Two-stage exchange of infected knee arthroplasty with an prosthesis-like interim cement spacer.

Abstract

Two-stage revision in infected knee arthroplasty is standard practice. One problem during the interim period is soft tissue fibrosis. Attempts have been made to preserve leg length and ligament length by introducing spacers, usually made out of antibiotic-loaded bone cement. We present a new interim prosthesis, which is made intra-operatively out of polymethylmethacrylate (PMMA). Antibiotic-loaded cement provides a therapeutic level of antibiotics in the periarticular soft tissue. We report the results in ten patients, who were treated with this prosthesis-like spacer and were prospectively studied. After an average follow-up of 13.5 months, there was no recurrent infection.