Abstract
PurposeThis study assessed the clinical outcomes of periprosthetic joint infection patients who underwent two-stage revision total knee arthroplasty with antibiotic-loaded cement spacers fabricated using a handmade silicone mold.Materials and methodsThis study included seven patients (average age 77 years, average follow-up time 54 months) who underwent surgery at our hospital between 2009 and 2013. Clinical outcomes including knee scores, function scores, knee range of motion, and walking ability at the final observation, period from the primary total knee arthroplasty to implant removal, period from implant removal to revision total knee arthroplasty, and follow-up period after revision total knee arthroplasty were investigated.ResultsAt the final follow-up, the average knee range of motion was 99°, with no significant differences at each stage; average knee and function scores were 84 and 77, respectively. With cement spacers, five patients were able to walk with a t-cane. No recurrence of infection was observed.ConclusionsThe clinical outcomes of the current case series demonstrated good knee function with preserved walking ability, without any recurrence of periprosthetic joint infection. This study suggests that using a handmade silicone mold could be an effective option for periprosthetic joint infection after a total knee arthroplasty.
Highlights
Periprosthetic joint infection (PJI) is a serious complication after total knee arthroplasty (TKA), and its incidence after primary TKA has been reported to be 1–2% [1, 2]
The purpose of this study was to introduce our methods and to examine the midterm outcomes of PJI cases after primary TKA treated with antibiotic-loaded cement spacers produced using a handmade silicone mold
Bone cement was mixed with 2 g vancomycin and 180 mg tobramycin per 40 g of each package [16]
Summary
Periprosthetic joint infection (PJI) is a serious complication after total knee arthroplasty (TKA), and its incidence after primary TKA has been reported to be 1–2% [1, 2]. Previous studies have reported that PJI was one of the main reasons for the failure of primary TKA, with problems of reinfection and lowered patient activity levels [3]. The appropriate prevention and treatment of PJIs are crucial. Two-stage revision is considered the gold standard treatment for chronic PJI after TKA. A recent international consensus committee suggested that articulating spacers were better than static spacers during knee resection arthroplasty without major bone loss, lack of ligamentous integrity, or major soft-tissue defects [4]. Articulating spacers have some advantages such as maintaining joint space, maintaining mobility, preventing softtissue atrophy, and preserving walking ability [5,6,7]
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