Comparison Between Articulating vs. Fixed Spacers in Revision for Periprosthetic Knee Infection
DOI:
https://doi.org/10.15417/issn.1852-7434.2021.86.4.1391Keywords:
Knee arthroplasty, spacers, periprosthetic infection, joint range of motionAbstract
Introduction: Cement spacers with antibiotics can be fixed or articulating, with similar results in eradicating infection. Our objective was to compare joint range of motion (ROM) and functional outcomes after reimplantation.
Materials and Methods: A retrospective cohort study of patients who had undergone a knee prosthetic revision due to infection in two surgical stages. Functionality was analyzed according to the Knee Society Score (KSS) one year after surgery and ROM was recorded 45 days after surgery. Bone defect, pain, satisfaction, complications, and recurrence of infection were recorded.
Results: A total of 103 patients were included. 40 with articulating spacers and 63 with fixed spacers. The articulating spacer group presents a median of 2.5 degrees greater in final mobility (102.5 IQR 95-110 vs 100 IQR 90-105, p 0.01). The KSS functional scale and KSS of the knee did not show differences between the two groups. There were no differences concerning satisfaction, pain, and time until reimplantation. Complications
were similar in both groups, with a reinfection rate without statistically significant differences.
Conclusion: Articulating spacers have shown a benefit in ROM after prosthetic reimplantation.
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References
Lachiewicz PF, Wellman SS, Peterson JR. Antibiotic cement spacers for infected total knee arthroplasties. J Am
Acad Orthop Surg 2020;28:180-8. https://doi.org/10.5435/JAAOS-D-19-00332 DOI: https://doi.org/10.5435/JAAOS-D-19-00332
Warth LC, Hadley CJ, Grossman EL. Two-stage treatment for total knee arthroplasty infection utilizing an
articulating prefabricated antibiotic spacer. J Arthroplasty 2020;35:S57-S62. https://doi.org/10.1016/j.arth.2019.10.049 DOI: https://doi.org/10.1016/j.arth.2019.10.049
Guild GN 3rd, Wu B, Scuderi GR. Articulating vs. static antibiotic impregnated spacers in revision total knee
arthroplasty for sepsis. A systematic review. J Arthroplasty 2014;29: 558-63.
https://doi.org/10.1016/j.arth.2013.08.013 DOI: https://doi.org/10.1016/j.arth.2013.08.013
Pivec R, Naziri Q, Issa K, Banerjee S, Mont MA. Systematic review comparing static and articulating spacers used for revision of infected total knee arthroplasty. J Arthroplasty 2014;29:553-7.e1.
https://doi.org/10.1016/j.arth.2013.07.041 DOI: https://doi.org/10.1016/j.arth.2013.07.041
Mazzucchelli L, Rosso F, Marmotti A, Bonasia DE, Bruzzone M, Rossi R. The use of spacers (static and mobile) in
infection knee arthroplasty. Curr Rev Musculoskelet Med 2015;8:373-82. https://doi.org/10.1007/s12178-015-9293-8 DOI: https://doi.org/10.1007/s12178-015-9293-8
Liow RY, Walker K, Wajid MA, Bedi G, Lennox CM. The reliability of the American Knee Society Score. Acta
Orthop Scand 2000;71:603-8. https://doi.org/10.1080/000164700317362244 DOI: https://doi.org/10.1080/000164700317362244
Kahlenberg CA, Nwachukwu BU, McLawhorn AS, Cross MB, Cornell CN, Padgett DE. Patient satisfaction after
total knee replacement: a systematic review. HSS J 2018;14:192-201. https://doi.org/10.1007/s11420-018-9614-8 DOI: https://doi.org/10.1007/s11420-018-9614-8
Langley GB, Sheppeard H. The visual analogue scale: its use in pain measurement. Rheumatol Int 1985;5:145-8.
https://doi.org/10.1007/BF00541514 DOI: https://doi.org/10.1007/BF00541514
Engh GA, Parks NL. The management of bone defects in revision total knee arthroplasty. Instr Course Lect
;46:227-36. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/9143967
Arden N, Nevitt MC. Osteoarthritis: epidemiology. Best Pract Res Clin Rheumatol 2006;20:3-25.
https://doi.org/10.1016/j.berh.2005.09.007 DOI: https://doi.org/10.1016/j.berh.2005.09.007
Wyles CC, Abdel MP. Point/Counterpoint: Nonarticulating vs articulating spacers for resection arthroplasty of the knee or hip. J Arthroplasty 2020;35:S40-S44. https://doi.org/10.1016/j.arth.2019.10.055 DOI: https://doi.org/10.1016/j.arth.2019.10.055
Parvizi J, Gehrke T, Chen AF. Proceedings of the International Consensus on Periprosthetic Joint Infection. Bone Joint J 2013;95B:1450-2. https//doi.org/10.1302/0301-620X.95B11.33135 DOI: https://doi.org/10.1302/0301-620X.95B11.33135
Voleti PB, Baldwin KD, Lee G-C. Use of static or articulating spacers for infection following total knee
arthroplasty: a systematic literature review. J Bone Joint Surg Am 2013;95:1594-9.
https://doi.org/10.2106/JBJS.L.01461 DOI: https://doi.org/10.2106/JBJS.L.01461
Bowman EC, Malkani AL. Point/Counterpoint: Static vs articulating spacers-static spacers for resection arthroplasty of the knee. J Arthroplasty 2020;35:S35-S39. https://doi.org/10.1016/j.arth.2019.10.033 DOI: https://doi.org/10.1016/j.arth.2019.10.033
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