“…Ha et al [ 34 ] described the intraoperative sterilization of the removed femoral components and polyethylene inserts, followed by the construction of a mold from the removed components using lubricant and cement. Like hand-made spacers, spacers fashioned from molds can be personalized with sensitive antibiotics, and there exists a metal endoskeleton to enhance mechanical strength in many cases [ 21 , 35 ]. In clinical practice, molded spacers can also be used in some specific cases, as appropriate, such as combined acetabular cement screws, to manage bone defects (Fig.…”
Section: Types Of Articulating Spacersmentioning
confidence: 99%
“…2 ). Nevertheless, it is noteworthy that molded spacers reportedly increase the cost of the procedure, and their incidence of mechanical complications [ 13 , 35 ]. Fig.…”
Periprosthetic joint infection (PJI) is the most devastating complication following total joint arthroplasty (TJA) and is posing a global healthcare challenge as the demand for TJA mounts. Two-stage exchange arthroplasty with the placement of antibiotic-loaded spacers has been shown to be efficacious against chronic PJI. This study aimed to review the key concepts, types, and outcome evaluations of articulating spacers in the two-stage exchange for PJI. Previous studies indicated that articulating spacers have been widely used due to better functional improvement and a comparable infection control rate relative to static spacers. Several types of articulating spacers are reportedly available, including hand-made spacers, spacers fashioned from molds, commercially preformed spacers, spacers with additional metal or polyethylene elements, new or autoclaved prosthesis, custom-made articulating spacers, and 3D printing-assisted spacers. However, limited evidence suggested no significant difference in clinical outcomes among the different subtypes of articulating spacers. Surgeons should be familiar with different treatment strategies when using various spacers to know which is the most appropriate.
“…Ha et al [ 34 ] described the intraoperative sterilization of the removed femoral components and polyethylene inserts, followed by the construction of a mold from the removed components using lubricant and cement. Like hand-made spacers, spacers fashioned from molds can be personalized with sensitive antibiotics, and there exists a metal endoskeleton to enhance mechanical strength in many cases [ 21 , 35 ]. In clinical practice, molded spacers can also be used in some specific cases, as appropriate, such as combined acetabular cement screws, to manage bone defects (Fig.…”
Section: Types Of Articulating Spacersmentioning
confidence: 99%
“…2 ). Nevertheless, it is noteworthy that molded spacers reportedly increase the cost of the procedure, and their incidence of mechanical complications [ 13 , 35 ]. Fig.…”
Periprosthetic joint infection (PJI) is the most devastating complication following total joint arthroplasty (TJA) and is posing a global healthcare challenge as the demand for TJA mounts. Two-stage exchange arthroplasty with the placement of antibiotic-loaded spacers has been shown to be efficacious against chronic PJI. This study aimed to review the key concepts, types, and outcome evaluations of articulating spacers in the two-stage exchange for PJI. Previous studies indicated that articulating spacers have been widely used due to better functional improvement and a comparable infection control rate relative to static spacers. Several types of articulating spacers are reportedly available, including hand-made spacers, spacers fashioned from molds, commercially preformed spacers, spacers with additional metal or polyethylene elements, new or autoclaved prosthesis, custom-made articulating spacers, and 3D printing-assisted spacers. However, limited evidence suggested no significant difference in clinical outcomes among the different subtypes of articulating spacers. Surgeons should be familiar with different treatment strategies when using various spacers to know which is the most appropriate.
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