The Effect of Subluxation of Articulating Antibiotic Spacers on Bone Defects and Degree of Constraint in Revision Knee Arthroplasty.
This study investigated whether subluxation of articulating antibiotic spacers is associated with the bone defects found and constraint required when re-implanting the knee arthroplasty components. Staged revisions for infections of primary total knee arthroplasties between 2004 and 2012 were examined. Radiographic sagittal and coronal subluxations of 72 knees were measured prior to second stage revision. Coronal subluxation was found to be associated with increased requirement for constrained knee systems (P<0.035). Sagittal subluxation was associated with greater tibia bone defects (P<0.037). Careful surgical technique and monitoring of articulating spacers should be done to avoid subluxation after stage 1 revision. If subluxation of the articulating spacer is present, constrained revision knee systems as well as augments should be available at time of re-implantation.
Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada.
Adrian C K
AC
Lau
Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada.
James L
JL
Howard
Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada.
Steven J
SJ
Macdonald
Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada; Department of Medical Biophysics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada; Surgical Innovation Program, Lawson Health Research Institute, London, ON, Canada.
Matthew G
MG
Teeter
Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada.
Brent A
BA
Lanting
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging* / Q000601:surgery; D007720:Knee Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000601:surgery*; D011859:Radiography; D012086:Reoperation / Q000295:instrumentation; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery
D000900:Anti-Bacterial Agents
articulating spacer; bone defects; constraint; revision knee; subluxation