TWO-STAGE SEPTIC KNEE PROSTHESIS USING PRE-FORMED CEMENT SPACERS AND MODULAR REVISION PFC SIGMA PROSTHESIS

Abstract

Septic knee prosthesis revision is particularly challenging either for the eradication of the infection and for functional recovery of the patient.

18 patients treated from year 2000 to 2003, treated according to the same medical and surgical protocol have been reviewed. In all cases the following steps have been followed:

• - removal of the septic prosthesis, debridement and implant of an articulated pre-formed cement spacer;

• - at 2 months, removal of the spacer and implant of a modular PFC knee revision prosthesis;

• - when appropriate osteotomy and synthesis of the anterior tibial tuberosity;

• - double antibiotic therapy, parentheral and oral, for 2 months after the first and after the second stage procedure.

At a mean 18 months follow-up, we observed:

• - no infection recurrence in all cases (one patient is lost to follow-up);

• - range of motion: flexion 73° +− 25°, extension – 5° +− 3°;

• - 1 dislocation of the articulated spacer;

• - 1 femoral fracture.

Two-stage septic knee prosthesis revision, according to a the described protocol, allows to obtain high infection eradication rate and acceptable functional recovery, in the medium term follow-up.