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PURPOSE: Our purpose was to compare 2 methods of treatment of chronic infection in hip arthroplasties-with or without an antibiotic-loaded cement spacer. METHODS: In a prospective study, we treated 68 infected hip arthroplasties with discharging sinuses and bone loss, comparing 30 patients treated in 2 stages without the use of a spacer (control group) and 38 patients treated with a vancomycin-loaded spacer (study group). The average follow-up was 4 years (2-8.5 years). One patient died of unrelated causes 4 months after first-stage surgery and was excluded from the study. RESULTS: The 2-stage surgery without spacer controlled the infection in 66.7% of patients, and the 2-stage surgery using the spacer controlled it in 89.1% (P < 0.05). At last follow-up, the average Harris Hip Score increased from 19.3 to 69.0 in the control group versus 19.7 to 75.2 in the study group (P > 0.05). The average leg length discrepancy was 2.6 cm in the control group and 1.5 cm in the study group (P < 0.05). The patients treated with a spacer had better clinical results (81.5% of patients with good results against 60.0% for the control group). CONCLUSION: The use of an antibiotic-loaded spacer in the 2-stage treatment of infected hip arthroplasties provides better infection control with good functional results and is superior to treatment in 2 stages without a spacer. Level of Evidence: Therapeutic study, Level I-1.OBJETIVO: As revisões em dois tempos continuam sendo os métodos preferidos no tratamento das artroplastias infectadas do quadril. O procedimento em dois estágios apresenta várias desvantagens teóricas, ainda não comprovadas por estudos comparativos. MATERIAIS E MÉTODOS: Em um estudo prospectivo, tratamos 68 pacientes com artroplastias infectadas de quadril com perdas ósseas e fístulas ativas, comparando 30 casos tratados em dois tempos sem espaçador (grupo controle) e 38 casos tratados em dois tempos com o uso de um espaçador de cimento adicionado a vancomicina (grupo de estudo). Um paciente faleceu após quatro meses da cirurgia e foi excluído do estudo. O seguimento médio foi de quatro anos (2-8,5 anos). RESULTADOS: A cirurgia em dois tempos sem espaçador controlou a infecção em 66,7% dos casos comparada a 89,1% (p0,05). A média de discrepância de membros inferiores foi de 2,6cm no grupo controle e de 1,5cm nos grupo do estudo (p