Does spiked tibial cement spacer reduce spacer-related problems in two-stage revision total knee arthroplasty for infection?

Int Orthop. 2022 Sep;46(9):2009-2017. doi: 10.1007/s00264-022-05438-6. Epub 2022 May 18.

Abstract

Purpose: Articulating cement spacers are frequently used in staged approaches for infected total knee arthroplasty (TKA). This study investigated whether a tibial cement spacer (TCS) with spikes could reduce spacer-related problems in two-stage revision TKA (R-TKA).

Methods: A total of 27 patients (27 knees; 10 men and 17 women) who underwent two-stage R-TKA for infected TKA were retrospectively analyzed. Group A comprised 12 patients who used TCS with spikes added to the bottom surface, whereas group B consisted of 15 patients who used conventional TCS with a flat bottom. For each group, plain radiographs were obtained after cement spacer implantation and before R-TKA to measure mediolateral (ML) translation and TCS's tilting angle. Patients' demographic data, ML translation of the TCS, and changes in the TCS's tilting angle between the groups were analyzed.

Results: The mean ML translation was significantly lower in group A than that in group B (1.7 mm vs. 5.4 mm, p = 0.04). The mean change in the tilting angle was significantly lower in group A than that in group B (4.5° vs. 19.4°, p = 0.047).

Conclusion: The spiked TCS in two-stage R-TKA provides superior stability compared to the TCS with a conventional design.

Keywords: Cement spacer; Infection; Knee; Revision; Spiked; Total knee arthroplasty.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Arthroplasty, Replacement, Knee* / adverse effects
  • Bone Cements
  • Female
  • Humans
  • Knee Joint / surgery
  • Knee Prosthesis* / adverse effects
  • Male
  • Prosthesis-Related Infections* / drug therapy
  • Prosthesis-Related Infections* / prevention & control
  • Prosthesis-Related Infections* / surgery
  • Reoperation
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Bone Cements