Second-stage revision surgery with mobile cement spacer in the treatment of infected total knee arthroplasty

Abstract

Objective To investigate the effects of second-stage revision surgery with mobile cement spacer in the treatment of deep infection following primary knee arthroplasty.Methods From April 2007 to August 2011,eleven patients who suffered from infected total knee arthroplasty were treated with second-stage revision arthroplasty using mobile cement spacer.There were two males and nine females with an average age of 61 years(range,56-68 years).The first stage operation included prosthesis removal,radical debridement,insertion of antibiotic-impregnated mobile cement spacer.Then the patients received antibiotic treatment for a period of 8-10 weeks.When the infection was controlled,the second operation was done with removal of the spacer and reimplantation of new rotatory hinged knee prothesis.HSS rating scale was used for assessment of outcomes.Results All the patients were followed for a mean period of 22 months(range,13-40 months).No recurrence of infections or other complications were noted.Preoperative HSS scores averaged 48 points(range,34-62 points).Prior to the second operation,HSS scores increased to an average of 76 points(range,61-90 points).At final follow-up,the average HSS score was 88 points(range,76-94 points).The satisfactory rate of the knee function for pre-first operation,pre-second operation,and final follow-up was 0,seventy-three percent,and one hundred percent respectively.Conclusions Second-stage revision surgery with mobile cement spacer is effective and safe for the treatment of infected knee arthroplasty with well preserved knee function. Key words: Knee prosthesis ; Infection ; Revision surgery ; Cement spacer