Use of temporary implants (spacers) in revision knee arthroplasty
DOI:
https://doi.org/10.15674/0030-59872012213-19Keywords:
knee joint, total arthropasty, operative exploration, spacerAbstract
There is currently no consensus concerning the best option of a spacer for two-stage arthroplasty with an infected knee prosthesis. This retrospective study examined case histories of 16 patients who underwent two-stage revision surgery with use of re-sterilized prosthesis elements as spacers. The results of operations, which were performed within the same period (2004–2010) with use of cement spacers (8 patients), were retrospectively analysed. During the postoperative observation period, which averaged 21 months, 24 cases (100 %) developed control over infection, good or excellent clinical results being observed in 18 cases. Two patients did not undergo reimplantation. The patients, treated with re-sterilized elements, had a greater range of movements during the period between the two operations. Reimplantations with use of prosthetic spacers lasted less time, blood losses were lower. We believe that re-sterilized prosthesis elements are a reliable and efficient alternative to cement spacer for treating infected prosthetic knee joint.References
- Barrack R. L. Patient satisfaction and outcome after septic versus aseptic revision total knee arthroplasty / R. L. Barrack, G. A. Engh, C. J. Rorabeck // Arthroplasty. — 2000. — Vol. 15. — P. 990–993.
- Booth R. E. The results of spacer block technique in revision of infected total knee arthroplasty / R. E. Booth, P. A. Lotke // Clin. Orthop. — 1989. — Vol. 248. — P. 57–60.
- Costerton J.W. Bacterial biofilms: a common cause of persistent infections / J. W. Costerton, P. S. Stewart, E. P. Greenberg // Science. — 1999. — Vol. 284. — P. 1318–1322.
- Emerson R.H. Comparison of a static with a mobile spacer in total knee infection. / R. H. Emerson, M. Muncie, T. R. Tarbox // Clin. Orthop. — 2002. — Vol. 404. — P. 132–138.
- Fehring T. K. Articulating versus static spacers in revision total knee arthroplasty for sepsis / T. K. Fehring, S. Odum, T. F. Calton // Clin. Orthop. — 2000. — Vol. 380. — P. 9–16.
- Haddad F.S. The PROSTALAC functional spacer in two-stage revision for infected knee replacements / F. S. Haddad, B. A. Masri, D. Campbell // J. Bone Joint Surg. — 2000. — Vol. 82. — P. 807–812.
- Hirn M. Y. J. High-pressure saline washing of allografts reduces bacterial contamination / M. Y. J. Hirn, P. M. Salmela, R. E. Vuento // Acta Orthop. Scand. — 2001. — Vol. 72. — P. 83–85.
- Hofmann A.A. Treatment of infected knee arthroplasty using an articulating spacer / A. A. Hofmann, T. Goldberg, S. M. Kurtin // Clin. Orthop. — 2005. — Vol. 430. — P. 125–131.
- Hofmann A.A. Treatment of infected total knee arthroplasty using an articulating spacer / A. A. Hofmann, K. R. Kane, M. P. Camargo // Clin. Orhop. — 1995. — Vol. 321. — P. 45–54.
- Insall J. N. Rationale of the knee society clinical rating system / J. N. Insall, L. D. Dorr, R. D. Scott // Clin. Orthop. — 1989. — Vol. 248. — P. 13–14.
- Masri B. A. Two-stage exchange arthroplasty using a functional antibiotic-loaded spacer in the treatment of the infected knee replacement: the Vancouver experience / B. A. Masri, R. W. Kendall, C. P. Duncan // Semin. Arthroplasty. — 1994. — Vol. 5. — P. 122–136.
- Neut D. Pseudomonas aerigunosa biofilm formation and slime excretion on antibiotic-loaded bone cement / D. Neut, J. G. Hendriks, H. J. Busscher // Acta Orthop. — 2005. — Vol. 76. — P. 109–114.
- Pitto R. P. Antibiotic-loaded bone cement spacers in two-stage management of infected total knee arthroplasty / R. P. Pitto, I. A. Spika // Int. Orthop. — 2004. — Vol. 28. — P. 129–133.
- Van de Belt H. Gentamicin release from polymethylmethacrylate bone cements and Staphylococcus aureus biofilm formation / H. van de Belt, D. Neut, H. J. Busscher // Acta Orthop. Scand. — 2000. — Vol. 71. — P. 625–629.
- Wang C. J. Clinical outcome and patient satisfaction in aseptic and septic revision total knee arthroplasty / C. J. Wang, M. C. Hsieh, T. W. Huang // Knee. — 2000. — Vol. 11. — P. 45–49.
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