Use of a New Knee Prosthesis As an Articulating Spacer in Two-Stage Revision of Infected Total Knee Arthroplasty

Overview

Journal Knee Surg Relat Res

Publisher Biomed Central

Date 2016 Sep 6

PMID 27595079

Citations 4

Authors

Rasmus Juul

Jesper Fabrin

Klaus Poulsen

Henrik Morville Schroder

Affiliations

Soon will be listed here.

Abstract

Purpose: To report our experience with two-stage revision using a new femoral component (NFC) spacer (Depuy Synthes) as an articulating spacer.

Materials And Methods: In this retrospective study, we reviewed 22 two-stage revisions that were performed using an NFC spacer in 22 patients suspected of having an infected total knee arthroplasty (TKA) from December 2010 to March 2013. The result was considered successful when eradication of infection was achieved using only one NFC spacer.

Results: The average time from primary TKA to the first stage procedure was 29.1 months and the average time from the first stage procedure until the final second stage procedure was 12.7 weeks. The average range of motion increased from 82° preoperatively to 104° postoperatively. The American Knee Society Knee score increased from 29.3 points to 66 points. The Function score increased from 29.5 points to 64 points. Four cases were reinfected after two-stage revision. The mean follow-up was 37.6 months.

Conclusions: The new articulating spacer showed promising short-term results both with regard to eradication of infection and functional improvement.

Citing Articles

Handmade articulating spacer for two-stage exchange at the knee.

Ludemann M, von Hertzberg-Bolch S, Gurok A, Oberfeld J, Rudert M Oper Orthop Traumatol. 2023; 35(3-4):154-162.

PMID: 37173423 DOI: 10.1007/s00064-023-00810-0.

Articular spacers in two-stage revision arthroplasty for prosthetic joint infection of the hip and the knee.

Craig A, King S, van Duren B, Veysi V, Jain S, Palan J EFORT Open Rev. 2022; 7(2):137-152.

PMID: 35192512 PMC: 8897569. DOI: 10.1530/EOR-21-0037.

Temporary new implant spacers increase post-reimplantation total knee prosthesis survival after periprosthetic joint infection.

Woon C, Nguyen J, Kapadia M, Russell C, Henry M, Miller A Knee Surg Sports Traumatol Arthrosc. 2020; 29(11):3621-3632.

PMID: 33083860 DOI: 10.1007/s00167-020-06325-6.

Treatment of Infected Total Knee Arthroplasty.

Ha C Knee Surg Relat Res. 2017; 29(3):153-154.

PMID: 28854759 PMC: 5596398. DOI: 10.5792/ksrr.17.301.

References

Blom A, Brown J, Taylor A, Pattison G, Whitehouse S, Bannister G . Infection after total knee arthroplasty. J Bone Joint Surg Br. 2004; 86(5):688-91. DOI: 10.1302/0301-620x.86b5.14887. View

Silvestre A, Almeida F, Renovell P, Morante E, Lopez R . Revision of infected total knee arthroplasty: two-stage reimplantation using an antibiotic-impregnated static spacer. Clin Orthop Surg. 2013; 5(3):180-7. PMC: 3758987. DOI: 10.4055/cios.2013.5.3.180. View

Kalore N, Maheshwari A, Sharma A, Cheng E, Gioe T . Is there a preferred articulating spacer technique for infected knee arthroplasty? A preliminary study. Clin Orthop Relat Res. 2011; 470(1):228-35. PMC: 3237967. DOI: 10.1007/s11999-011-2037-1. View

Park S, Song E, Seon J, Yoon T, Park G . Comparison of static and mobile antibiotic-impregnated cement spacers for the treatment of infected total knee arthroplasty. Int Orthop. 2009; 34(8):1181-6. PMC: 2989090. DOI: 10.1007/s00264-009-0907-x. View

Freeman M, Fehring T, Odum S, Fehring K, Griffin W, Mason J . Functional advantage of articulating versus static spacers in 2-stage revision for total knee arthroplasty infection. J Arthroplasty. 2007; 22(8):1116-21. DOI: 10.1016/j.arth.2007.04.009. View

Anderson J, Sculco P, Heitkemper S, Mayman D, Bostrom M, Sculco T . An articulating spacer to treat and mobilize patients with infected total knee arthroplasty. J Arthroplasty. 2008; 24(4):631-5. DOI: 10.1016/j.arth.2008.04.003. View

Pitto R, Spika I . Antibiotic-loaded bone cement spacers in two-stage management of infected total knee arthroplasty. Int Orthop. 2004; 28(3):129-33. PMC: 3474493. DOI: 10.1007/s00264-004-0545-2. View

Fehring T, Odum S, Calton T, Mason J . Articulating versus static spacers in revision total knee arthroplasty for sepsis. The Ranawat Award. Clin Orthop Relat Res. 2000; (380):9-16. DOI: 10.1097/00003086-200011000-00003. View

Pitto R, Castelli C, Ferrari R, Munro J . Pre-formed articulating knee spacer in two-stage revision for the infected total knee arthroplasty. Int Orthop. 2005; 29(5):305-8. PMC: 3456645. DOI: 10.1007/s00264-005-0670-6. View

10.

Parvizi J, Zmistowski B, Berbari E, Bauer T, Springer B, Della Valle C . New definition for periprosthetic joint infection: from the Workgroup of the Musculoskeletal Infection Society. Clin Orthop Relat Res. 2011; 469(11):2992-4. PMC: 3183178. DOI: 10.1007/s11999-011-2102-9. View

11.

Scott I, Stockley I, Getty C . Exchange arthroplasty for infected knee replacements. A new two-stage method. J Bone Joint Surg Br. 1993; 75(1):28-31. DOI: 10.1302/0301-620X.75B1.8421028. View

12.

Kamme C, Lindberg L . Aerobic and anaerobic bacteria in deep infections after total hip arthroplasty: differential diagnosis between infectious and non-infectious loosening. Clin Orthop Relat Res. 1981; (154):201-7. View

13.

Hsu Y, Cheng H, Ng T, Chiu K . Antibiotic-loaded cement articulating spacer for 2-stage reimplantation in infected total knee arthroplasty: a simple and economic method. J Arthroplasty. 2007; 22(7):1060-6. DOI: 10.1016/j.arth.2007.04.028. View

14.

Kim Y, Bae K, Cho C, Lee K, Sohn E, Kim B . Two-stage revision using a modified articulating spacer in infected total knee arthroplasty. Knee Surg Relat Res. 2013; 25(4):180-5. PMC: 3867610. DOI: 10.5792/ksrr.2013.25.4.180. View

15.

Trezies A, Parish E, Dixon P, Cross M . The use of an articulating spacer in the management of infected total knee arthroplasties. J Arthroplasty. 2006; 21(5):702-4. DOI: 10.1016/j.arth.2005.05.033. View

16.

Brunnekreef J, Hannink G, de Waal Malefijt M . Recovery of knee mobility after a static or mobile spacer in total knee infection. Acta Orthop Belg. 2013; 79(1):83-9. View

17.

Calton T, Fehring T, Griffin W . Bone loss associated with the use of spacer blocks in infected total knee arthroplasty. Clin Orthop Relat Res. 1998; (345):148-54. View

18.

Willis-Owen C, Konyves A, Martin D . Factors affecting the incidence of infection in hip and knee replacement: an analysis of 5277 cases. J Bone Joint Surg Br. 2010; 92(8):1128-33. DOI: 10.1302/0301-620X.92B8.24333. View

19.

Emerson Jr R, Muncie M, Tarbox T, Higgins L . Comparison of a static with a mobile spacer in total knee infection. Clin Orthop Relat Res. 2002; (404):132-8. DOI: 10.1097/00003086-200211000-00023. View