Articulating spacers compared to fixed spacers for the treatment of infected knee arthroplasty: A follow-up of 37 cases

• Published in: Technology and health care Vol. 24; no. 4; pp. 571 - 577
• Main Authors: Skwara, A, Tibesku, C, Paletta, R J R, Sommer, C, Krödel, A, Lahner, M, Daniilidis, K
• Format: Journal Article
• Language: English
• Published: Netherlands 25.03.2016
• Subjects: Aged; Arthroplasty, Replacement, Knee - adverse effects; Female; Humans; Male; Prosthesis-Related Infections - drug therapy; Prosthesis-Related Infections - microbiology; Prosthesis-Related Infections - surgery; Range of Motion, Articular; Recovery of Function; Retrospective Studies; spacer; infection; Total knee arthroplasty (TKA); two-stage revision
• ISSN: 0928-7329; 1878-7401
• DOI: 10.3233/THC-161152

The standard treatment of a periprosthetic infection after TKA involves a two-stage reimplantation with the intermittent implantation of spacers. Different designs of spacers have been described; currently articulating spacers and fixed spacers are used. The aim of the present study is to compare the advantages/disadvantages of the different spacers. In this retrospective study we analyzed 37 cases after revision surgery of infected TKA. All patients that received spacers as part of the two-stage reimplantation were included. Exclusion criteria were massive bone loss prior to revision, because the implantation of a mobile spacer would not have been possible. The average ROM was 98.0 (± 14.9) degrees in the articulating spacer group (group 1) and 79.3 (± 22.5) in the group that received the fixed spacers (group 2) before revision surgery started. At a late follow up the average ROM for group 1 was 102.0 (± 8.4) and 79.0 (± 26) for group 2. The use of articulating spacers in the two-stage revision for infected total knee arthroplasty is a safe alternative to fixed spacers, that equally preserves ligament balancing and has equal infection eradication rates. A long term improvement of the range of motion following reimplantation of the new joint was, however, not observed.