Abstract
2 stage revisions of infected knee replacements using a static spacer are complicated by poor patient mobility between stages and the need for extensive soft tissue releases at the second stage. In this study we hypothesised that the use of the resterilsed components as temporary functional spacers, maintains patient function, and reduces soft tissue releases at second stage without reducing the rate of septic failure and obviating the need for expensive purpose made spacers.
Method We report our series of seven two-stage revisions of infected total knee replacements using the resterilised femoral and tibial components as a temporary articulating spacers. This was compared to a second cohort of 6 patients in which the standard “hamburger” static spacer was used. Outcomes measured include reinfection rates, interval mobility, final range of movement, and bone loss.
Results The articulating spacer allowed more comfortable function between stages and obviated the need for rectus snips and tibial tubercle osteotomies for exposure at the second stage. There was less bone loss in the articulating group requiring less stems or augments. The range of movement averaged 88 degrees at 9.3 months compared to 80 degrees at 9.2 months in the “static” cohort. There were no reinfections in either group.
Discussion We have shown that this is a safe and effective way of treating infected knee arthroplasties with significant advantages for the surgeon and patient over more traditional methods.
Correspondence should be addressed to Roger Smith, Honorary Secretary, BASK c/o Royal College of Surgeons, 35 – 43 Lincoln’s Inn Fields, London WC2A 3PN
