Table 1. Types of articulating antibiotic-loaded cement spacers.

Types of cement spacers

Hand-made spacers: these spacers mimic either joint anatomy [26] or joint kinematics (ball and socket spacer) [9,27].

Intraoperatively constructed spacers: based on commercially available molds [28-30] or using molds, which have been created on removed and sterilized implants [6,31,32]. These spacers have good congruency and the antibiotic concentration achieved is potentially higher than that of commercial spacers.

Commercial (prefabricated), ready-to-use cement spacers [9].

Spacers with additional metal or plastic articulating elements incorporated within the cement (prosthesis with antibiotic-loaded acrylic cement, PROSTALAC) [6,22,33,34].

Application of a new or reused (autoclaving) sterilized femoral component with antibiotic-loaded cement. Stabilization of a new tibial PE insert with antibiotic-loaded cement [6,18].