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. 2013 Dec;25(4):180-5.
doi: 10.5792/ksrr.2013.25.4.180. Epub 2013 Nov 29.

Two-stage revision using a modified articulating spacer in infected total knee arthroplasty

Young Soo Kim  1 , Ki Cheor Bae  1 , Chul Hyun Cho  1 , Kyung Jae Lee  1 , Eun Seok Sohn  1 , Beom Soo Kim  1
Affiliations

Two-stage revision using a modified articulating spacer in infected total knee arthroplasty

Young Soo Kim et al. Knee Surg Relat Res. 2013 Dec.

Abstract

Purpose: To evaluate clinical results of two-stage revision using a modified articulating spacer for treatment of infected total knee arthroplasty (TKA).

Materials and methods: We retrospectively reviewed 20 cases treated by two-stage revision arthroplasty using a modified articulating spacer under the diagnosis of infected TKA from January 2006 to December 2011. The mean follow-up period was 22.3 months. The first operation consisted of debridement after removal of the prosthesis, reinsertion of the femoral component after autoclaving, and implantation of antibiotic-loaded cement with a new polyethylene in the proximal tibia.

Results: The mean period between the primary TKA and the first stage operation was 39 months and between the first stage operation and the revision arthroplasty was 3.3 months. The average range of motion (ROM) increased from 69.8° preoperatively to 102.8° postoperatively (p<0.001). The mean Knee Society knee score increased from 33.8 points to 85.3 points (p<0.001). The mean Knee Society function score increased from 35 points to 87.5 points (p<0.001). The mean Hospital for Special Surgery score increased from 57.6 points preoperatively to 82.6 points postoperatively (p<0.001). Two cases (10%) were re-infected after the revision arthroplasty.

Conclusions: Two-stage revision arthroplasty using an articulating cement spacer can be an effective therapy not only for the treatment of an infected TKA but also for recovery of knee ROM and function.

Keywords: Infection; Knee; Revision total knee arthroplasty; Two-stage.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
A 56-year-old woman who received primary total knee arthroplasty (TKA) due to osteoarthritis complained of persistent pain and diffuse swelling after TKA. At 27 months after primary TKA, the radiographs show radiolucency around the tibial prosthesis.
Fig. 2
Fig. 2
(A) Anteroposterior and (B) lateral radiographs obtained after the first stage operation using a modified articulating spacer.
Fig. 3
Fig. 3
(A) Anteroposterior and (B) lateral radiographs obtained at 18 months after second-stage revision arthoplasty using a stemmed prosthesis.
See this image and copyright information in PMC

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