An articulating spacer to treat and mobilize patients with infected total knee arthroplasty.
This retrospective study analyzed 25 consecutive patients (25 knees) with chronic deep TKA infection. During 1997-2004, patients underwent two-stage articulating spacer surgery. The original femoral component was removed, autoclaved and replaced and a new polyethylene was utilized. The second- stage procedure occurred at a mean of 11 weeks (range: 4 to 39 weeks) after spacer insertion. Mobilization was encouraged between stages. All patients were assessed at a minimum of two years (mean 54 months; range: 24-108 months) post re-implantation, and Modified Hospital for Special Surgery (HSS) knee scores were calculated. Only one patient (4%) had re-infection. Average ROM before re-implantation was 5 degrees to 112 degrees , and 3 degrees to 115 degrees at latest follow-up. HSS scores averaged 91 (Range: 65-100) at latest follow-up. Two-stage re-implantation with an articulating spacer for infected TKA effectively treats infection and gives excellent knee motion between stages, and at mid- to long-term follow-up.
Anderson
John A
JA
Hospital for Special Surgery, New York, New York 10021, USA.
Sculco
Peter K
PK
Heitkemper
Sven
S
Mayman
David J
DJ
Bostrom
Mathias P
MP
Sculco
Thomas P
TP
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D001843:Bone Cements / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000502:physiology; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy* / Q000382:microbiology; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000209:etiology; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012086:Reoperation / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D001843:Bone Cements