Hammerich, Kristoff and Pollack, Jens and Hasse, Alexander F. and El Saman, Andre and Huber, Rene and Rupp, Markus and Alt, Volker and Kinne, Raimund W. and Mika, Joerg (2021) The Inverse Spacer-A Novel, Safe, and Cost-Effective Approach in Routine Procedures for Revision Knee Arthroplasty. JOURNAL OF CLINICAL MEDICINE, 10 (5): 971. ISSN , 2077-0383
Full text not available from this repository. (Request a copy)Abstract
Background: A major disadvantage of current spacers for two-stage revision total knee arthroplasty (R-TKA) is the risk of (sub-) luxation during mobilization in the prosthesis-free interval, limiting their clinical success with detrimental consequences for the patient. The present study introduces a novel inverse spacer, which prevents major complications, such as spacer (sub-) luxations and/or fractures of spacer or bone. Methods: The hand-made inverse spacer consisted of convex tibial and concave femoral components of polymethylmethacrylate bone cement and was intra-operatively molded under maximum longitudinal tension in 5 degrees flexion and 5 degrees valgus position. Both components were equipped with a stem for rotational stability. This spacer was implanted during an R-TKA in 110 knees with diagnosed or suspected periprosthetic infection. Postoperative therapy included a straight leg brace and physiotherapist-guided, crutch-supported mobilization with full sole contact. X-rays were taken before and after prosthesis removal and re-implantation. Results: None of the patients experienced (sub-) luxations/fractures of the spacer, periprosthetic fractures, or soft tissue compromise requiring reoperation. All patients were successfully re-implanted after a prosthesis-free interval of 8 weeks, except for three patients requiring an early exchange of the spacer due to persisting infection. In these cases, the prosthetic-free interval was prolonged for one week. Conclusion: The inverse spacer in conjunction with our routine procedure is a safe and cost-effective alternative to other articulating or static spacers, and allows crutch-supported sole contact mobilization without major post-operative complications. Maximum longitudinal intra-operative tension in 5 degrees flexion and 5 degrees valgus position appears crucial for the success of surgery.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | 2-STAGE REVISION; ARTICULATING SPACERS; INFECTION; MOBILE; REIMPLANTATION; COMPLICATIONS; inverse spacer; intraoperatively molded; cost-effective; (sub-) luxation; dislocation; revision knee arthroplasty |
| Divisions: | Medicine > Lehrstuhl für Unfallchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 21 Sep 2022 08:35 |
| Last Modified: | 21 Sep 2022 08:35 |
| URI: | https://pred.uni-regensburg.de/id/eprint/47803 |
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