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The Effect of Time Spent with a Dynamic Spacer on Clinical and Functional Outcomes in Two-Stage Revision Knee Arthroplasty

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Abstract

Introduction

The present study aimed to evaluate the effect of a longer interval between the first and second stages of infected total knee arthroplasty (TKA) revision on the clinical and functional outcome.

Methods

This study included a total of 56 patients who underwent two-stage revision TKA with a dynamic spacer with a minimum of 2 years of follow-up. Patients were categorized into two groups according to time with the spacer: < 3 months (Group 1, 31 patients) or > 3 months (Group 2, 25 patients). Clinical outcome and quality of life were assessed by knee range of motion (ROM), Knee Society Score for Knee (KSS-K), Knee Society Score for Function (KSS-F) and Short Form 36 (SF-36).

Results

The mean follow-up period was 48 ± 19.1 months (range, 24–84 months). The KSS-K, KSS-F, and ROM values were significantly higher in Group 1 than in Group 2 (p < 0.05). The SF-36 scores for general health, physical function, and bodily pain were significantly higher in Group 1 (p < 0.05). Re-infection occurred in 10 patients (17.8%). Time with spacer was not associated with re-infection development (Group 1, n = 6, 19% vs. Group 2, n = 4, 16%; p > 0.05).

Conclusion

Increased duration with a spacer is associated with poorer clinical and functional outcomes as well as higher treatment costs in two-stage revision knee arthroplasty. Surgeons can attempt to reduce the time patients spend in a spacer to obtain better postoperative functional outcomes, as well as a better quality of life.

Level of Evidence

3.

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Funding

This study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, Tunceli State Hospital, Cumhuriyet Mah., Tunceli-Elazığ karayolu Merkez, 62000, Tunceli, Turkey

    Fatih Golgelioglu

  2. Department of Orthopaedics and Traumatology, Sarkısla State Hospital, Yıldırım Mahallesi No: 27, Şarkışla, 58400, Sivas, Turkey

    Sinan Oguzkaya

  3. Department of Orthopaedics and Traumatology, Health Sciences University Gaziosmanpasa Training and Research Hospital, Karayollari Mah. Osmanbey Cad. 621. Sk Gaziosmanpasa, 34255, Istanbul, Turkey

    Abdulhamit Misir

  4. Faculty of Medicine, Department of Orthopaedics and Traumatology, Erciyes University, Yenidoğan Mahallesi, Turhan Baytop Sokak No: 1, Talas, 38280, Kayseri, Turkey

    Ahmet Guney

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  1. Fatih Golgelioglu
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Contributions

FG: Data Collection and Statisical analysis. SO: Manuscipt writing. AM: Critical reviewing. AG: Data Collection.

Corresponding author

Correspondence to Fatih Golgelioglu.

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Conflict of interest

Fatih Golgelioglu, Sinan Oguzkaya, Abdulhamit Misir and Ahmet Guney declare that they have no conflict of interest.

Ethical standard statement

Erciyes University Institutional Research Ethics Review Board approved the study protocol (Approval date/number: 06.06.2018/2018-305).

Informed consent

All patients signed informed constent form before be included into the study.

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Golgelioglu, F., Oguzkaya, S., Misir, A. et al. The Effect of Time Spent with a Dynamic Spacer on Clinical and Functional Outcomes in Two-Stage Revision Knee Arthroplasty. JOIO 54, 824–830 (2020). https://doi.org/10.1007/s43465-020-00247-8

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  • DOI: https://doi.org/10.1007/s43465-020-00247-8

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