Primary Total Knee Arthroplasty Implants as Functional Prosthetic Spacers for Definitive Management of Periprosthetic Joint Infection: A Multicenter Study

Siddiqi, Ahmed; Nace, James; George, Nicole E.; Buxbaum, Eric J.; Ong, Alvin; Orozco, Fabio; Ponzio, Danielle Y.; Post, Zachary D.

doi:10.1016/j.arth.2019.07.007

Cited by 31 publications

(40 citation statements)

References 49 publications

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“…Raut et al revealed 84% eradication rate [53] and 86% eradication rate in patients with sinus tracts [10] at 7-year follow-up in THA. As for TKA, Siddiqi et al [54] recently reported an 86% eradication rate and 80.7% surgery-free survival rate at 5-year follow-up in patients receiving cemented all-polyethylene tibia components. Table 2 lists current studies on outcomes following single-stage exchange.…”

Section: Single-stage Exchange Arthroplastymentioning

confidence: 99%

Single vs 2-Stage Revision for the Treatment of Periprosthetic Joint Infection

Kildow

DellaValle

Springer

2020

The Journal of Arthroplasty

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Section: Single-stage Exchange Arthroplastymentioning

confidence: 99%

Single vs 2-Stage Revision for the Treatment of Periprosthetic Joint Infection

Kildow

DellaValle

Springer

2020

The Journal of Arthroplasty

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“…1 CD). For knees, two types of spacers were also used [13][14][15] : for type I, an aseptic silicone mold imitating the joint shape was used, and a joint-like spacer was made intraoperatively ( Fig. 1 EF); for type II, the removed femoral end prosthesis was washed, soaked in povidone iodine solution and resterilized, and the resterilized tibial prosthesis was used or replaced with a new polyethylene tibial component ( Fig.…”

Section: The Process Of Revision Surgery and Preparation Of Joint Spamentioning

confidence: 99%

Compared with Two-Stage Revision, Destination Joint Spacers Have a Similar Infection-Relief Rate and a Higher Complication Rate

Cai¹,

Fang²,

Lin³

et al. 2020

Preprint

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Background: Two-stage revision is regarded as the “gold standard” for periprosthetic joint infection (PJI) treatment, in which antibiotic-impregnated spacers play an important role. However, some patients are unable to undergo reimplantation of the prosthesis after spacer implantation. The clinical outcomes of these patients remain unknown. The purpose of this research was to study the infection-relief rate and clinical outcome of these patients.Methods: From January 2006 to December 2017, data from PJI patients who underwent implantation with antibiotic-impregnated cement spacers in our center due to chronic PJI were collected retrospectively. Age, sex, body mass index (BMI) and laboratory test results were recorded, and the infection-relief rate and clinical outcomes were observed.Results: A total of 62 patients who were diagnosed with PJI were enrolled, with an age of 65.13 ±9.94 (39-88) years. There were 21 cases in the destination joint spacer group and 41 cases in the temporary spacer group (reimplantation of prosthesis after infection relief). The Charlson comorbidity index (CCI) in the destination joint spacer group was higher than that in the temporary spacer group. Our study showed that the infection-relief rate of destination joint spacers was similar to that of two-stage revision, but the incidence of complications was higher than that of two-stage revision, especially for the type I spacer used in this study.Conclusions: The infection-relief rate of destination joint spacers was similar to that of two-stage revision, but the complication rate was higher than that of two-stage revision (especially for the type I spacer).

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“…For type II, 105 mm femoral stem, 28 mm femoral head and 32 mm femoral neck (CM-CZ; AK Medical, Beijing, China) were used as scaffolds, which were embedded with antibiotic-impregnated cement and molded under pressure (Fig 1 CD). For knees, two types of spacers were also used [13][14][15] : for type I, an aseptic silicone mold imitating the joint shape was used, and a joint-like spacer was made intraoperatively (Fig 1 EF); for type II, the removed femoral end prosthesis was washed, soaked in povidone iodine solution and resterilized, and the resterilized tibial prosthesis was used or replaced with a new polyethylene tibial component (Fig 1 GH). The antibiotics used in the antibiotic-impregnated joint spacer were selected according to the microbial culture and drug sensitivity test results.…”

Section: The Process Of Revision Surgery and Preparation Of Joint Spamentioning

confidence: 99%

Compared with two-stage revision, retained spacers have a similar infection-relief rate and a higher complication rate

Cai

Fang

Lin

et al. 2020

Preprint

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Background: Periprosthetic joint infection (PJI) is a devastating complication for joint arthroplasty, there are many challenges in therapy. The treatment of PJI including surgery and systemic administration of antibiotics. As for surgery, two-stage revision is regarded as the “gold standard” for PJI treatment presently, in which antibiotic-impregnated spacers play an important role. However, some patients are unable to undergo reimplantation of the prosthesis after spacer implantation, this spacer, namely, “destination joint spacer”. The clinical outcomes of these patients remain unknown. The purpose of this research was to study the infection-relief rate and clinical outcome of these patients.Methods: From January 2006 to December 2017, data from PJI patients who underwent implantation with antibiotic-impregnated cement spacers in our center due to chronic PJI were collected retrospectively. Age, sex, body mass index (BMI) and laboratory test results were recorded, and the infection-relief rate and clinical outcomes were observed.Results: A total of 62 patients who were diagnosed with PJI were enrolled, with an age of 65.13 ±9.94 (39-88) years. There were 21 cases in the destination joint spacer group and 41 cases in the temporary spacer group (reimplantation of prosthesis after infection relief). The Charlson comorbidity index (CCI) in the destination joint spacer group was higher than that in the temporary spacer group. Our study showed that the infection-relief rate of destination joint spacers was similar to that of two-stage revision, but the incidence of complications was higher than that of two-stage revision, especially for the type I spacer used in this study.Conclusions: The infection-relief rate of destination joint spacers was similar to that of two-stage revision, but the complication rate was higher than that of two-stage revision (especially for the type I spacer).

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Primary Total Knee Arthroplasty Implants as Functional Prosthetic Spacers for Definitive Management of Periprosthetic Joint Infection: A Multicenter Study

Cited by 31 publications

References 49 publications

Single vs 2-Stage Revision for the Treatment of Periprosthetic Joint Infection

Single vs 2-Stage Revision for the Treatment of Periprosthetic Joint Infection

Compared with Two-Stage Revision, Destination Joint Spacers Have a Similar Infection-Relief Rate and a Higher Complication Rate

Compared with two-stage revision, retained spacers have a similar infection-relief rate and a higher complication rate

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