An intraoperatively moulded PMMA prostheses like spacer for two-stage revision of infected total knee arthroplasty

作者：Kohl Sandro^*; Evangelopoulos Dimitrios S; Kohlhof Hendrik; Krueger Andreas; Hartel Maximilian; Roeder Christoph; Eggli Stefan

来源：Knee, 2011, 18(6): 464-469.

DOI：10.1016/j.knee.2010.09.002

• Total knee arthroplasty (TKA)
• Infection
• Cement-prostheses-like spacer (CPLS)
• Two-stage revision TKA

We report a series of 16 consecutive total knee arthroplasty (TKA) revision procedures for deep infection, treated with a newly developed intraoperatively moulded PMMA cement-prostheses-like spacer (CPLS). The standard treatment consisted of a two-stage protocol with initial explantation of the infected components combined with radical debridement, followed by implantation of a temporary cement spacer and final reimplantation of a new TKA. A sterilizeable Teflon tapered aluminium mould was developed for production of a custom made CPLS during the intervention. Stable implantation of the CPLS was achieved with a second cementation, allowing for correct alignment and ligament balancing. The spacer remained 3.5 months on average until reimplantation of a TKA occurred. At time of reimplantation, patients had an average KSS score of 84.44 points with an average flexion capacity of 102 degrees There was no recurrent infection during the study period of minimum 2 years. With this new technique, a low friction articulation with good stability, high comfort and a better range of motion compared to handcrafted spacers was achieved. The use of this spacer is a time sparing, cheap and convenient option in 2-stage TKA revision.

• 出版日期2011-12