Compared with Two-Stage Revision, Destination Joint Spacers Have a Similar Infection-Relief Rate and a Higher Complication Rate

Abstract

Background: Two-stage revision is regarded as the “gold standard” for periprosthetic joint infection (PJI) treatment, in which antibiotic-impregnated spacers play an important role. However, some patients are unable to undergo reimplantation of the prosthesis after spacer implantation. The clinical outcomes of these patients remain unknown. The purpose of this research was to study the infection-relief rate and clinical outcome of these patients.Methods: From January 2006 to December 2017, data from PJI patients who underwent implantation with antibiotic-impregnated cement spacers in our center due to chronic PJI were collected retrospectively. Age, sex, body mass index (BMI) and laboratory test results were recorded, and the infection-relief rate and clinical outcomes were observed.Results: A total of 62 patients who were diagnosed with PJI were enrolled, with an age of 65.13 ±9.94 (39-88) years. There were 21 cases in the destination joint spacer group and 41 cases in the temporary spacer group (reimplantation of prosthesis after infection relief). The Charlson comorbidity index (CCI) in the destination joint spacer group was higher than that in the temporary spacer group. Our study showed that the infection-relief rate of destination joint spacers was similar to that of two-stage revision, but the incidence of complications was higher than that of two-stage revision, especially for the type I spacer used in this study.Conclusions: The infection-relief rate of destination joint spacers was similar to that of two-stage revision, but the complication rate was higher than that of two-stage revision (especially for the type I spacer).