An Articulating Versus Non-articulating Spacer for 2-Stage Reimplantation Patients Who Undergo in Infected Total Knee Arthroplasty

Hwang, Jun Kyung; Oh, Chang Wug; Lee, Hyun Joo; Kyung, Hee Soo

Abstract

PURPOSE
We compared the results between an articulating spacer and a non-articulating spacer for 2-stage reimplantation when performing infected total knee arthroplasty (TKA).
MATERIALS AND METHODS
From 1998 to 2007, for 22 patients with infected TKA, we retrospectively evaluated 23 knees that were treated with debridement, component removal and insertion of a non-articulating or articulating spacer, followed by second-stage TKA revision. Non-articulating spacers were used in 13 knees and articulating spacers were used in 10 knees. The most common infecting organism was Staphylococcus aureus in 9 cases, but the infecting organism could not be found in 10 cases. The average length of follow-up was 24 months.
RESULTS
The eradication rate was 100% (0 infections in 10 knee) in the articulating group compared with 92.3% (1 infection in 13 knee) in the non-articulating group. The average range of motion before removal of the implant was 60.3degrees for the articulating group and 61degrees for the non-articulating group. After revision arthroplasty, the average range of motion was 104.3degrees for the articulating group and 92.3degrees for the non-articulating group. The rectus snip was done for 3 cases in the articulating group and in 13 cases for the non-articulating group. Yet there were no functional differences between the two groups during the final follow-up period.
CONCLUSION
We conclude that the articulating spacer can maintain knee mobility during between the interval stages and improve knee flexion without an increased risk of infection at the final follow-up period.