Custom-made Articulating Spacer in Two-stage Revision Total Knee Arthroplasty. An Early Follow-up of 14 Cases of at Least 1 Year After Surgery

Abstract

Total knee replacement (TKR) infection represents only a small percentage of all the potential complications in joint replacement, but one that can lead to disastrous consequences. Two-stage revision, which has been proven to be the most effective technique in eradicating infection, includes prosthesis removal, positioning of an antibiotic-loaded spacer, and systemic antimicrobial therapy for at least 6 weeks. It has been suggested that there is better performance in terms of range of motion, pain, extensor mechanism shortening, and spacer-related bone loss if articulating spacers are used instead of fixed spacers. In this paper, we describe our results in two-stage revision of infected total knee arthroplasty with a minimum follow-up of 12 months on 14 patients treated by antibiotic-loaded custom-made articulating spacer as described by Villanueva et al. (Acta Orthop 77(2):329–332, 2006). The mean flexion achieved after the second stage of the revision was 120°, ranging from 97° to 130°. The mean Hospital for Special Surgery score was 84. At 1 year after surgery, none of the knees showed any evidence of recurrence of the infection. Articulating spacers are a suitable alternative to fixed spacers with good range of motion after reimplantation and effectiveness against total knee replacement deep infections.

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Correspondence to Valerio Pascale MD.

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Pascale, V., Pascale, W. Custom-made Articulating Spacer in Two-stage Revision Total Knee Arthroplasty. An Early Follow-up of 14 Cases of at Least 1 Year After Surgery. HSS Jrnl 3, 159–163 (2007). https://doi.org/10.1007/s11420-007-9048-1

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Keywords

  • Total Knee Arthroplasty
  • Total Knee Replacement
  • Infected Total Knee Arthroplasty
  • Patellar Tendon Length
  • Total Knee Joint Replacement