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The Use of Static Spacers in Periprosthetic Knee Infections

Published in N°18 - July / August 2022
Article viewed 50 times

The Use of Static Spacers in Periprosthetic Knee Infections

By Nicolas Cance, Cécile Batailler, J. Shatrov, Elvire Servien, F. Laurent, Tristan Ferry, Sébastien Lustig in category TECHNIQUE
Orthopaedic Department, Lyon North University Hospital, Lyon, France / [email protected]

The increasing number of total knee arthroplasty (TKA) being performed has led to a corresponding increase in the overall number of TKA infections. Periprosthetic knee infection is a severe and not infrequent complication, with an incidence ranging from 0.4 to 2.5% for primary TKA and 4 to 8% for revision surgery.

Introduction

The increasing number of total knee arthroplasty (TKA) being performed has led to a corresponding increase in the overall number of TKA infections. Periprosthetic knee infection is a severe and not infrequent complication, with an incidence ranging from 0.4 to 2.5% for primary TKA and 4 to 8% for revision surgery. The surgical treatment differs depending on the duration of the infection. The aim is to eradicate infection and maintain satisfactory knee function (range of motion, stability, no pain). For acute infection, prosthesis removal may not be necessary and a DAIR (Debridement, Antibiotics, Implant Retention) should be performed in association with exchange of the polyethylene insert.

For subacute or chronic infection, prosthetic replacement is necessary, and two methods of management can be discussed: single-stage or two-stage exchange arthroplasty [1, 2]. Single-stage exchange arthroplasty involves implant removal with debridement, followed by reimplantation of a new prosthesis during the same operation. Although single-stage exchange knee arthroplasty is possible in certain specific cases, prosthetic replacement in two stages is currently considered as standard treatment [3, 4, 5].

During two-stage exchange arthroplasty, the first stage is to remove all...

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