Spacer-related problems in two-stage revision knee arthroplasty

Although articulated cement spacers are frequently used in a staged approach of an infected total knee arthroplasty (TKA), no data are available on the incidence and type of spacer-related problems in these patients. A retrospective analysis of 154 patients who underwent a two-stage revision procedure for an infected TKA was performed. All patients received an articulating cement spacer at the implant removal procedure ; their radiographs were analyzed for spacer-related issues such as spacer dislocation, fracture, tilting or translation, and knee subluxation. In 43% of the patients, the spacer was considered as optimal. The main finding of this study is the large incidence (57%) of spacer-specific problems in twostage revision knee arthroplasty for infected TKA. Spacer tilting and mediolateral translation were found to be the most frequent spacer-specific problems, in 24% and 21% of the cases respectively. These were considered as minor problems. Major problems were seen in 12 %: in 3% of the knees the spacer had dislocated, in 5% the spacer fractured and in 4%, although the spacer seemed to be adequately positioned relative to the femoral and tibial bone, frank knee subluxation could be noted. The impact of spacerspecific problems with articulating cement spacers on final outcome in two-stage revision knee surgery will be further investigated. © 2013, Acta Orthopædica Belgica.

Publication year:2013