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Temporary arthrodesis of the knee joint using coupled AO rods

Published in N°014 - November / December 2021
Article viewed 177 times

Temporary arthrodesis of the knee joint using coupled AO rods

By Stefanie Donner, Clemens Gwinner, Stephanie Kirschbaum, Carsten Perka in category SURGICAL TECHNIQUE
Charité Universitätsmedizin Berlin, Centrum für Muskuloskeletale Chirurgie

The current gold standard in the treatment of periprosthetic infections is the two-stage septic revision of the affected knee joint with reported success rates of up to 90%.Usually, a bone-cement (polymethylmethacrylate—PMMA) spacer is used in the interim phase between explanation of the infected prosthesis and reimplantation of the new implant.

Introduction and Indication

The current gold standard in the treatment of periprosthetic infections is the two-stage septic revision of the affected knee joint with reported success rates of up to 90%.(1,2) Usually, a bone-cement (polymethylmethacrylate—PMMA) spacer is used in the interim phase between explanation of the infected prosthesis and reimplantation of the new implant. The spacer  supports eradication of the infection by local delivery of antibiotics and facilitates optimum management of the dead space. (9) Depending on the ligament and bone condition, the available choices include dynamic and static spacers. Whilst static spacers can be used with major bone and soft tissue defects especially in cases after multiple revisions, articulating spacers are suitable only for minor superficial defects and require adequate fixation in the metaphysis with good bone quality. (6,7) Whilst no significant differences were found between the use of static and dynamic spacers in terms of eradication of the infection (2,3), some authors report reduced mobility following reimplantation when using static spacers in the prosthesis-free interval. (9) However, comparing the two spacer types is difficult because static spacers are generally only used in cases where the ligament and bone...

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