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Customized intraoperatively molded articulating cement spacers for two-stage revisions TKA with major bone defects

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

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Abstract

Background

The use of articulating spacers, molded or prefabricated, becomes difficult in case of severe bone losses. Our idea was to customize the Molded Articulating Cement Spacers with cement stem extensions and if necessary metaphyseal cement augmentations in order to use them also in case of major bone defects.

Methods

Fifty-four knees in fifty-three patients undergoing 2-stage exchange arthroplasty were divided in 4 groups, treated with 4 different types of spacers (Static, articulating molded, customized molded and metal on Poly) and evaluated in terms of Range of Motion (ROM), Knee Society Score (KSS), patients’ related outcome measures (PROMs), rate of complication and ease of the surgical exposure at the time of reimplantation.

Results

At final follow-up, no statistical differences in terms of ROM and KSS were found between the articulating groups. Static Spacers showed statistically significant lower results both in terms of ROM and KSS comparing to the other 3 groups (P < 0.05). Considering PROMs, statistically better outcomes for all articulating spacers were found both when spacer was in place and at final follow-up comparing to the static spacers group (P < 0.05). No statistically significant difference was found between the 3 articulating spacers groups. Radiographic analysis did not show signs of loosening, migration or major bone loss.

Conclusions

Customized Intraoperatively Molded Articulating Cement Spacers are a safe solution for two-stage revisions TKA with major bone defects and may provide a better quality of life for patients when in place comparing to static ones.

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Funding

This study obtained IRB Approval (No. 2015001968), and written consent was obtained from all patients.

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Authors and Affiliations

  1. Sezione di Chirurgia Protesica ad Indirizzo Robotico - Unità di Traumatologia dello Sport, U.O. Ortopedia e Traumatologia Fondazione Poliambulanza, Via Bissolati 57, Brescia, Italy

    Stefano Marco Paolo Rossi, Loris Perticarini & Francesco Benazzo

  2. Clinica Ortopedica e Traumatologia, Fondazione IRCCS Policlinico San Matteo, P.le Golgi 19, Pavia, Italy

    Marta Medetti & Matteo Ghiara

  3. Università degli Studi di Pavia, Pavia, Italy

    Francesco Benazzo

Authors
  1. Stefano Marco Paolo Rossi
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  2. Marta Medetti
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  3. Loris Perticarini
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  4. Matteo Ghiara
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  5. Francesco Benazzo
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Corresponding author

Correspondence to Stefano Marco Paolo Rossi.

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The authors declare no conflict of interest for this study.

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Cite this article

Rossi, S.M.P., Medetti, M., Perticarini, L. et al. Customized intraoperatively molded articulating cement spacers for two-stage revisions TKA with major bone defects. Eur J Orthop Surg Traumatol 31, 1121–1128 (2021). https://doi.org/10.1007/s00590-020-02844-7

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  • DOI: https://doi.org/10.1007/s00590-020-02844-7

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