Spacer prostheses in two-stage revision of infected knee arthroplasty.
At present, no consensus exists on the best spacer alternative for the management of two-stage exchange arthroplasty of infected knee arthroplasties. In this retrospective study, patient records of 24 patients, who had undergone two-stage revisions in which resterilised prosthetic components were used as spacers, were reviewed. The outcome was compared to that of operations performed during the same period (1993-2003) using cement spacers (n=10). With an average follow-up of 32 months, control of infection was achieved in 26 cases (76%), with good or excellent clinical outcome in 19 cases (56%). Treatment failed and resulted in amputation at the level of the thigh before reimplantation in one case. Three patients did not undergo reimplantation. In four cases (12%) infection relapsed. The reinfection rate did not differ between the two spacer groups. Patients treated with resterilised components had a superior range of motion during the period between the two stages. Operative time was shorter and there was less blood loss in the reimplantation arthroplasty when a prosthetic spacer was used. We consider resterilised prosthetic components a safe and effective alternative to cement spacers in the management of infected knee arthroplasties.
Jämsen
E
E
Medical School, University of Tampere, Tampere, Finland.
Sheng
P
P
Halonen
P
P
Lehto
M U K
MU
Moilanen
T
T
Pajamäki
J
J
Puolakka
T
T
Konttinen
Y T
YT
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001424:Bacterial Infections / Q000209:etiology* / Q000601:surgery*; D001843:Bone Cements; D005260:Female; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000209:etiology* / Q000601:surgery*; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies
D001843:Bone Cements