Augmented Articulating Spacers in Infected Total Knee Arthroplasty: Surgical Technique
Periprosthetic joint infections (PJIs) are a prominent subject of discussion in orthopedics and are frequently debated at conferences and congresses. In the context of PJIs affecting the knee, the decision between following a one-stage or two-stage treatment approach has historically been a pivotal...
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| Published in | Healthcare (Basel) Vol. 12; no. 7; p. 735 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Switzerland
MDPI AG
01.04.2024
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| Subjects | |
| Online Access | Get full text |
| ISSN | 2227-9032 2227-9032 |
| DOI | 10.3390/healthcare12070735 |
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| Abstract | Periprosthetic joint infections (PJIs) are a prominent subject of discussion in orthopedics and are frequently debated at conferences and congresses. In the context of PJIs affecting the knee, the decision between following a one-stage or two-stage treatment approach has historically been a pivotal consideration. The first option is limited by indications and potentially devastating complications in case of failure, whereas the second is widely accepted as the gold standard. Initially, the spacer was conceived solely to restore and maintain knee space after removal of the implant. An articulating spacer was introduced to mitigate patient limitations and improve knee function and quality of life. Two main types of articulating spacers are utilized in knee PJI treatment: the mold spacer and the metal-on-poly spacer. This text outlines a technique for metal-on-poly spacer implants. Based on our experience and the existing literature, this approach facilitates early full weight bearing and faster recovery of the knee’s range of motion, ultimately improving the quality of life after surgery, thus allowing the spacer retention for an extended period, as suggested by the 1.5-stage revision. |
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| AbstractList | Periprosthetic joint infections (PJIs) are a prominent subject of discussion in orthopedics and are frequently debated at conferences and congresses. In the context of PJIs affecting the knee, the decision between following a one-stage or two-stage treatment approach has historically been a pivotal consideration. The first option is limited by indications and potentially devastating complications in case of failure, whereas the second is widely accepted as the gold standard. Initially, the spacer was conceived solely to restore and maintain knee space after removal of the implant. An articulating spacer was introduced to mitigate patient limitations and improve knee function and quality of life. Two main types of articulating spacers are utilized in knee PJI treatment: the mold spacer and the metal-on-poly spacer. This text outlines a technique for metal-on-poly spacer implants. Based on our experience and the existing literature, this approach facilitates early full weight bearing and faster recovery of the knee's range of motion, ultimately improving the quality of life after surgery, thus allowing the spacer retention for an extended period, as suggested by the 1.5-stage revision.Periprosthetic joint infections (PJIs) are a prominent subject of discussion in orthopedics and are frequently debated at conferences and congresses. In the context of PJIs affecting the knee, the decision between following a one-stage or two-stage treatment approach has historically been a pivotal consideration. The first option is limited by indications and potentially devastating complications in case of failure, whereas the second is widely accepted as the gold standard. Initially, the spacer was conceived solely to restore and maintain knee space after removal of the implant. An articulating spacer was introduced to mitigate patient limitations and improve knee function and quality of life. Two main types of articulating spacers are utilized in knee PJI treatment: the mold spacer and the metal-on-poly spacer. This text outlines a technique for metal-on-poly spacer implants. Based on our experience and the existing literature, this approach facilitates early full weight bearing and faster recovery of the knee's range of motion, ultimately improving the quality of life after surgery, thus allowing the spacer retention for an extended period, as suggested by the 1.5-stage revision. Periprosthetic joint infections (PJIs) are a prominent subject of discussion in orthopedics and are frequently debated at conferences and congresses. In the context of PJIs affecting the knee, the decision between following a one-stage or two-stage treatment approach has historically been a pivotal consideration. The first option is limited by indications and potentially devastating complications in case of failure, whereas the second is widely accepted as the gold standard. Initially, the spacer was conceived solely to restore and maintain knee space after removal of the implant. An articulating spacer was introduced to mitigate patient limitations and improve knee function and quality of life. Two main types of articulating spacers are utilized in knee PJI treatment: the mold spacer and the metal-on-poly spacer. This text outlines a technique for metal-on-poly spacer implants. Based on our experience and the existing literature, this approach facilitates early full weight bearing and faster recovery of the knee’s range of motion, ultimately improving the quality of life after surgery, thus allowing the spacer retention for an extended period, as suggested by the 1.5-stage revision. |
| Audience | Academic |
| Author | Mariconda, Massimo Di Gennaro, Donato Coletta, Giannantonio Ascione, Tiziana Balato, Giovanni Festa, Enrico De Mauro, Domenico |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/38610157$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.3390/jcm12020600 10.3390/jcm11206128 10.1016/j.artd.2021.01.009 10.1186/s42836-023-00167-6 10.1016/j.arth.2018.09.015 10.1097/00003086-199512000-00008 10.1016/j.artd.2020.08.006 10.1302/0301-620X.97B10.36475 10.1016/j.arth.2021.01.039 10.1016/j.arth.2023.01.017 10.1186/s12891-021-04945-8 10.1097/01.blo.0000214434.64774.d5 10.7150/jbji.16448 10.1007/s12178-015-9294-7 10.1007/s12306-021-00722-x 10.1302/0301-620X.104B11.BJJ-2022-0944 10.1016/j.arth.2020.12.005 10.3390/antibiotics10030270 10.1016/j.arth.2018.02.078 10.5194/jbji-6-423-2021 10.3928/01477447-20170208-06 10.2340/17453674.2023.12307 10.1016/j.arth.2022.01.043 10.1016/j.knee.2009.11.007 10.7150/jbji.16067 |
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| Keywords | total knee arthroplasty two-stage metal-on-poly articulating spacer 1.5-stage periprosthetic joint infections |
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| SubjectTerms | Antibiotics Care and treatment Debridement Health aspects Infection Infections Joint replacement surgery Knee Orthopedic implants Patient outcomes Patients Polyethylene Polymethyl methacrylate Quality of life Surgical techniques Transplants & implants |
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| Title | Augmented Articulating Spacers in Infected Total Knee Arthroplasty: Surgical Technique |
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