New Primary Total Knee Arthroplasty Components Versus Other Contemporary Types of Spacers for the Treatment of Chronic Periprosthetic Knee Infection With a Two-Stage Protocol

Andrew M. Schneider, Adam M. Holzmeister, Joseph FrazzettA, William Adams, William J. Hopkinson, Nicholas M. Brown

Research output: Contribution to journalArticlepeer-review

Abstract

The optimal type of antibiotic spacer for the treatment of a knee periprosthetic joint infection (PJI) remains a topic of debate. Although the ultimate goal of an antibiotic spacer is infection control, contemporary spacer iterations, such as the use of a new femoral component (NFC), may offer unique advantages. The primary goal of this study was to compare rates of infection control and functional outcomes between contemporary spacer types. We retrospectively reviewed 96 patients who underwent removal of a total knee arthroplasty with insertion of an antibiotic spacer for knee PJI over a 14-year period at a single institution with a minimum 1-year follow-up. Three patient cohorts were defined based on spacer type: NFC (n=30), cement-on-cement (n=19), and static (n=47). There was no association between spacer type and the odds of infection clearance (P=.60). The NFC spacers resulted in increased knee range of motion before replantation and improved ambulatory status at 8 weeks postre-plantation, although no difference was seen at final follow-up. The use of NFC spacers may provide functional advantages over their contemporary counterparts, and the potential of NFC spacers to be used in single-stage exchange arthroplasty remains an appealing area of investigation. Future high-powered, prospective, noninferiority studies between contemporary spacer types are needed. [Orthopedics. 2022;45(2):109-115.].

Original languageEnglish
Pages (from-to)109-115
Number of pages7
JournalOrthopedics
Volume45
Issue number2
DOIs
Publication statusPublished - 1 Mar 2022

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