An intraoperatively moulded PMMA prostheses like spacer for two-stage revision of infected total knee arthroplasty.
We report a series of 16 consecutive total knee arthroplasty (TKA) revision procedures for deep infection, treated with a newly developed intraoperatively moulded PMMA cement-prostheses-like spacer (CPLS). The standard treatment consisted of a two-stage protocol with initial explantation of the infected components combined with radical debridement, followed by implantation of a temporary cement spacer and final reimplantation of a new TKA. A sterilizeable Teflon tapered aluminium mould was developed for production of a custom made CPLS during the intervention. Stable implantation of the CPLS was achieved with a second cementation, allowing for correct alignment and ligament balancing. The spacer remained 3.5 months on average until reimplantation of a TKA occurred. At time of reimplantation, patients had an average KSS score of 84.44 points with an average flexion capacity of 102°. There was no recurrent infection during the study period of minimum 2 years. With this new technique, a low friction articulation with good stability, high comfort and a better range of motion compared to handcrafted spacers was achieved. The use of this spacer is a time sparing, cheap and convenient option in 2-stage TKA revision.
Department of Orthopaedic Surgery, Inselspital, University of Bern, Switzerland. sandro.kohl@gmail.com
Sandro
S
Kohl
Dimitrios S
DS
Evangelopoulos
Hendrik
H
Kohlhof
Andreas
A
Krueger
Maximilian
M
Hartel
Christoph
C
Roeder
Stefan
S
Eggli
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation / Q000379:methods; D001843:Bone Cements; D002484:Cementation; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D007719:Knee Joint / Q000473:pathology / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D019904:Polymethyl Methacrylate; D011446:Prospective Studies; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000473:pathology / Q000601:surgery*; D012086:Reoperation; D016896:Treatment Outcome
D001843:Bone Cements; D019904:Polymethyl Methacrylate