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Meta-Analysis
. 2022 Jul 15;17(1):348.
doi: 10.1186/s13018-022-03238-7.

Comparison of dynamic and static spacers for the treatment of infections following total knee replacement: a systematic review and meta-analysis

Jiasheng Tao #  1 , Zijian Yan #  1 , Bin Pu  1 , Ming Chen  1 , Xiaorong Hu  1 , Hang Dong  2
Affiliations
Meta-Analysis

Comparison of dynamic and static spacers for the treatment of infections following total knee replacement: a systematic review and meta-analysis

Jiasheng Tao et al. J Orthop Surg Res. .

Abstract

Background: Revision surgery is the most common treatment for patients who develop infection after total knee arthroplasty (TKA). Two types of spacers are often used in revision surgery: dynamic spacers and static spacers. The comparative efficacy of these two types of spacers on knee prosthesis infections is not well established. Therefore, we carried out a systematic evaluation and meta-analysis with the aim of comparing the difference in efficacy between dynamic and static spacers.

Methods: We conducted the literature search in PubMed, Web of Science, Cochrane Library, and Embase databases. The articles searched were clinical study comparing the difference in efficacy between dynamic spacers and static spacers for the treatment of prosthetic infections occurring after total knee arthroplasty.

Results: We conducted a literature search and screening based on the principles of PICOS. Ultimately, 14 relevant clinical studies were included in our current study. We use infection control rate as the primary evaluation indicator. The KSS knee scores (KSSs), KSS functional scores, bone loss and range of motion (ROM) are secondary indicators of evaluation. Thirteen of these included studies reported the infection control rates, with no significant difference between dynamic and static shims (RR: 1.03; 95% Cl 0.98, 1.09; P = 0.179 > 0.05). The KSSs were reported in 10 articles (RR: 5.98; 95% CI 0.52, 11.43; P = 0.032 < 0.05). Six articles reported the KSS functional scores (RR: 13.90; 95% CI 4.95, 22.85; P = 0.02 < 0.05). Twelve articles reported the ROM (RR: 17.23. 95% CI 10.18, 24.27; P < 0.0001). Six articles reported the bone loss (RR: 2.04; 95% CI 1.11, 3.77; P = 0.022 < 0.05).

Conclusion: Current evidence demonstrates that dynamic spacers are comparable to static spacers in controlling prosthetic joint infection. In terms of improving the functional prognosis of the knee joint, dynamic spacers are more effective than static spacers.

Keywords: Dynamic spacers; Meta-analysis; Periprosthetic joint infection; Static spacers; Total knee arthroplasty.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The inclusion process of literature
Fig. 2
Fig. 2
Forest plot of the infection control rate
Fig. 3
Fig. 3
Funnel plot of the infection control rate
Fig. 4
Fig. 4
Forest plot of the KSSs
Fig. 5
Fig. 5
Forest plot of the KSS functional score
Fig. 6
Fig. 6
Forest plot of the bone loose
Fig. 7
Fig. 7
Forest plot of the ROM
See this image and copyright information in PMC

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