Comparison of articulating and static spacers regarding infection with resistant organisms in total knee arthroplasty

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Abstract

Introduction The result of treatment of infections involving antibiotic-resistant organisms in total knee arthroplasty (TKA) is often poor. We evaluated the efficacy of 2-stage revision in TKAs infected with resistant organisms and compared the clinical outcomes with articulating and conventional static spacers, in terms of both infection control and function. Methods In a prospective manner, from June 2003 to January 2007 selected patients with a TKA infected with resistant organisms were enrolled and treated with 2-stage re-implantation. The 45 patients were divided into 2 groups: group A (23 patients) implanted with the articulating spacers and group S (22 patients) implanted with static spacers. All patients followed the same antibiotic protocols and had the same re-implantation criteria. The efficacy of infection control was evaluated using re-implantation rate, recurrence rate, and overall success rate. The functional and radiographic results were interpreted with the Hospital of Special Surgery (HSS) knee score and the Insall-Salvati ratio. Results With mean 40 (2461) months of follow-up, 22 of 23 knees were re-implanted in group A and 21 of 22 were re-implanted in group S. Of these re-implanted prostheses, 1 re-infection occurred in group A and 2 occurred in group S. Range of motion after re-implantation, the final functional scores, and the satisfaction rate were better in group A. One third of the patients in group S, and none in group A, had a patella baja. Interpretation After 2-stage re-implantation of TKAs originally infected with resistant organisms, the clinical outcome was satisfactoryand similar to that reported after treatment of TKAs infected with low-virulence strains. Treatment with an articulating spacer resulted in better functional outcome and lower incidence of patella baja. © 2011 Nordic Orthopaedic Federation.

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Chiang, E. R., Su, Y. P., Chen, T. H., Chiu, F. Y., & Chen, W. M. (2011). Comparison of articulating and static spacers regarding infection with resistant organisms in total knee arthroplasty. Acta Orthopaedica, 82(4), 460–464. https://doi.org/10.3109/17453674.2011.581266

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