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· DOS Abstracts
The use of a primary knee prosthesis as articulating
spacer in two-stage revision of infected knee
arthroplasty.
Rasmus Juul, Jesper Fabrin, Klaus Poulsen, Jeannette Østergaard Penny
Department of Orthopaedic Surgery, Køge Hospital
Background:
Gold standard for treating chronic prosthetic infection is two-
stage revision. Traditional static spacers impair the rehabilitation whereas ar-
ticulating spacers allow weight bearing and maintain joint movement. We cre-
ated an articulating spacer using a new P.F.C.® Sigma® femoral component and
a cemented tibial polyethylene insert (NFI spacer).
Purpose / Aim of Study:
The aim of this study is to report the infection con-
trol after two-stage revision using the NFI spacer.
Materials and Methods:
From December 2010 to March 2013 two-stage
revision using NFI spacer was performed on 31 patients (32 knees), 18 women
and 13 men, with an average age of 64 years. The patient’s medical records
were reviewed retrospectively. The diagnosis was verified from microbiologic
examination of tissue cultures obtained at first-stage surgery. Successful result
was considered when eradication of infection was achieved with two-stage re-
vision using only one NFI spacer.
Findings / Results:
Nine patients were excluded because of negative tissue
cultures and 1 patient due to prior surgery with static cement spacers. 2 pa-
tients died from unrelated medical reason and were lost to follow-up. 1 patient
had bilateral NFI spacers. The left NFI spacer was excluded as the patient choose
to have above knee amputation due to a tendency to luxation in the spacer. The
remaining 19 patients (19 knees), mean time follow-up was 24 months, all had
positive tissue cultures except one patient that had negative tissue culture but
the intraoperative findings were obvious purulent. 3 patients (16 %) had recur-
rence of infection after second-stage surgery. 16 patient (84 %) required only
one NFI spacer.
Conclusions:
Successful eradication of infection was achieved in 16 of 19 cas-
es (84%) with infected TKA. This is comparable to others studies describing the
use of articulation spacer.
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