International Orthopaedics

, Volume 43, Issue 11, pp 2503–2509 | Cite as

Functional outcome of two-stage reimplantation in patients with periprosthetic joint infection after primary total knee arthroplasty

  • Petr Mikhailovich PreobrazhenskyEmail author
  • Svetlana Anatolievna Bozhkova
  • Alexander Viktorovich Kazemirsky
  • Rashid Murtazalievich Tikhilov
  • Taras Andreevich Kulaba
  • Nikolai Nikolaevich Kornilov
Original Paper



Two-stage reimplantation in patients with chronic periprosthetic joint infection (PJI) after total knee arthroplasty (TKA) with the use of either articulating or static antibiotic-loaded spacers during the first step is considered to be the golden standard in orthopaedics.

The aim of the study

The aim of the study was to evaluate the correlation of spacer type with the infection elimination rate as well as functional outcomes after two-staged revision TKA in patients with PJI.

Materials and methods

The cohort comprised 161 patients who were treated for PJI after TKA during a period from January 2007 to December 2015. After the exclusion of patients with severe bone defects (AORI 2B or 3), 104 were left for the analysis: 72 patients with articulating and 32 with static spacers. The overall patient mean age was 62 years old (95% CI, 30–84): 73 for females, 31 for males. The outcomes were evaluated after three, six and 12 months using the American Knee Society Score (KSS) and EQ-5D. Only 92 patients were available for observation: 25 with static and 67 with articulating spacers.


One year after the surgery, patients with articulating spacers demonstrated significantly higher mean KSS and function scores in comparison to patients with static spacers (90.4, 77.3 and 78.5, 67.8, respectively (p < 0.05)). The range of motion was also significantly better in patients with articulating spacers: 104.9° in comparison to 93.9° (р < 0.0001). The final EQ-5D score was comparable in both groups (0.82, 73.1 in articulating and 0.82, 72.6 in static spacers).


The two-stage revision TKA for PJI using articulating spacers in comparison to the static ones provides better infection eradication rate as well as functional outcomes and improved quality of life.


Total knee arthroplasty Periprosthetic joint infection Two-stage revision Spacer Quality of life Outcome 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.


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Copyright information

© SICOT aisbl 2019

Authors and Affiliations

  • Petr Mikhailovich Preobrazhensky
    • 1
    Email author
  • Svetlana Anatolievna Bozhkova
    • 1
  • Alexander Viktorovich Kazemirsky
    • 1
  • Rashid Murtazalievich Tikhilov
    • 1
  • Taras Andreevich Kulaba
    • 1
  • Nikolai Nikolaevich Kornilov
    • 1
  1. 1.Russian Scientific Research Institute of Traumatology and Orthopedics named after R.R. VredenSt. PetersburgRussian Federation

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