Are prosthetic spacers safe to use in 2-stage treatment for infected total knee arthroplasty?

Abstract

This retrospective study compares treatment results of infected total knee arthroplasty with 2-stage exchange technique using 14 articulating spacers using metallic and polyethylene components (prosthetic group) and 33 static all-cement spacer (static group). For the prosthetic and static groups, treatment success rate was 71% and 67% at 58 months of follow-up, respectively, and not significantly different. The prosthetic group required less frequent extensile surgical approaches at the second-stage reimplantation. Range of motion was significantly improved in both groups, but there was no difference at latest follow-up between the groups. Of 14 in the prosthetic group, 4 (28%) did not undergo second-stage procedure. Antibiotic spacers consisting of prosthetic components can be a safe and effective treatment option for 2-stage revision total knee arthroplasty with equivalent infection control rates.