title: The cement prosthesis-like spacer: an intermediate halt on the road to healing.
abstract: BACKGROUND
  Periprosthetic infections remain a devastating problem in the field of joint arthroplasty. In the following study, the results of a two-stage treatment protocol for chronic periprosthetic infections using an intraoperatively molded cement prosthesis-like spacer (CPLS) are presented.
  
  
  METHODS
  Seventy-five patients with chronically infected knee prosthesis received a two-stage revision procedure with the newly developed CPLS between June 2006 and June 2011. Based on the microorganism involved, patients were grouped into either easy to treat (ETT) or difficult to treat (DTT) and treated accordingly. Range of motion (ROM) and the knee society score (KSS) were utilized for functional assessment.
  
  
  RESULTS
  Mean duration of the CPLS implant in the DTT group was 3.6 months (range 3-5 months) and in the ETT group 1.3 months (range 0.7-2.5 months). Reinfection rates of the final prosthesis were 9.6% in the ETT and 8.3% in the DTT group with no significant difference between both groups regarding ROM or KSS (P = 0.87, 0.64, resp.).
  
  
  CONCLUSIONS
  The results show that ETT patients do not necessitate the same treatment protocol as DTT patients to achieve the same goal, emphasizing the need to differentiate between therapeutic regimes. We also highlight the feasibility of CLPS in two-stage protocols.
authors.affiliation: Department of Orthopedic Surgery and Traumatology, University of Bern, Switzerland.
authors.forename: Sufian S
authors.initials: SS
authors.lastname: Ahmad
authors.forename: Kim
authors.initials: K
authors.lastname: Huber
authors.forename: Dimitrios S
authors.initials: DS
authors.lastname: Evangelopoulos
authors.forename: Barbara
authors.initials: B
authors.lastname: Kleer
authors.forename: Hendrik
authors.initials: H
authors.lastname: Kohlhof
authors.forename: Michael
authors.initials: M
authors.lastname: Schär
authors.forename: Stefan
authors.initials: S
authors.lastname: Eggli
authors.forename: Sandro
authors.initials: S
authors.lastname: Kohl
mesh_terms: D001170:Arthritis, Infectious / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology / Q000601:surgery*; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation*; D001843:Bone Cements; D003646:Debridement; D016983:Enterococcus; D005839:Gentamicins / Q000008:administration & dosage / Q000627:therapeutic use; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects*; D055624:Methicillin-Resistant Staphylococcus aureus; D020370:Osteoarthritis, Knee / Q000601:surgery; D019904:Polymethyl Methacrylate; D019736:Prostheses and Implants; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D013290:Streptococcal Infections / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements; D005839:Gentamicins; D019904:Polymethyl Methacrylate