The Efficacy Of Static And Articulating Spacers Used For Tow-stage Revision Of Infected Total Knee Arthroplasty:A Meta-analysis

ObjectiveTo compare the efficacy of two different antibiotic bone cement spacers(Spacer)in the two-stage revision surgery of periprosthetic infection after total knee arthroplasty.by comparing the infection eradication rate,postoperative knee motion and knee scores,soft tissue contracture in the exclusion period for clinical treatment and research.MethodBy searching the PubMed,Medline,EMBASE,Cochrane Library,Chinese Journal Full-text Database(CNKI),and Wanfang database,etc,collected the published literature about the efficacy of static and articulating spacers used for tow-stage revision of infected total knee arthroplasty.the relevant data were extracted and analyzed using Review Manager 5.3.ResultsA total of 11 articles(10 retrospective case-control studies and 1 prospective cohort study)were included based on the PICOS Principles.The results of the Review Manager 5.3 analysis were as follows: There was no significant difference in the eradication rate between the two kinds of Spacers(P = 0.28),and the knee pain score(KSS)after the two-stage revision(P = 0.11),due to soft tissue contraction caused by exposure difficulties need to release surgery,which Quadriceps plasty was not significantly different between the two groups(P = 0.50),and the tibial tubercle osteotomy also did not differ significantly between the two groups(P = 0.50).(ROM)were significantly greater in the articulaing group than in the static group(P <0.00001).The two groups had significant differences in the Hospital for Special Surgery score(HSS)and Knee society Score(KSS-function)after the two-stage revision,a significantly higher scores were found in the articulating group(P <0.00001 and P = 0.009).ConclusionThe use of two different types of antibiotic cemented Spacer showed no significant difference in infection eradication rate,soft tissue contracture during exclusion period,and knee pain score after two-stage revision.However,there were significant differences in knee joint mobility(ROM)and knee function recovery after two-stage revision.The knee joint mobility and the knee function score was higher in patients with articulating Spacer.