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Pre-formed articulating knee spacer in two-stage revision for the infected total knee arthroplasty

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Abstract

We performed a prospective study to assess safety and effectiveness of a pre-formed articulating spacer made of gentamicin-impregnated acrylic cement in the management of infected total knee arthroplasty. Twenty-one consecutive patients with unilateral deep infection were treated by two-stage revision in two centres. Two patients were excluded, and 19 patients remained available for assessment. The mean implantation time of the spacer was 12 weeks. The rehabilitation programme between stages consisted in early range of motion exercises and partial weight bearing. Mean follow-up after removal of the spacer and insertion of the final prosthesis was 24 (range, 12–43) months. No patient had recurrence of infection at the latest follow-up. The mean Knee Society functional score during spacer management was rated 75 points and was rated 84 points at the latest follow-up. No device-related complication was observed.

Résumé

Nous avons étudié prospectivement la sécurité et l’efficacité d’un espaceur articulé pré-formé fait en ciment acrylique imprégné de gentamicine dans la gestion de l’arthroplastie totale infectée du genou. Vingt et un malades consécutifs avec une infection profonde monolatérale ont été traités dans deux centres, avec une révision en deux temps. Deux malades ont été exclus, et 19 malades sont restés disponibles pour l’estimation. Le temps d’implantation moyen de l’espaceur était de 12 semaines. La rééducation entre les deux étapes a consisté en un travail précoce de la mobilité et un appui partiel. Le suivi moyen après réimplantation prothétique était de 24 mois (12 à 43 mois). Aucun malade n’avait de récidive de l’infection au dernier recul. Le score fonctionnel moyen (Knee Society) pendant le port de l’espaceur a été estimé à 75 points et à 84 points au dernier recul. Aucune complication liée à l’espaceur n’a été observée.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Middlemore Hospital, South Auckland Clinical School, University of Auckland, Auckland, New Zealand

    R. P. Pitto & J. Munro

  2. Departments of Orthopaedics and Traumatology, Ospedali Riuniti di Bergamo, Bergamo, Italy

    C. C. Castelli & R. Ferrari

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  1. R. P. Pitto
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  2. C. C. Castelli
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  3. R. Ferrari
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  4. J. Munro
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Correspondence to R. P. Pitto.

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Pitto, R.P., Castelli, C.C., Ferrari, R. et al. Pre-formed articulating knee spacer in two-stage revision for the infected total knee arthroplasty. International Orthopaedics (SICOT) 29, 305–308 (2005). https://doi.org/10.1007/s00264-005-0670-6

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  • DOI: https://doi.org/10.1007/s00264-005-0670-6

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