title: Two-stage revision using a modified articulating spacer in infected total knee arthroplasty.
abstract: OBJECTIVE
  To evaluate clinical results of two-stage revision using a modified articulating spacer for treatment of infected total knee arthroplasty (TKA).
  
  
  METHODS
  We retrospectively reviewed 20 cases treated by two-stage revision arthroplasty using a modified articulating spacer under the diagnosis of infected TKA from January 2006 to December 2011. The mean follow-up period was 22.3 months. The first operation consisted of debridement after removal of the prosthesis, reinsertion of the femoral component after autoclaving, and implantation of antibiotic-loaded cement with a new polyethylene in the proximal tibia.
  
  
  RESULTS
  The mean period between the primary TKA and the first stage operation was 39 months and between the first stage operation and the revision arthroplasty was 3.3 months. The average range of motion (ROM) increased from 69.8° preoperatively to 102.8° postoperatively (p<0.001). The mean Knee Society knee score increased from 33.8 points to 85.3 points (p<0.001). The mean Knee Society function score increased from 35 points to 87.5 points (p<0.001). The mean Hospital for Special Surgery score increased from 57.6 points preoperatively to 82.6 points postoperatively (p<0.001). Two cases (10%) were re-infected after the revision arthroplasty.
  
  
  CONCLUSIONS
  Two-stage revision arthroplasty using an articulating cement spacer can be an effective therapy not only for the treatment of an infected TKA but also for recovery of knee ROM and function.
authors.affiliation: Department of Orthopedic Surgery, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Ki Cheor
authors.initials: KC
authors.lastname: Bae
authors.affiliation: Department of Orthopedic Surgery, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Chul Hyun
authors.initials: CH
authors.lastname: Cho
authors.affiliation: Department of Orthopedic Surgery, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Kyung Jae
authors.initials: KJ
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Eun Seok
authors.initials: ES
authors.lastname: Sohn
authors.affiliation: Department of Orthopedic Surgery, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Beom Soo
authors.initials: BS
authors.lastname: Kim
keywords: Infection; Knee; Revision total knee arthroplasty; Two-stage