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Intramedullary tibiofemoral rod, antibiotic-laden cement spacer useful in chronically infected TKA
Kotwal SY, et al. J Arthroplasty. 2011. doi:10.1016/j.arth.2011.04.021
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Resection arthroplasty with an intramedullary tibiofemoral rod and antibiotic-laden cement spacer can be used in the treatment of chronically infected total knee arthroplasties, according to researchers in Chicago.
Prosthetic knee joint infections are typically treated with two-stage reimplantation using an interval antibiotic-impregnated cement spacer. However, the authors added, patients with prior failed surgeries or other comorbidities tend to experience poor outcomes.
The research team examined 58 infected total knee arthroplasties in patients who experienced extensive bone and soft tissue loss. These patients were treated with resection arthroplasty, as well as an intramedullary tibiofemoral rod with an antibiotic-laden cement spacer.
Thirty-seven of the 58 patients underwent delayed reimplantation, the authors reported, with 83.8% being found free of recurrent infection at a mean 29.4-month follow-up. Debridement was required in the 16.2% of patients who did experience reinfection.
Twenty-one patients who were reported as having poor operative risks remained with their spacer for a mean 11.4 months, the authors noted.
“All patients, during spacer phase, had brace-free ambulation with simulated tibiofemoral fusion, without bone loss or loss of limb length,” they wrote.