Clinical Orthopaedics and Related Research®

, Volume 470, Issue 1, pp 228–235 | Cite as

Is There a Preferred Articulating Spacer Technique for Infected Knee Arthroplasty?: A Preliminary Study

  • Niraj V. Kalore
  • Aditya Maheshwari
  • Amit Sharma
  • Edward Cheng
  • Terence J. Gioe
Symposium: Papers Presented at the Annual Meetings of The Knee Society
First Online:

Abstract

Background

Periprosthetic infection in TKA is a devastating and challenging problem for both patients and surgeons. Two-stage exchange arthroplasty with an interval antibiotic spacer reportedly has the highest infection control rate. Studies comparing static spacers with articulating spacers have reported varying ROM after reimplant, which could be due to differences in articulating spacer technique.

Questions/purposes

We therefore determined whether one of three articulating spacer techniques was superior in terms of (1) infection control, (2) final ROM, and (3) cost.

Patients and Methods

We retrospectively reviewed 53 patients with infected TKAs who had two-stage exchange arthroplasty with one of three techniques with articulating spacers: autoclaving an original component (n = 15), a new femoral component (n = 16), and a silicone mold component (n = 22). We compared infection control, ROM, and cost. Minimum followup was 12 months (mean, 39 months; range, 12–105 months).

Results

We found no difference in infection control among the three techniques. Infection control was achieved in 13 of 15 (86.7%) autoclaved original component spacers at mean 73 months (range, 37–105 months), 15 of 16 (93.8%) new femoral component spacers at mean 19 months (range, 12–32 months), and 20 of 22 (90.9%) silicone mold component spacers at mean 32 months (range, 14–56 months). Mean final flexion was 95.7°, 98.3°, and 93.8°, respectively. Direct costs for all implants, molds, cement, and antibiotics were $932, $3589, and $3945, respectively.

Conclusions

We found comparable infection control and ROM for the three techniques. Direct cost was least for the autoclaved original component technique.

Level of Evidence

Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Keywords

Infection Control Space Technique Polyethylene Insert Silicone Mold Reinfection Rate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Notes

Acknowledgments

The authors thank Paul Lender (University of Minnesota) and Penny Tatman, MPH (HealthEast Care System, St Paul, MN) for their help with the statistical analysis.

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Copyright information

© The Association of Bone and Joint Surgeons® 2011

Authors and Affiliations

  • Niraj V. Kalore
    • 1
  • Aditya Maheshwari
    • 1
  • Amit Sharma
    • 1
  • Edward Cheng
    • 1
  • Terence J. Gioe
    • 1
    • 2
  1. 1.Department of Orthopaedic SurgeryUniversity of Minnesota Medical SchoolMinneapolisUSA
  2. 2.Department of Orthopaedic SurgeryMinneapolis Veterans Affairs Medical CenterMinneapolisUSA

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