Intérêt d’un spacer articulé dans la reprise en deux temps d’une prothèse totale de genou infectée - 27/05/14
Functional interest of an articulating spacer in two-stage infected total knee arthroplasty revision
, M. von Knoch b, M. Wernsmann a, S. Landgraeber a, F. Löer a, M. Jäger aAbstract |
Deep periprosthetic infection is one of the most serious complications after total knee replacement. The two-stage procedure with implantation of a temporary cement spacer and later re-implantation of revision total knee prosthesis is an accepted procedural standard. The use of articulating spacers has been proposed to enhance ease of revision and functional results.
Patients and methods |
Twenty-three patients treated with an articulating spacer were retrospectively studied. All patients had undergone a two-stage surgery. The infected prosthesis was explanted and the femoral component was sterilized and re-implanted. On the tibial side, a block of gentamicin-loaded bone cement was produced intraoperatively using specially manufactured templates. Eighteen total knee arthroplasty revisions and 5 arthrodesis were finally performed.
Results |
A total of three (13%) re-infections occurred 5–20 months after revision of total knee arthroplasty in a mean follow-up period of 47 months. Prior to re-implantation, flexion with the articulating spacer ranged between 15° and 100° (mean 68°±28°). The average postoperative flexion after re-implantation of TKR was 105°±11°.
Conclusion |
The articulating spacer used in this study appears to be as effective as the standard procedures in terms of re-infection risk rate and postoperative range of motion recovery.
Level of evidence |
Level IV
Le texte complet de cet article est disponible en PDF.Keywords : Knee, Total knee arthroplasty, Infection, Two-stage revision, Articulating spacer
| ☆ | Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus. |
Vol 100 - N° 4
P. 309 - juin 2014 Retour au numéro
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