title: Spacer-related problems in two-stage revision knee arthroplasty.
abstract: Although articulated cement spacers are frequently used in a staged approach of an infected total knee arthroplasty (TKA), no data are available on the incidence and type of spacer-related problems in these patients. A retrospective analysis of 154 patients who underwent a two-stage revision procedure for an infected TKA was performed. All patients received an articulating cement spacer at the implant removal procedure; their radiographs were analyzed for spacer-related issues such as spacer dislocation, fracture, tilting or translation, and knee subluxation. In 43% of the patients, the spacer was considered as optimal. The main finding of this study is the large incidence (57%) of spacer-specific problems in two-stage revision knee arthroplasty for infected TKA. Spacer tilting and mediolateral translation were found to be the most frequent spacer-specific problems, in 24% and 21% of the cases respectively. These were considered as minor problems. Major problems were seen in 12 % : in 3% of the knees the spacer had dislocated, in 5% the spacer fractured and in 4%, although the spacer seemed to be adequately positioned relative to the femoral and tibial bone, frank knee subluxation could be noted. The impact of spacer-specific problems with articulating cement spacers on final outcome in two-stage revision knee surgery will be further investigated.
authors.affiliation: Orthopaedic department, University Hospital Pellenberg, Belgium. bernard.struelens@uzleuven.be
authors.forename: Bernard
authors.initials: B
authors.lastname: Struelens
authors.forename: Steven
authors.initials: S
authors.lastname: Claes
authors.forename: Johan
authors.initials: J
authors.lastname: Bellemans
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation / Q000379:methods*; D001843:Bone Cements; D003646:Debridement; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000601:surgery*; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D000074402:Synovectomy; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D001843:Bone Cements