Clinical outcomes of two-stage revision total knee arthroplasty in infected cases with antibiotic-loaded cement spacers produced using a handmade silicone mold
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This study assessed the clinical outcomes of periprosthetic joint infection patients who underwent two-stage revision total knee arthroplasty with antibiotic-loaded cement spacers fabricated using a handmade silicone mold.This study included seven patients (average age 77 years, average follow-up time 54 months) who underwent surgery at our hospital between 2009 and 2013. Clinical outcomes including knee scores, function scores, knee range of motion, and walking ability at the final observation, period from the primary total knee arthroplasty to implant removal, period from implant removal to revision total knee arthroplasty, and follow-up period after revision total knee arthroplasty were investigated.At the final follow-up, the average knee range of motion was 99°, with no significant differences at each stage; average knee and function scores were 84 and 77, respectively. With cement spacers, five patients were able to walk with a t-cane. No recurrence of infection was observed.The clinical outcomes of the current case series demonstrated good knee function with preserved walking ability, without any recurrence of periprosthetic joint infection. This study suggests that using a handmade silicone mold could be an effective option for periprosthetic joint infection after a total knee arthroplasty.
Abstract
This study assessed the clinical outcomes of periprosthetic joint infection patients who underwent two-stage revision total knee arthroplasty with antibiotic-loaded cement spacers fabricated using a handmade silicone mold.This study included seven patients (average age 77 years, average follow-up time 54 months) who underwent surgery at our hospital between 2009 and 2013. Clinical outcomes including knee scores, function scores, knee range of motion, and walking ability at the final observation, period from the primary total knee arthroplasty to implant removal, period from implant removal to revision total knee arthroplasty, and follow-up period after revision total knee arthroplasty were investigated.At the final follow-up, the average knee range of motion was 99°, with no significant differences at each stage; average knee and function scores were 84 and 77, respectively. With cement spacers, five patients were able to walk with a t-cane. No recurrence of infection was observed.The clinical outcomes of the current case series demonstrated good knee function with preserved walking ability, without any recurrence of periprosthetic joint infection. This study suggests that using a handmade silicone mold could be an effective option for periprosthetic joint infection after a total knee arthroplasty.
참고문헌 (29)
- Matsen Ko LJ, "The effect of implementing a multimodal approach on the rates of periprosthetic joint infection after total joint arthroplasty", J Arthroplasty, 31(2), pp.451~455 (2016)
- Terteliene E, "Inadequate evaluation and management of suspected infections after TKA surgery in Lithuania : a retrospective study of 2, 769 patients with 2-year follow-up", Acta Orthop, 90(4), pp.373~376 (2019)
- Koh CK, "Periprosthetic joint infection is the main cause of failure for modern knee arthroplasty : an analysis of 11, 134 knees", Clin Orthop Relat Res, 475(9), pp.2194~2201 (2017)
- Abdel MP, "Hip and knee section, treatment, two-stage exchange spacer-related: proceedings of International Consensus on Orthopedic Infections", J Arthroplasty, 34(2S), pp.S427~S438 (2019)
- Guild GN, "Articulating vs. static antibiotic impregnated spacers in revision total knee arthroplasty for sepsis. A systematic review", J Arthroplasty, 29(3), pp.558~563 (2014)
- Voleti PB, "Use of static or articulating spacers for infection following total knee arthroplasty : a systematic literature review", J Bone Joint Surg Am, 95(17), pp.1594~1599 (2013)
- Romano CL, "Two-stage revision of septic knee prosthesis with articulating knee spacers yields better infection eradication rate than one-stage or two-stage revision with static spacers", Knee Surg Sports Traumatol Arthrosc, 20(12), pp.2445~2453 (2012)
- Nodzo SR, "Success rates, characteristics, and costs of articulating antibiotic spacers for total knee periprosthetic joint infection", Knee, 24(5), pp.1175~1181 (2017)
- Yu Q, "Comparison of infection eradication rate of using articulating spacers containing bio-inert materials versus all-cement articulating spacers in revision of infected TKA : a systematic review and meta-analysis", Arch Orthop Trauma Surg, 139(5), pp.695~707 (2019)
- Durbhakula SM, "Antibiotic-loaded articulating cement spacer in the 2-stage exchange of infected total knee arthroplasty", J Arthroplasty, 19(6), pp.768~774 (2004)
- Hsu YC, "Antibiotic-loaded cement articulating spacer for 2-stage reimplantation in infected total knee arthroplasty : a simple and economic method", J Arthroplasty, 22(7), pp.1060~1066 (2007)
- Van Thiel GS, "Intraoperative molds to create an articulating spacer for the infected knee arthroplasty", Clin Orthop Relat Res, 469(4), pp.994~1001 (2011)
- Jiranek WA, "Surgical treatment of prosthetic joint infections of the hip and knee : changing paradigms?", J Arthroplasty, 30(6), pp.912~918 (2015)
- Brown NM, "Dilute betadine lavage before closure for the prevention of acute postoperative deep periprosthetic joint infection", J Arthroplasty, 27(1), pp.27~30 (2012)
- Kühn KD, "Up to date comparison of physical and chemical properties of commercial materials", pp.27~29 (2000), Bone Cements Springer
- Mazzucchelli L, "The use of spacers(static and mobile)in infection knee arthroplasty", Curr Rev Musculoskelet Med, 8(4), pp.373~382 (2015)
- Watanabe T, "Coronal and sagittal laxity affects clinical outcomes in posterior-stabilized total knee arthroplasty : assessment of well-functioning knees", Knee Surg Sports Traumatol Arthrosc, 28(5), pp.1400~1409 (2020)
- Faul F, "Statistical power analyses using G*Power 3. 1 : tests for correlation and regression analyses", Behav Res Methods, 41(4), pp.1149~1160 (2009)
- Castelli CC, "Two-stage treatment of infected total knee arthroplasty : two to thirteen year experience using an articulating preformed spacer", Int Orthop, 38(2), pp.405~412 (2014)
- Incavo SJ, "Initial results of managing severe bone loss in infected total joint arthroplasty using customized articulating spacers", J Arthroplasty, 24(4), pp.607~613 (2009)
- Shen H, "Intraoperatively-made cement-on-cement antibiotic-loaded articulating spacer for infected total knee arthroplasty", Knee, 17(6), pp.407~411 (2010)
- Su Y-P, "A facile technique to make articulating spacers for infected total knee arthroplasty", J Chin Med Assoc, 72(3), pp.138~145 (2009)
- Penner MJ, "Elution characteristics of vancomycin and tobramycin combined in acrylic bone-cement", J Arthroplasty, 11(8), pp.939~944 (1996)
- Slane J, "Antibiotic elution from acrylic bone cement loaded with high doses of tobramycin and vancomycin", J Orthop Res, 36(4), pp.1078~1085 (2018)
- Pivec R, "Systematic review comparing static and articulating spacers used for revision of infected total knee arthroplasty", J Arthroplasty, 29(3), pp.553~557 (2014)
- Mahmud T, "Assessing the gold standard : a review of 253 two-stage revisions for infected TKA", Clin Orthop Relat Res, 470(10), pp.2730~2736 (2012)
- Kubista B, "Reinfection after two-stage revision for periprosthetic infection of total knee arthroplasty", Int Orthop, 36(1), pp.65~71 (2012)
- Kunutsor SK, "Re-infection outcomes following one-and two-stage surgical revision of infected knee prosthesis : a systematic review and meta-analysis", PLoS One, 11(3), pp.e0151537~ (2016)
- Mortazavi SM, "Failure following revision total knee arthroplasty : infection is the major cause", Int Orthop, 35(8), pp.1157~1164 (2011)
