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Meta-Analysis
. 2017 Oct 17;12(1):151.
doi: 10.1186/s13018-017-0644-6.

Comparison of the efficacy of static versus articular spacers in two-stage revision surgery for the treatment of infection following total knee arthroplasty: a meta-analysis

Hai Ding  1 , Jian Yao  2 , Wenju Chang  2 , Fendou Liu  2
Affiliations
Meta-Analysis

Comparison of the efficacy of static versus articular spacers in two-stage revision surgery for the treatment of infection following total knee arthroplasty: a meta-analysis

Hai Ding et al. J Orthop Surg Res. .

Abstract

Background: The aim of this study was to compare the outcomes of static versus articular spacers in two-stage reimplantation for the treatment of infected total knee arthroplasty (TKA).

Methods: The literature regarding the articulating and static spacers for treating infected TKA were searched in PubMed, Embase, Cochrane Library, Chinese Periodical Full-Text Database of CNKI, and Wanfang database. Data were extracted according to the inclusion and exclusion criteria and analyzed by Review Manager 5.3.

Results: Ten studies were included to this meta-analysis (nine retrospective studies, one prospective study) according to the principle of PICOS. There was no significant difference regarding the eradication rate (P = 0.28) and the American Knee Society knee score (KSS) pain score (P = 0.11) between the articulating and static spacers in the two-stage revision surgery. There was no significant difference regarding quadriceps femoroplasty and tibial tubercle osteotomy between the two groups (P = 0.50). The knee range of motion (ROM), Hospital for Special Surgery (HSS) score, and KSS function score in the articulating group were significantly higher than those in the static group (P < 0.00001).

Conclusion: Articulating spacers can provide better ROM and knee function scores after revision surgery when compared to static spacer while not compromising the infection eradication rate, soft tissue contracture during exclusion period, and knee pain scores.

Keywords: Antibiotic bone cement spacer; Meta-analysis; Periprosthetic infection; Total knee arthroplasty; Two-stage revision arthroplasty.

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The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Flowchart of literature search
Fig. 2
Fig. 2
Forest plot diagram shows postoperative infection eradication between the two groups
Fig. 3
Fig. 3
Forest plot diagram shows postoperative lengthening of the femoral quadriceps between the two groups
Fig. 4
Fig. 4
Forest plot diagram shows the tibial tubercle osteotomy between the two groups
Fig. 5
Fig. 5
Forest plot diagram shows postoperative ROM between the two groups
Fig. 6
Fig. 6
Forest plot diagram shows postoperative KSS (function) score between the two groups
Fig. 7
Fig. 7
Forest plot diagram shows postoperative KSS (pain) score between the two groups
Fig. 8
Fig. 8
Forest plot diagram shows postoperative HSS score between the two groups
Fig. 9
Fig. 9
The graphical funnel plot
See this image and copyright information in PMC

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References

    1. Kurtz SM, Lau E, Schmier J, Ong KL, Zhao K, Parvizi J. Infection burden for hip and knee arthroplasty in the United States. J Arthroplast. 2008;23(7):984–991. doi: 10.1016/j.arth.2007.10.017. - DOI - PubMed
    1. Kurtz SM, Ong KL, Lau E, Bozic KJ, Berry D, Parvizi J. Prosthetic joint infection risk after TKA in the Medicare population. Clin Orthop Relat Res. 2010;468(1):52–56. doi: 10.1007/s11999-009-1013-5. - DOI - PMC - PubMed
    1. Sherrell JC, Fehring TK, Odum S, Hansen E, Zmistowski B, Dennos A, et al. The Chitranjan Ranawat Award: fate of two-stage reimplantation after failed irrigation and debridement for periprosthetic knee infection. Clin Orthop Relat Res. 2011;469(1):18–25. doi: 10.1007/s11999-010-1434-1. - DOI - PMC - PubMed
    1. Parvizi J, Della Valle CJ. AAOS Clinical Practice Guideline: diagnosis and treatment of periprosthetic joint infections of the hip and knee. J Am Acad Orthop Surg. 2010;18(12):771–772. doi: 10.5435/00124635-201012000-00007. - DOI - PubMed
    1. Lonner JH, Barrack R, Fitzgerald RH Jr, Hanssen AD, Windsor ER. Infection in total knee arthroplasty: part I. Classification, prophylaxis, and diagnosis. American journal of orthopedics (Belle Mead, NJ) 1999;28(9):530-535. - PubMed

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