title: Articulating vs. Static antibiotic impregnated spacers in revision total knee arthroplasty for sepsis. A systematic review.
abstract: Periprosthetic infection after total knee arthroplasty is a devastating complication, and two-stage exchange is the standard of care in North America. Articulating and static spacers have been developed to treat these infections but controversy exists over which method is superior. We performed a systematic review using MEDLINE and other literature search engines identifying 47 articles meeting inclusion criteria producing 2011 spacers for comparison. Articulating spacers had increased range of motion 100.1° vs. 82.9° (P<0.003), lower re-infection rate 7.5% (P<0.0031), facilitated re-implantation (P<0.0011), and developed less bone loss (P<.0001) than did static spacers. This study answers several clinically relevant questions and provides useful information in guiding clinical decision making in treating periprosthetic infection.
authors.affiliation: Insall Scott Kelly Institute for Orthopaedics and Sports Medicine, Lenox Hill Hospital Fellow, New York, New York.
authors.forename: George N
authors.initials: GN
authors.lastname: Guild
authors.affiliation: Emory Department of Biostatistics, Department of Orthopaedic Surgery, Emory University, Atlanta, Georgia.
authors.forename: Baohua
authors.initials: B
authors.lastname: Wu
authors.affiliation: Insall Scott Kelly Institute for Orthopaedics and Sports Medicine, New York, New York; Orthopedic Service Line, Northshore LIJ Health System, New York, New York.
authors.forename: Giles R
authors.initials: GR
authors.lastname: Scuderi
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery
chemical_list: D000900:Anti-Bacterial Agents
keywords: infection; total knee arthroplasty; two-stage exchange