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Comparative Study
. 2006 Aug;30(4):257-61.
doi: 10.1007/s00264-006-0102-2. Epub 2006 Mar 25.

Spacer prostheses in two-stage revision of infected knee arthroplasty

E Jämsen  1 , P Sheng, P Halonen, M U K Lehto, T Moilanen, J Pajamäki, T Puolakka, Y T Konttinen
Affiliations
Comparative Study

Spacer prostheses in two-stage revision of infected knee arthroplasty

E Jämsen et al. Int Orthop. 2006 Aug.

Abstract
in English, French

At present, no consensus exists on the best spacer alternative for the management of two-stage exchange arthroplasty of infected knee arthroplasties. In this retrospective study, patient records of 24 patients, who had undergone two-stage revisions in which resterilised prosthetic components were used as spacers, were reviewed. The outcome was compared to that of operations performed during the same period (1993-2003) using cement spacers (n=10). With an average follow-up of 32 months, control of infection was achieved in 26 cases (76%), with good or excellent clinical outcome in 19 cases (56%). Treatment failed and resulted in amputation at the level of the thigh before reimplantation in one case. Three patients did not undergo reimplantation. In four cases (12%) infection relapsed. The reinfection rate did not differ between the two spacer groups. Patients treated with resterilised components had a superior range of motion during the period between the two stages. Operative time was shorter and there was less blood loss in the reimplantation arthroplasty when a prosthetic spacer was used. We consider resterilised prosthetic components a safe and effective alternative to cement spacers in the management of infected knee arthroplasties.

Il n’existe pas actuellement de consensus sur les meilleurs spacers à utiliser dans le traitement des reprises en deux temps des prothèses totales du genou infectées. Dans cette étude rétrospective, 24 patients ont été évalués, patients ayant bénéficié d’un changement prothétique en deux temps, le spacer utilisé pouvant être les composants prothétiques stérilisés. Nous avons comparé le devenir de cette série (1993–2003) à une autre série traitée pendant la même période et en utilisant un spacer en ciment (10 patients). Le délai moyen était de 32 mois et la guérison de l’infection a été obtenue dans 76% des cas (26) avec un excellent ou un bon résultat dans 19 cas (56%). Les échecs du traitement sont secondaires à une amputation de cuisse avant la réimplantation (un cas). Trois patients n’ont pas eu de réimplantation et dans 4 cas (12%) l’infection a récidivé. La récidive de l’infection n’est pas différente entre les deux groupes de patients quelle que soit la nature du spacer. Les patients traités avec des composants prothétiques re-stérilisés ont eu une meilleure mobilité pendant la période intermédiaire. Le temps opératoire et les pertes sanguines sont significativement diminués lorsque le spacer utilisé est la prothèse re-stérilisée. Nous considérons en conclusion, que la re-stérilisation du composant prothétique est une méthode sure, efficace et une bonne alternative au spacer en ciment lors du traitement des prothèses totales du genou infectées.

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Figures

Fig. 1
Fig. 1
Treatment and outcome in the eradication of infection with the use of resterilised prosthesis spacer and cement spacer
See this image and copyright information in PMC

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