Custom Made Articulating Spacer in Two Stage Revision Total Knee Arthroplasty: An Early Follow-up of 14 Cases with At Least One Year After Surgery

HSS Journal


Valerio Pascale, MD
Clinica Ortopedica e Traumatologica

Walter Pascale, MD, IRCCS
Istituto Ortopedico Galeazzi, Unità Operativa di Artroscopia e Chirurgia del Ginocchio II

Abstract
Total knee replacement (TKR) infection represent only a small percentage of all the potential complications in joint replacement, but one that can lead to disastrous consequences. Two stage revision includes prosthesis removal, positioning of an antibiotic loaded spacer and systemic antimicrobial therapy for at least six weeks, and has proven to be the most effective technique in eradicating infection.  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 twelve months on fourteen patients treated by antibiotic loaded  custom made articulating spacer, as described by Villanueva et al(1).

The mean flexion achieved after the second stage of the revision was 120°, ranging from 97° to 130°. The mean HSS score was 84. At one 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.

This article appears in HSS Journal: Volume 3, Number 2.
View the full article at springerlink.com.


About the HSS Journal
HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.


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