An articulating spacer to treat and mobilize patients with infected total knee arthroplasty.

This retrospective study analyzed 25 consecutive patients (25 knees) with chronic deep TKA infection. During 1997-2004, patients underwent two-stage articulating spacer surgery. The original femoral component was removed, autoclaved and replaced and a new polyethylene was utilized. The second- stage procedure occurred at a mean of 11 weeks (range: 4 to 39 weeks) after spacer insertion. Mobilization was encouraged between stages. All patients were assessed at a minimum of two years (mean 54 months; range: 24-108 months) post re-implantation, and Modified Hospital for Special Surgery (HSS) knee scores were calculated. Only one patient (4%) had re-infection. Average ROM before re-implantation was 5 degrees to 112 degrees , and 3 degrees to 115 degrees at latest follow-up. HSS scores averaged 91 (Range: 65-100) at latest follow-up. Two-stage re-implantation with an articulating spacer for infected TKA effectively treats infection and gives excellent knee motion between stages, and at mid- to long-term follow-up.