title: Articulating spacers compared to fixed spacers for the treatment of infected knee arthroplasty: A follow-up of 37 cases.
abstract: BACKGROUND
  The standard treatment of a periprosthetic infection after TKA involves a two-stage reimplantation with the intermittent implantation of spacers. Different designs of spacers have been described; currently articulating spacers and fixed spacers are used. The aim of the present study is to compare the advantages/disadvantages of the different spacers.
  
  
  METHODS
  In this retrospective study we analyzed 37 cases after revision surgery of infected TKA. All patients that received spacers as part of the two-stage reimplantation were included. Exclusion criteria were massive bone loss prior to revision, because the implantation of a mobile spacer would not have been possible.
  
  
  RESULTS
  The average ROM was 98.0 (± 14.9) degrees in the articulating spacer group (group 1) and 79.3 (± 22.5) in the group that received the fixed spacers (group 2) before revision surgery started. At a late follow up the average ROM for group 1 was 102.0 (± 8.4) and 79.0 (± 26) for group 2.
  
  
  CONCLUSIONS
  The use of articulating spacers in the two-stage revision for infected total knee arthroplasty is a safe alternative to fixed spacers, that equally preserves ligament balancing and has equal infection eradication rates. A long term improvement of the range of motion following reimplantation of the new joint was, however, not observed.
authors.affiliation: Orthopädische Gemeinschaftspraxis Borken, Borken, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Skwara
authors.affiliation: Sporthopaedicum Straubing, Straubing, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Tibesku
authors.affiliation: Department of Orthopaedics and Rheumatology, University Hospital Marburg, Marburg, Germany.
authors.forename: R J R
authors.initials: RJ
authors.lastname: Paletta
authors.affiliation: Department of Orthopaedics and Rheumatology, University Hospital Marburg, Marburg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Sommer
authors.affiliation: Alfried Krupp Krankenhaus, Rüttenscheid, Essen, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Krödel
authors.affiliation: Alfried Krupp Krankenhaus, Rüttenscheid, Essen, Germany.|Ruhr Universität Bochum, Bochum, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Lahner
authors.affiliation: Sporthopaedicum Straubing, Straubing, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Daniilidis
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies
keywords: Total knee arthroplasty (TKA); infection; spacer; two-stage revision