Two Spacer Prostheses In Two-stage Revision Treat Infection After Total Knee Arthroplasty

Objective To explore two spacer prostheses in two-stage revision treat the infection after total knee arthroplasty, as well as compare the curative effect.Methods From January 2011 to September 2015,20 cases of infection after TKA was treated, including 13 males and 7 females, with a mean age of 64.6years(56-77years). After the first stage of two-stage revision treat for debridement, the spacer of 8 cases of TKA patients was made of original femoral component after disinfection, new liner and antibiotic-loaded cement,and 12 cases of TKA patients choose the cement spacer. Reimplantation was performed after eradication of infection. The management of infection and function of knee joint were recorded in the follow-up.Results The outcomes of resterilized prosthetic components spacers(Group I,n=8)were compared to those of operations performed during the same period of time using cement spacers(Group II,n=12).With an average follow-up of 27 months, the patients of group Ⅰ,after the first stage of two-stage revision treat, had a wider range of motion[mean(92 ±18)vs(35 ±20)degrees, P＜0.001] than patients with cement spacers.They also tended to score higher in Knee Society knee[median65 (0-79)vs22 (1-57), P=0.026]. The success rate in terms of infection eradication was 90%, but there were no signifcant differences.Conclusions Spacer made of original femoral component after disinfection, new liner and antibiotic-loaded cement may bring superior range of motion and play an effective role in the in two-stage revision treat the infection after total knee arthroplasty.