INTRODUCTION: Two-stage reimplantation in patients with chronic periprosthetic joint infection (PJI) after total knee arthroplasty (TKA) with the use of either articulating or static antibiotic-loaded spacers during the first step is considered to be the golden standard in orthopaedics. THE AIM OF THE STUDY: The aim of the study was to evaluate the correlation of spacer type with the infection elimination rate as well as functional outcomes after two-staged revision TKA in patients with PJI. MATERIALS AND METHODS: The cohort comprised 161 patients who were treated for PJI after TKA during a period from January 2007 to December 2015. After the exclusion of patients with severe bone defects (AORI 2B or 3), 104 were left for the analysis: 72 patients with articulating and 32 with static spacers. The overall patient mean age was 62 years old (95% CI, 30-84): 73 for females, 31 for males. The outcomes were evaluated after three, six and 12 months using the American Knee Society Score (KSS) and EQ-5D. Only 92 patients were available for observation: 25 with static and 67 with articulating spacers. RESULTS: One year after the surgery, patients with articulating spacers demonstrated significantly higher mean KSS and function scores in comparison to patients with static spacers (90.4, 77.3 and 78.5, 67.8, respectively (p < 0.05)). The range of motion was also significantly better in patients with articulating spacers: 104.9° in comparison to 93.9° (р < 0.0001). The final EQ-5D score was comparable in both groups (0.82, 73.1 in articulating and 0.82, 72.6 in static spacers). CONCLUSION: The two-stage revision TKA for PJI using articulating spacers in comparison to the static ones provides better infection eradication rate as well as functional outcomes and improved quality of life.
INTRODUCTION: Two-stage reimplantation in patients with chronic periprosthetic joint infection (PJI) after total knee arthroplasty (TKA) with the use of either articulating or static antibiotic-loaded spacers during the first step is considered to be the golden standard in orthopaedics. THE AIM OF THE STUDY: The aim of the study was to evaluate the correlation of spacer type with the infection elimination rate as well as functional outcomes after two-staged revision TKA in patients with PJI. MATERIALS AND METHODS: The cohort comprised 161 patients who were treated for PJI after TKA during a period from January 2007 to December 2015. After the exclusion of patients with severe bone defects (AORI 2B or 3), 104 were left for the analysis: 72 patients with articulating and 32 with static spacers. The overall patient mean age was 62 years old (95% CI, 30-84): 73 for females, 31 for males. The outcomes were evaluated after three, six and 12 months using the American Knee Society Score (KSS) and EQ-5D. Only 92 patients were available for observation: 25 with static and 67 with articulating spacers. RESULTS: One year after the surgery, patients with articulating spacers demonstrated significantly higher mean KSS and function scores in comparison to patients with static spacers (90.4, 77.3 and 78.5, 67.8, respectively (p < 0.05)). The range of motion was also significantly better in patients with articulating spacers: 104.9° in comparison to 93.9° (р < 0.0001). The final EQ-5D score was comparable in both groups (0.82, 73.1 in articulating and 0.82, 72.6 in static spacers). CONCLUSION: The two-stage revision TKA for PJI using articulating spacers in comparison to the static ones provides better infection eradication rate as well as functional outcomes and improved quality of life.
Entities:
Keywords:
Outcome; Periprosthetic joint infection; Quality of life; Spacer; Total knee arthroplasty; Two-stage revision
Authors: Georgios K Triantafyllopoulos; Stavros G Memtsoudis; Wei Zhang; Yan Ma; Thomas P Sculco; Lazaros A Poultsides Journal: J Arthroplasty Date: 2016-08-24 Impact factor: 4.757
Authors: Chuan Kong Koh; Irene Zeng; Saiprassad Ravi; Mark Zhu; Kelly G Vince; Simon W Young Journal: Clin Orthop Relat Res Date: 2017-06-01 Impact factor: 4.176
Authors: Javad Parvizi; Khalid Azzam; Elie Ghanem; Matthew S Austin; Richard H Rothman Journal: Clin Orthop Relat Res Date: 2009-05-01 Impact factor: 4.176
Authors: M F Janssen; A Simon Pickard; Dominik Golicki; Claire Gudex; Maciej Niewada; Luciana Scalone; Paul Swinburn; Jan Busschbach Journal: Qual Life Res Date: 2012-11-25 Impact factor: 4.147
Authors: S P Boelch; A Jakuscheit; S Doerries; L Fraissler; M Hoberg; J Arnholdt; M Rudert Journal: BMC Musculoskelet Disord Date: 2018-11-10 Impact factor: 2.362
Authors: Jeremy M Gililland; Victor R Carlson; Keith Fehring; Bryan D Springer; William L Griffin; Lucas A Anderson Journal: Arthroplast Today Date: 2020-10-01
Authors: Edward Vasarhelyi; Sahil Prabhnoor Sidhu; Lyndsay Somerville; Brent Lanting; Douglas Naudie; James Howard Journal: Arthroplast Today Date: 2022-01-20
Authors: Andreas Enz; Silke C Mueller; Philipp Warnke; Martin Ellenrieder; Wolfram Mittelmeier; Annett Klinder Journal: J Fungi (Basel) Date: 2021-05-21