Self-made active antibiotic bone cement spacer:revision for infection after total knee arthroplasty

Wang Li; Ha Baxi?kaken; Yin Jian; Yuan Hong

doi:10.3969/j.issn.2095-4344.2015.13.010

Abstract：BACKGROUND:The purpose of total knee arthroplasty is to relieve the pain of joint, to restore the function of joint, and to elevate the quality of life of patients. If infection happened, for the patient it is disaster and for surgeon it is failure. As the development of technique, infection rate surrounding the prosthesis has lowered apparently after replacement. OBJECTIVE:To observe application effect of self-made active antibiotic bone cement spacer in the revision of total knee arthroplasty infection. METHODS:A total of 22 patients who had infection after total knee arthroplasty were treated in the Xinjiang Uygur Autonomous Region People’s Hospital from January 2006 to December 2012, including 14 females and 8 males, at the age of 66-81 years old, averagely 69.5 years. After definitive diagnosis, revision was performed. If one-stage revision should be conducted, original prosthesis should be removed, and antibiotic bone cement was used for second fixation. If two-stage revision should be conducted, self-made active antibiotic bone cement spacer should be placed in femur and tibia during debridement. When infection was control ed after 6 months to 1 year, the prosthesis was considered to be placed. Fol ow-up was conducted after revision. New York Hospital for Special Surgery knee score was used. RESULTS AND CONCLUSION:Al patients were fol owed up for 1 to 60 months. After treatment, two cases of debridement alone and one case of one-stage revision affected infection recurrence, and underwent two-stage revision. They did not suffer from neurovascular injury, prosthesis dislocation, loosening or deep vein thrombosis, and reached the standard of infection cure. At final fol ow-up, Hospital for Special Surgery score was 58-86, averagely (70.2±0.4). These results indicated that after total knee arthroplasty, correct therapeutic method should be selected to treat infection according to corresponding patient’s condition and different stages of infection. Joint function should be retained as much as possible so as to improve quality of life of patients.