Complications and Outcomes Associated With a Novel, Prefabricated, Articulating Spacer for Two-Stage Periprosthetic Joint Infection Treatment.

Abstract

Various prefabricated articulating spacer options have been described for 2-stage treatment of chronic periprosthetic joint infection, but their results are poorly generalizable between designs due to differing antibiotic and material properties. This study reports outcomes for a novel, prefabricated, commercially available cement-on-cement articulating spacer. A retrospective review of prospectively collected data for patients undergoing treatment with a prefabricated articulating cement spacer was performed. Outcomes were categorized as spacer complications, reimplantation rates, function, reinfection, and mortality. Seventy-six knees and 28 hips were analyzed. Spacer survival free of fracture, instability, or other implant-related complication until reimplantation was 100%. There were no bony or spacer fractures during the interstage or reimplantation. Reimplantation occurred in 84.6% of resected joints. Following spacer implantation, all but 1 patient was allowed to bear weight. The proportion of patients requiring an assistive device decreased from 67% prior to resection to 31% following reimplantation. Knee flexion improved from an average of 88.1° before resection to 111.9° following reimplantation. Eighty-seven percent of cases were infection free at mean follow-up of 16.6 ± 10.4 months. Study results demonstrate that this novel, prefabricated, articulating antibiotic spacer is safe, allows for good interstage function, and results in reasonable infection eradication rates at early term follow-up. Therapeutic Level III.