Comparing the Efficacy of Articulating Spacer Constructs for Knee Periprosthetic Joint Infection Eradication: All-Cement vs Real-Component Spacers

Roof, Mackenzie A.; Baylor, Jessica L.; Bernstein, Jenna A.; Antonelli, Brielle; Kugelman, David; Egol, Alexander J.; Melnic, Christopher M.; Chen, Antonia F.; Long, William J.; Aggarwal, Vinay K.; Schwarzkopf, Ran

doi:10.1016/j.arth.2021.01.039

Cited by 6 publications

(6 citation statements)

References 29 publications

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“…All cement spacers are still widely used worldwide to address PJIs in TKA in a twostage approach [22]. Our concerns about this type of spacer are linked to the limitations well described in the current literature, such as the preformed sizes not allowing personalization to the patient, and the incapability to provide enough stability to the joint, strongly limiting the quality of life and knee function [9,23].…”

Section: Discussionmentioning

confidence: 99%

“…To mitigate patient limitations and improve knee function and quality of life, the concept of an articulating spacer was introduced [9]. Two main types of articulating spacers are utilized in knee PJI treatment: the mold spacer and the metal-on-poly spacer.…”

Section: Introductionmentioning

confidence: 99%

“…Advantages of this kind of spacer are limited costs, ease of crafting, and easier removal in the second stage. The limitations of this spacer type include a limited range of sizes in most cases, the inability to address asymmetrical deformities, lower mechanical resistance, and moreover, lower ROM and knee function after the first stage in two-stage revision [9].…”

Section: Introductionmentioning

confidence: 99%

“…However, contemporary practice has evolved to incorporate a new femoral component, coupled with a fresh polyethylene liner directly cemented onto the tibia. Notably, studies have demonstrated that the use of a metal femoral component does not correlate with an increased risk of infections or spacer failure attributable to infection [9]. This design facilitates earlier mobilization, enabling patients to utilize the spacer as a primary knee.…”

Section: Introductionmentioning

confidence: 99%

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Augmented Articulating Spacers in Infected Total Knee Arthroplasty: Surgical Technique

De Mauro,

Festa,

Di Gennaro

et al. 2024

Healthcare

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Periprosthetic joint infections (PJIs) are a prominent subject of discussion in orthopedics and are frequently debated at conferences and congresses. In the context of PJIs affecting the knee, the decision between following a one-stage or two-stage treatment approach has historically been a pivotal consideration. The first option is limited by indications and potentially devastating complications in case of failure, whereas the second is widely accepted as the gold standard. Initially, the spacer was conceived solely to restore and maintain knee space after removal of the implant. An articulating spacer was introduced to mitigate patient limitations and improve knee function and quality of life. Two main types of articulating spacers are utilized in knee PJI treatment: the mold spacer and the metal-on-poly spacer. This text outlines a technique for metal-on-poly spacer implants. Based on our experience and the existing literature, this approach facilitates early full weight bearing and faster recovery of the knee’s range of motion, ultimately improving the quality of life after surgery, thus allowing the spacer retention for an extended period, as suggested by the 1.5-stage revision.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Augmented Articulating Spacers in Infected Total Knee Arthroplasty: Surgical Technique

De Mauro,

Festa,

Di Gennaro

et al. 2024

Healthcare

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“…The mean ROM of the PG increased by 31.76° (SD 8.32°) after first-stage revision, and the mean KSS improved by 31.64 points (SD 10.11), which was significantly higher than that of the CG. Roof et al 1 compared 164 cases of infected knee function with different spacers and demonstrated that metal-polyethylene spacers could provide better ROM and KSS after first-stage revision. Our results were consistent with previous literature (mean ROM: 99.41° (SD 21.36°) in the PG, 81.55° (SD 19.10°) in the CG, p = 0.004; mean KSS (85.87 (SD 8.97) in the PG, 76.64 (SD 8.32) in the CG, p = 0.002, both independent-samples t -test).…”

Section: Discussionmentioning

confidence: 99%

Prosthetic spacers in two-stage revision for knee periprosthetic joint infection achieve better function and similar infection control

Wu,

Su,

Zhang

et al. 2024

Bone Joint Res

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AimsTo explore the clinical efficacy of using two different types of articulating spacers in two-stage revision for chronic knee periprosthetic joint infection (kPJI).MethodsA retrospective cohort study of 50 chronic kPJI patients treated with two types of articulating spacers between January 2014 and March 2022 was conducted. The clinical outcomes and functional status of the different articulating spacers were compared. Overall, 17 patients were treated with prosthetic spacers (prosthetic group (PG)), and 33 patients were treated with cement spacers (cement group (CG)). The CG had a longer mean follow-up period (46.67 months (SD 26.61)) than the PG (24.82 months (SD 16.46); p = 0.001).ResultsInfection was eradicated in 45 patients overall (90%). The PG had a better knee range of motion (ROM) and Knee Society Score (KSS) after the first-stage revision (p = 0.004; p = 0.002), while both groups had similar ROMs and KSSs at the last follow-up (p = 0.136; p = 0.895). The KSS in the CG was significantly better at the last follow-up (p = 0.013), while a larger percentage (10 in 17, 58.82%) of patients in the PG chose to retain the spacer (p = 0.008).ConclusionProsthetic spacers and cement spacers are both effective at treating chronic kPJI because they encourage infection control, and the former improved knee function status between stages. For some patients, prosthetic spacers may not require reimplantation.Cite this article: Bone Joint Res 2024;13(6):306–314.

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Higher 2-Year Cumulative Incidence of Mental Health Disorders Following Antibiotic Spacer Placement for Chronic Periprosthetic Joint Infection following Total Joint Arthroplasty

Das

Agarwal

et al. 2023

The Journal of Arthroplasty

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Comparing the Efficacy of Articulating Spacer Constructs for Knee Periprosthetic Joint Infection Eradication: All-Cement vs Real-Component Spacers

Cited by 6 publications

References 29 publications

Augmented Articulating Spacers in Infected Total Knee Arthroplasty: Surgical Technique

Augmented Articulating Spacers in Infected Total Knee Arthroplasty: Surgical Technique

Prosthetic spacers in two-stage revision for knee periprosthetic joint infection achieve better function and similar infection control

Higher 2-Year Cumulative Incidence of Mental Health Disorders Following Antibiotic Spacer Placement for Chronic Periprosthetic Joint Infection following Total Joint Arthroplasty

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