Clinical outcomes of two-stage revision total knee arthroplasty in infected cases with antibiotic-loaded cement spacers produced using a handmade silicone mold
Tóm tắt
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.
Tài liệu tham khảo
Matsen Ko LJ, Yoo JY, Maltenfort M, Hughes A, Smith EB, Sharkey PF (2016) The effect of implementing a multimodal approach on the rates of periprosthetic joint infection after total joint arthroplasty. J Arthroplasty 31(2):451–455
Terteliene E, Grigaitis K, Robertsson O, Stucinskas J, Tarasevicius S, Porvaneckas N, Venalis A (2019) 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):373–376
Koh CK, Zeng I, Ravi S, Zhu M, Vince KG, Young SW (2017) 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):2194–2201
Abdel MP, Barreira P, Battenberg A, Berry DJ, Blevins K, Font-Vizcarra L, Frommelt L, Goswami K, Greiner J, Janz V, Kendoff DO, Limberg AK, Manrique J, Moretti B, Murylev V, O’Byrne J, Petrie MJ, Porteous A, Saleri S, Sandiford NA, Sharma V, Shubnyakov I, Sporer S, Squire MW, Stockley I, Tibbo ME, Turgeon T, Varshneya A, Wellman S, Zahar A (2019) Hip and knee section, treatment, two-stage exchange spacer-related: proceedings of International Consensus on Orthopedic Infections. J Arthroplasty 34(2S):S427–SS38
Guild GN 3rd, Wu B, Scuderi GR (2014) Articulating vs. static antibiotic impregnated spacers in revision total knee arthroplasty for sepsis. A systematic review. J Arthroplasty 29(3):558–563
Voleti PB, Baldwin KD, Lee GC (2013) Use of static or articulating spacers for infection following total knee arthroplasty: a systematic literature review. J Bone Joint Surg Am 95(17):1594–1599
Romano CL, Gala L, Logoluso N, Romano D, Drago L (2012) 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):2445–2453
Nodzo SR, Boyle KK, Spiro S, Nocon AA, Miller AO, Westrich GH (2017) Success rates, characteristics, and costs of articulating antibiotic spacers for total knee periprosthetic joint infection. Knee 24(5):1175–1181
Yu Q, Luo M, Wu S, Lai A, Sun Y, Hu Q, He Y, Tian J (2019) 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):695–707
Durbhakula SM, Czajka J, Fuchs MD, Uhl RL (2004) Antibiotic-loaded articulating cement spacer in the 2-stage exchange of infected total knee arthroplasty. J Arthroplasty 19(6):768–774
Hsu YC, Cheng HC, Ng TP, Chiu KY (2007) Antibiotic-loaded cement articulating spacer for 2-stage reimplantation in infected total knee arthroplasty: a simple and economic method. J Arthroplasty 22(7):1060–1066
Van Thiel GS, Berend KR, Klein GR, Gordon AC, Lombardi AV, Della Valle CJ (2011) Intraoperative molds to create an articulating spacer for the infected knee arthroplasty. Clin Orthop Relat Res 469(4):994–1001
Jiranek WA, Waligora AC, Hess SR, Golladay GL (2015) Surgical treatment of prosthetic joint infections of the hip and knee: changing paradigms? J Arthroplasty 30(6):912–918
Brown NM, Cipriano CA, Moric M, Sporer SM, Della Valle CJ (2012) Dilute betadine lavage before closure for the prevention of acute postoperative deep periprosthetic joint infection. J Arthroplasty 27(1):27–30
Kühn KD (2000) Up to date comparison of physical and chemical properties of commercial materials. Bone Cements Springer, Berlin, pp 27–29
Mazzucchelli L, Rosso F, Marmotti A, Bonasia DE, Bruzzone M, Rossi R (2015) The use of spacers (static and mobile) in infection knee arthroplasty. Curr Rev Musculoskelet Med 8(4):373–382
Watanabe T, Koga H, Katagiri H, Otabe K, Nakagawa Y, Muneta T, Sekiya I, Jinno T (2020) 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):1400-1409.
Faul F, Erdfelder E, Buchner A, Lang AG (2009) Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods 41(4):1149–1160
Castelli CC, Gotti V, Ferrari R (2014) Two-stage treatment of infected total knee arthroplasty: two to thirteen year experience using an articulating preformed spacer. Int Orthop 38(2):405–412
Incavo SJ, Russell RD, Mathis KB, Adams H (2009) Initial results of managing severe bone loss in infected total joint arthroplasty using customized articulating spacers. J Arthroplasty 24(4):607–613
Shen H, Zhang X, Jiang Y, Wang Q, Chen Y, Wang Q, Shao J (2010) Intraoperatively-made cement-on-cement antibiotic-loaded articulating spacer for infected total knee arthroplasty. Knee 17(6):407–411
Su Y-P, Lee OK, Chen W-M, Chen T-H (2009) A facile technique to make articulating spacers for infected total knee arthroplasty. J Chin Med Assoc 72(3):138–145
Penner MJ, Masri BA, CP D. (1996) Elution characteristics of vancomycin and tobramycin combined in acrylic bone-cement. J Arthroplasty 11(8):939–944
Slane J, Gietman B, Squire M (2018) Antibiotic elution from acrylic bone cement loaded with high doses of tobramycin and vancomycin. J Orthop Res 36(4):1078–1085
Pivec R, Naziri Q, Issa K, Banerjee S, Mont MA (2014) Systematic review comparing static and articulating spacers used for revision of infected total knee arthroplasty. J Arthroplasty 29(3):553–557 e1
Mahmud T, Lyons MC, Naudie DD, Macdonald SJ, McCalden RW (2012) Assessing the gold standard: a review of 253 two-stage revisions for infected TKA. Clin Orthop Relat Res 470(10):2730–2736
Kubista B, Hartzler RU, Wood CM, Osmon DR, Hanssen AD, Lewallen DG (2012) Reinfection after two-stage revision for periprosthetic infection of total knee arthroplasty. Int Orthop 36(1):65–71
Kunutsor SK, Whitehouse MR, Lenguerrand E, Blom AW, Beswick AD, Team I (2016) Re-infection outcomes following one- and two-stage surgical revision of infected knee prosthesis: a systematic review and meta-analysis. PLoS One 11(3):e0151537
Mortazavi SM, Molligan J, Austin MS, Purtill JJ, Hozack WJ, Parvizi J (2011) Failure following revision total knee arthroplasty: infection is the major cause. Int Orthop 35(8):1157–1164