Hand-made articulating spacers for infected total knee arthroplasty: A technical note

Villanueva, Manuel; Rı́os, Antonio; Pereiro, Javier; Chana, Francisco; Fahandez-Saddi, Homid

doi:10.1080/17453670610046190

Cited by 29 publications

(20 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We have recently described a step-by-step technique to construct articulating spacers with just 3 basic surgical tools, thus representing an inexpensive method that is applicable in all operating theaters (Villanueva et al 2006). Our findings in this consecutive series of 30 patients imply that our hand-made spacers function as well as more complex constructs.…”

Section: Discussionmentioning

confidence: 55%

“…A Hohmann retractor, a curved osteotome, and a high-speed tip burr were all the surgical tools required. The components of the spacer were conformed manually following the basic guidelines that we have previously described (Villanueva et al 2006) (Figures 1-3).…”

Section: Methodsmentioning

confidence: 99%

“…Most modifications have yielded good results (Insall et al 1983, Cohen et al 1988, Booth and Lotke 1989, Duncan et al 1992, McPherson et al 1995, Siebel et al 2002, Durbhakula et al 2004, Ha 2006, Mcavoy and Ries 2006. The simplest, cheapest, and universally available method for making articulating spacers is to build them during surgery (Villanueva et al 2006).…”

mentioning

confidence: 99%

See 2 more Smart Citations

Hand-made articulating spacers in two-stage revision for infected total knee arthroplasty: Good outcome in 30 patients

Villanueva‐Martínez

Rıos-Luna²,

Pereiro

et al. 2008

Acta Orthopaedica

Self Cite

View full text Add to dashboard Cite

Background and purpose The most reliable results when treating an infected total knee arthroplasty have been obtained with a two-stage reimplantation protocol. We have used a simple technique for hand-made spacers and now report the outcome.Patients and methods 30 patients with an infected total knee arthroplasty (TKA) were treated with a 2-stage reimplantation protocol. Spacers were built and customized to the type of defect using only 2 retractors and a high-speed tip burr. Partial weight bearing and discharge from the hospital were encouraged in the time between surgeries. 29 of 30 patients (97%) had successful reimplantations and they were followed for an average of 3 (2-5) years.Results Range of motion with the articulating spacer averaged 80° (55-100) and 21 of the 30 patients achieved motion greater than 75°. At the latest follow-up, there were no reinfections. According to the Knee Society score (KSS), the results were considered excellent or good in 25 patients, and fair or poor in 4 of the 29 patients with reimplantations. Motion after reimplantation averaged 107° (90-120).Interpretation One of the key factors related to a successful outcome with a two-stage reimplantation procedure is to keep the joint mobile and functional in the time between surgeries. Hand-made articulating spacers retain most of the advantages of more complex spacers in terms of mobility, pain, bone loss, success, or re-infection rate-with the major advantages of price and universal availability. Limitations related to this technique

show abstract

Section: Discussionmentioning

confidence: 55%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Hand-made articulating spacers in two-stage revision for infected total knee arthroplasty: Good outcome in 30 patients

Villanueva‐Martínez

Rıos-Luna²,

Pereiro

et al. 2008

Acta Orthopaedica

Self Cite

View full text Add to dashboard Cite

show abstract

“…ROM, patellar tracking, and knee stability are checked carefully [47]. Following the same technique described for static spacers, a drain is inserted in articulation to reduce postoperative hematoma formation.…”

Section: Cement-on-cement Interface: Molded or Preformed Spacersmentioning

confidence: 99%

The use of spacers (static and mobile) in infection knee arthroplasty

Mazzucchelli

Rosso

Marmotti

et al. 2015

Curr Rev Musculoskelet Med

View full text Add to dashboard Cite

Revision total knee arthroplasty (TKA) is the treatment of choice in patients with periprosthetic joint infection. It may be performed in either a single stage or two stages. In the latter option, between stages, an antibiotic-loaded spacer may be used to maintain a certain amount of joint stability and mobility after the infected implant is removed, adding an intra-articular concentration of antibiotics. There are two types of antibiotic-loaded cement spacers: static and dynamic. Static spacers basically create a temporary arthrodesis with antibiotic-loaded cement and usually are handmade within the surgical field. Dynamic spacers can be created intraoperatively by using different tools or may be prepackaged by the manufacturer; they allow range of motion between stages. In this article, the authors review the indications, surgical techniques, and results for static and dynamic spacers in two-stage revision TKA.

show abstract

“…In another technique [12], premolded antibiotic spacers (Stage One [Biomet, Warsaw, IN] or Prostalac) are used. In a third technique, first described by Villaneuva et al [1], Ha [14], and Goldstein [15], custom-molded spacers were used. This is the technique that we used in our series.…”

Section: Introductionmentioning

confidence: 99%

Custom-made Articulating Spacer in Two-stage Revision Total Knee Arthroplasty. An Early Follow-up of 14 Cases of at Least 1 Year after Surgery

Pascale

2007

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

View full text Add to dashboard Cite

Total knee replacement (TKR) infection represents only a small percentage of all the potential complications in joint replacement, but one that can lead to disastrous consequences. Two-stage revision, which has been proven to be the most effective technique in eradicating infection, includes prosthesis removal, positioning of an antibiotic-loaded spacer, and systemic antimicrobial therapy for at least 6 weeks. It has been suggested that there is better performance in terms of range of motion, pain, extensor mechanism shortening, and spacer-related bone loss if articulating spacers are used instead of fixed spacers. In this paper, we describe our results in two-stage revision of infected total knee arthroplasty with a minimum follow-up of 12 months on 14 patients treated by antibiotic-loaded custommade articulating spacer as described by Villanueva et al. (Acta Orthop 77(2):329-332, 2006). The mean flexion achieved after the second stage of the revision was 120-, ranging from 97-to 130-. The mean Hospital for Special Surgery score was 84. At 1 year after surgery, none of the knees showed any evidence of recurrence of the infection. Articulating spacers are a suitable alternative to fixed spacers with good range of motion after reimplantation and effectiveness against total knee replacement deep infections.

show abstract

Hand-made articulating spacers for infected total knee arthroplasty: A technical note

Cited by 29 publications

References 12 publications

Hand-made articulating spacers in two-stage revision for infected total knee arthroplasty: Good outcome in 30 patients

Hand-made articulating spacers in two-stage revision for infected total knee arthroplasty: Good outcome in 30 patients

The use of spacers (static and mobile) in infection knee arthroplasty

Custom-made Articulating Spacer in Two-stage Revision Total Knee Arthroplasty. An Early Follow-up of 14 Cases of at Least 1 Year after Surgery

Contact Info

Product

Resources

About