Knee Spacers in Periprosthetic Joint Infections: A Narrative Review

Abstract

Introduction. Periprosthetic joint infection (PJI) is a most common causes of failure of total knee arthroplasty. Knee spacers can be static or dynamic and are commonly used in the management of periprosthetic joint infection. Several types of spacers are available including rods, fixator rods, inverse spacers, handmade, molded, or preformed spacers with a cement-on-cement interface. This article provides a detailed review of knee spacers, their differences, and indications. Materials and methods. In February 2023, PubMed, Embase, Scopus, and Google Scholar were accessed, with no time constraints. Discussion. Spacers can be static or dynamic. Static spacers do not allow any movement, and should be used in patients with joint instability, insufficiency of the knee extensor mechanism, massive bone loss, and impaired wound healing with skin loss. On the other hand, dynamic spacers allow flexion and extension of the knee. Conclusions. There is no evidence indicating the best choice when it comes to decide which articulating spacer to use.