not the nursing notes
- Hand the information over explicitly if a different surgeon is doing the reimplantation
- Note how the patient mobilised during the interval — it informs the bearing decision
- Radiographs during the spacer interval are worth reviewing before planning, not just filing
Why it matters
The best available predictor of instability after reimplantation is generated during the interval and then routinely discarded.
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