Temporary arthrodesis through static spacer implantation in two-stage treatment of periprosthetic joint infections of the knee

Oper Orthop Traumatol. 2023 May 12. doi: 10.1007/s00064-023-00809-7. Online ahead of print.ABSTRACTOBJECTIVE: Treatment of chronic periprosthetic joint infection of the knee requires the removal of the implant and thorough debridement, with reimplantation in a second stage surgery. Intramedullary spacers can be helpful during the interval between explantation and reimplantation and provide a temporary arthrodesis which fixes the knee in extension preserving leg length and administers local antibiotic therapy.INDICATIONS: Periprosthetic joint infection of the knee with large bony defects and severe infection of the native joint with advanced destruction/infiltration of the cartilage and bone and/or ligament insufficiency.CONTRAINDICATIONS: Suspected antibiotic resistance of the microbiological pathogen to local antibiotic drugs, incompliant patient, and known allergy to bone cement or antibiotic.SURGICAL TECHNIQUE: After implant removal, suitable metal rods are coated with antibiotic-loaded bone cement and inserted into the cleaned intramedullary canals of femur and tibia. Rods are joined at the joint line with a connector and joint space is filled with more bone cement to achieve temporary and very stable arthrodesis.POSTOPERATIVE MANAGEMENT: Partial weight-bearing and no flexion/extension while spacer is in place; second stage reimplantation as soon as infection is controlled.RESULTS: Complications related to the spacer were rare (5.3%). Reimplantation of an implant was poss...
Source: Operative Orthopadie und Traumatologie - Category: Orthopaedics Authors: Source Type: research