Role of Articulating Spacer in Two Stage Reimplantation of Infected Total Knee Arthroplasty

ABSTRACT

The objective of this study is to assess the role of articulating spacer in two stage reimplantation of infected TKA. Fifteen patients with deep infected total knee arthroplasties were treated by two stage reimplantation protocol between Jan. 1987 and Oct. 1997. Seven cases in Group A were treated by debridement, removal of the prosthesis and placement of antibiotic impregnated cement spacer before reimplantation. Eight cases in Group B were treated by debridement, and reinsertion of the retrieved implant after autoclaving with antibiotic impregnated cement fixation. The average follow-up period was 77 months(range, 28-141 months) in group A, and 25 months(range, 12-63 months) in group B. The average knee flexion after revision was 82 degrees in group A, and 106 degrees in group B. The average HSS knee rating score was 80 points in group A, and 88 points in group B. No patient had recurrence of infection during the follow-up period. In conclusion, our method using articulating spacer allowed emly range of motion and partial weight bearing during the spacer phase. This methods also delivered high local concentration of antibiotics and kept the functional joint before a second-stage reimplantation.