Skip to main content

Advertisement

SpringerLink
Log in

Comparison of static and mobile antibiotic-impregnated cement spacers for the treatment of infected total knee arthroplasty

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Infection after total knee arthroplasty (TKA) is a devastating complication, and two-stage reimplantation has evolved as an effective treatment option. This study was undertaken to compare the clinical results and radiological changes associated with static or mobile cement spacer placement for the treatment of infected TKA. Between July 2000 and February 2007, 36 consecutive patients were treated by two-stage reimplantation using antibiotic-impregnated cement spacers (AICS) for infected TKAs. Static spacers were used in 20 knees and mobile spacers in 16 knees. Clinical outcomes included success rates of TKR revisions, ranges of motion (ROM), and Hospital for Special Surgery knee scores (HSS), pain and function scores of the Knee Society (KS), joint exposure methods, and bone loss. In this study, mobile spacers provided better ranges of motion and functional knee scores without concomitant increases in infection rate and bone loss in the initial and mid-term periods.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Anderson JA, Sculco PK, Heitkemper S, Mayman DJ, Bostrom MP, Sculco TP (2009) An articulating spacer to treat and mobilize patients with infected total knee arthroplasty. J Arthroplast 24(4):631–635

    Article  Google Scholar 

  2. Antoci V, Phillips MJ, Antoci V Jr, Krackow KA (2009) The treatment of recurrent chronic infected knee arthroplasty with a 2-stage procedure. J Arthroplast 24(1):159.e13–17

    Article  Google Scholar 

  3. Borden LS, Gearen PF (1987) Infected total knee arthroplasty: a protocol for management. J Arthroplast 2(1):27–36

    Article  CAS  Google Scholar 

  4. Burnett RSJ, Kelly MA, Hanssen AD, Barrack RL (2007) Technique and timing of two-stage exchange for infection in TKA. Clin Orthop Relat Res 464:164–178

    PubMed  Google Scholar 

  5. Callaghan JJ, Katz RP, Johnston RC (1999) One-stage revision surgery of the infected hip. A minimum 10-year follow up study. Clin Orthop Relat Res 369:139–143

    Article  PubMed  Google Scholar 

  6. Emerson RH Jr, Muncie M, Tarbox TR, Higgins LL (2002) Comparison of a static with a mobile spacer in total knee infection. Clin Orthop Relat Res 404:132–138

    Article  PubMed  Google Scholar 

  7. Ewald FC (1989) The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 248:9–12

    PubMed  Google Scholar 

  8. Fehring TK, Odum S, Calton TF, Mason JB (2000) Articulating versus static spacers in revision total knee arthroplasty. Clin Orthop Relat Res 380:9–16

    Article  PubMed  Google Scholar 

  9. Gristina AG, Kolkin J (1983) Current concepts review: total joint replacement and sepsis. J Bone Jt Surg Am 65:128–134

    CAS  Google Scholar 

  10. Haddad FS, Masri BA, Campbell D et al (2000) The PROSTALAC functional spacer in two stage revision for infected knee replacements. Prosthesis of antibiotic-loaded acrylic cement. J Bone Jt Surg Br 82:807–812

    Article  CAS  Google Scholar 

  11. Haleem AA, Berry DJ, Hanssen AD (2004) Mid-term to long-term followup of two-stage reimplantation for infected total knee arthroplasty. Clin Orthop Relat Res 428:35–39

    Article  PubMed  Google Scholar 

  12. Hofmann AA, Goldberg T, Tanner AM, Kurtin SM (2005) Treatment of infected total knee arthroplasty using an articulating spacer: 2- to 12-year experience. Clin Orthop Relat Res 430:125–131

    Article  PubMed  Google Scholar 

  13. Hsu YC, Cheng HC, Ng TP, Chiu KY (2007) Antibiotic-loaded cement articulating spacer for 2-stage reimplantation in infected total knee arthroplasty: a simple and economic method. J Arthroplast 22(7):1060–1066

    Article  CAS  Google Scholar 

  14. Insall JN, Ranawat CS, Aglietti P, Shine J (1976) A comparison of four models of total knee replacement prostheses. J Bone Jt Surg Am 78:754–765

    Google Scholar 

  15. Kent M, Rachha R, Sood M (2009) A technique for the fabrication of a reinforced moulded articulating cement spacer in two-stage revision total hip arthroplasty. Int Orthop. doi:10.1007/s00264-009-0847-5

    PubMed  Google Scholar 

  16. Masri BA, Duncan CP, Beauchamp CP (1998) Long-term elution of antibiotics from bone-cement: an in vivo study using the prosthesis of antibiotic-loaded acrylic cement (PROSTALAC) system. J Arthroplast 13(3):331–338

    Article  CAS  Google Scholar 

  17. Meek RM, Masri BA, Dunlop D et al (2003) Patient satisfaction and functional status after treatment of infection at the site of a total knee arthroplasty with use of the PROSTALAC articulating spacer. J Bone Jt Surg Am 85:1888–1892

    Google Scholar 

  18. Pitto RP, Castelli CC, Ferrari R, Munro J (2005) Pre-formed articulating knee spacer in two-stage revision for the infected total knee arthroplasty. Int Orthop 29:305–308

    Article  CAS  PubMed  Google Scholar 

  19. Windsor RE, Insall JN, Urs WK, Miller DV, Brause BD (1990) Two-stage reimplantation for the salvage of total knee arthroplasty complicated by infection. Further follow-up and refinement of indications. J Bone Jt Surg Am 2:272–278

    Google Scholar 

Download references

Conflict of interest statement

No support in the form of grants, equipment or other items has occurred for this project. The authors have received nothing of value.

This manuscript does not contain information about medical devices.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Chonnam National University Hwasun Hospital, 160 Ilsimri, Hwasun-eup, Hwasun-gun, Jeonnam, 519-809, Korea

    Sang-Jin Park, Eun-Kyoo Song, Jong-Keun Seon, Taek-Rim Yoon & Gi-Heon Park

Authors
  1. Sang-Jin Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eun-Kyoo Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jong-Keun Seon
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Taek-Rim Yoon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gi-Heon Park
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eun-Kyoo Song.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Park, SJ., Song, EK., Seon, JK. et al. Comparison of static and mobile antibiotic-impregnated cement spacers for the treatment of infected total knee arthroplasty. International Orthopaedics (SICOT) 34, 1181–1186 (2010). https://doi.org/10.1007/s00264-009-0907-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-009-0907-x

Keywords

Search

Navigation