Two-Stage Reimplantation in Infected Total Knee Arthroplasty (A Method of Reinsertion of the Autoclaved Femoral Component and a Polyethylene Liner)

ABSTRACT

PURPOSE: We wanted to evaluate the results of treating infected total knee arthroplasty with an autoclaved femoral component and polyethylene liner. MATERIALS AND METHODS: From March 2003 to March 2008, 25 knees were diagnosed as infected total knee arthroplasty (TKA) and they underwent two-stage re-implantation. These knees were treated with debridement, reinsertion of the removed femoral component and a polyethylene liner, which were autoclaved, and antibiotic cement was used as an articulating spacer during the interim period to allow maintenance of motion and function. The range of motion and the Hospital for Special Surgery (HSS) score, the Knee Society Knee Score and the Function Score were evaluated. RESULTS: The mean follow up period was 52 months. There was one recurrence of infection. Prior to revision, the average range of motion was 83degrees and the average HSS score was 60 points. At final follow-up, the average range of motion was 110degrees and the average HSS score was 86 points. The knee score and function score showed an increase from a mean of 46 and 31 points preoperatively to a mean of 82 and 50 points postoperatively. The complications during reimplantation were one medial collateral ligament rupture, one lateral condyle fracture and one femoral distal metaphyseal fracture. CONCLUSION: The articulating spacer using an autoclaved femoral component and polyethylene can improve knee function and motion in two stage revision TKA.