J Korean Orthop Assoc.  2009 Oct;44(5):533-541. 10.4055/jkoa.2009.44.5.533.

Two-Stage Reimplantation of Infected Total Knee Arthroplasty with Antibiotic-Loaded Bone Cement Spacer: Comparison of the Types of Antibiotic-Loaded Cement Spacer

Affiliations
  • 1Department of Orthopaedic Surgery, Pusan National University School of Medicine, Busan, Korea. jtsuh@pusan.ac.kr

Abstract

PURPOSE
The treatment results of a two-stage reimplantation of infected total knee arthroplasty with either the articulating or non-articulating types of antibiotic-loaded bone cement spacers were compared and analyzed. MATERIALS AND METHODS: Between July 1995 and October 2005, this study reviewed 29 patients who underwent two-stage reimplantation of infected total knee arthroplasty and were followed up for at least 2 years. Of the 29 cases, 12 used articulating and 17 used the non-articulating type. RESULTS: Fifteen cases (52%) showed bacterial growth in the preoperative and intraoperative bacterial culture, and 14 cases (48%) had no growth. 27 cases showed no evidence of reinfection until the last follow up after two-stage reimplantation. One out of the 12 cases in the articulating group and 1 out of the 17 cases in the non-articulating group had a reinfection. The range of motion (ROM) of the knee joint and HSS knee rating scale increased more significantly in the articulating group than in the non-articulating group, and the degree of increase in the ROM of the knee joint and HSS knee rating scale was significantly larger in the articulating group. CONCLUSION: The two-stage reimplantation with an antibiotic-loaded bone cement spacer showed a 93.1% of success rate. The articulating group showed better results in the knee ROM and HSS knee rating scale than the non-articulating group

Keyword

Infected total knee arthroplasty; Two stage reimplantation; Antibiotic-loaded bone cement spacer; Articulating; Non-articulating

MeSH Terms

Arthroplasty
Follow-Up Studies
Humans
Knee
Knee Joint
Range of Motion, Articular
Replantation
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