Skip to main content
NCBI home page
International Orthopaedics logoLink to International Orthopaedics
. 2004 Mar 23;28(3):129–133. doi: 10.1007/s00264-004-0545-2

Antibiotic-loaded bone cement spacers in two-stage management of infected total knee arthroplasty

R P Pitto 1,✉, I A Spika 1
PMCID: PMC3474493  PMID: 15042322

Abstract

We reviewed the current use of spacers in the management of the infected knee prosthesis. There are two types of temporary spacers: block or non-articulating spacers and articulating or mobile spacers. Generally, spacers improve mobilisation and hasten recovery with shorter hospital stay between stages. Furthermore, spacers facilitate the second-stage procedure by maintaining joint space, and articulating spacers may also maintain range of motion. Last but not the least, the cost of spacers represents only a small fraction of the total expenses for management of infected knee arthroplasties.

Full Text

The Full Text of this article is available as a PDF (197.8 KB).

References

  • 1.Abudu Int Orthop. 2002;26:40. doi: 10.1007/s00264-001-0301-9. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2.Bengtson Acta Orthop Scand. 1991;62:301. doi: 10.3109/17453679108994458. [DOI] [PubMed] [Google Scholar]
  • 3.Bengtson Acta Orthop Scand. 1986;57:489. doi: 10.3109/17453678609014776. [DOI] [PubMed] [Google Scholar]
  • 4.BoothClin Orthop 1989248572805496 [Google Scholar]
  • 5.Calton Clin Orthop. 1997;345:148. doi: 10.1097/00003086-199712000-00020. [DOI] [PubMed] [Google Scholar]
  • 6.Castelli C, Martinelli R, Ferrari R (2002) Preformed all-cement knee spacer in two-stage revision for infected knee replacement. Proceedings of the SICOT XXII World Congress, 327c
  • 7.Cohen J Arthroplasty. 1988;3:369. doi: 10.1016/s0883-5403(88)80040-8. [DOI] [PubMed] [Google Scholar]
  • 8.Duncan Orthop Clin North Am. 1993;24:751. [PubMed] [Google Scholar]
  • 9.Duncan CP, Beauchamp C, Masri BA (1992) The antibiotic loaded joint replacement system: a novel approach to the management of the infected knee replacement. J Bone Joint Surg [Br] [Suppl III] 74:296
  • 10.EmersonClin Orthop 200240413212439251 [Google Scholar]
  • 11.Fehring Techniques for the infected. 2003;knee:Molded. [Google Scholar]
  • 12.FehringClin Orthop 2000380911064968 [Google Scholar]
  • 13.Goksan SB, Freeman MA (1992) One-stage reimplantation for infected total knee arthroplasty. J Bone Joint Surg [Br] 74:78–82 [DOI] [PubMed]
  • 14.Goldman Clin Orthop. 1996;331:118. doi: 10.1097/00003086-199610000-00016. [DOI] [PubMed] [Google Scholar]
  • 15.Haddad FS, Masri BA, Campbell D, McGraw RW, Beauchamp CP, Duncan CP (2000) The Prostalac functional spacer in two-stage revision for infected knee replacements. J Bone Joint Surg [Br] 82:807–812 [DOI] [PubMed]
  • 16.Haddad FS, Masri BA, Duncan CP (2001) Cement spacers in knee surgery. In: Insall JN, Scott WN (eds) Surgery of the knee, Churchill-Livingstone, Philadelphia 2:1891–1913
  • 17.Hanssen Techniques for the infected. 2003;knee:Static. [Google Scholar]
  • 18.HanssenClin Orthop 1994309447994976 [Google Scholar]
  • 19.Hebert Clin Orthop. 1996;331:140. doi: 10.1097/00003086-199610000-00019. [DOI] [PubMed] [Google Scholar]
  • 20.Hofmann Techniques for the infected. 2003;knee:10. [Google Scholar]
  • 21.HofmannClin Orthop 1995321457497685 [Google Scholar]
  • 22.Insall JN, Thompson FM, Brause BD (1983) Two-stage reimplantation for the salvage of infected total knee arthroplasty. J Bone Joint Surg [Am] 65:1087–1098 [PubMed]
  • 23.Masri BA, Duncan CP, Campbell D, McGraw RW (2000) Prostalac two-stage exchange for infected knee replacements: a prospective analysis. Proceedings of the 10th combined meeting of the orthopedic associations of the English speaking world, Auckland, NZ, J Bone Joint Surg [Br] [Suppl II] 82:153
  • 24.McPhersonJ Arthroplasty 199510877730836 [Google Scholar]
  • 25.Mont J Arthroplasty. 1997;12:426. doi: 10.1016/s0883-5403(97)90199-6. [DOI] [PubMed] [Google Scholar]
  • 26.NelsonClin Orthop 1993295968403676 [Google Scholar]
  • 27.PeersmanClin Orthop 20023921511716377 [Google Scholar]
  • 28.Rand Orthop Clin North Am. 1989;20:201. [PubMed] [Google Scholar]
  • 29.RandClin Orthop 1986205753698395 [Google Scholar]
  • 30.Resig Int Orthop. 2002;26:257. doi: 10.1007/s00264-002-0357-1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 31.Salvati EA, Robinson RP, Zeno SM, Koslin BL, Brause BD, Wilson PD (1982) Infection rates after 3175 total hip and total knee replacements performed with and without a horizontal unidirectional filtered air-flow system. J Bone Joint Surg [Am] 64:525–535 [PubMed]
  • 32.Scott IR, Stockley I, Getty CJ (1993) Exchange arthroplasty for infected knee replacements. A new two-stage method. J Bone Joint Surg [Br] 75:28–31 [DOI] [PubMed]
  • 33.Segawa H, Tsukayama DT, Kyle RF, Becker DA, Gustilo RB (1999) Infection after total knee arthroplasty. A retrospective study of the treatment of eighty-one infections. J Bone Joint Surg [Am] 81:1434–1445 [DOI] [PubMed]
  • 34.Spika IA, Castelli C, Ferrari R, Federici A, Grandizio M, Matamala PA, Asuncion MJ, Pitto RP (2004) Articulating spacers in two-stage revision of the infected total knee replacement. Proceedings of the 63rd Annual Meeting of the Australian Orthopaedic Association, J Bone Joint Surg [Br] [Suppl] (in press)
  • 35.Whiteside Clin Orthop. 1994;321:169. [PubMed] [Google Scholar]
  • 36.WildeClin Orthop 1988236233180576 [Google Scholar]
  • 37.Windsor J Am Acad Orthop Surg. 1994;2:44. doi: 10.5435/00124635-199401000-00006. [DOI] [PubMed] [Google Scholar]
  • 38.Windsor RE, Insall JN, Urs WK, Miller DV, Brause BD (1990) Two-stage reimplantation for the salvage of total knee arthroplasty complicated by infection. Further follow-up and refinement of indications. J Bone Joint Surg [Am] 72:272–278 [PubMed]

Articles from International Orthopaedics are provided here courtesy of Springer-Verlag

RESOURCES