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Dynamic (Mobile) Spacers in Infected Total Knee Arthroplasty

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Infection in Knee Replacement

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Abstract

Two-stage exchange for infected knee arthroplasty is the most common method for prosthetic joint infection. During the interim following removal of implants, the resection area is supported by implantation of spacers. There are two kinds of options: dynamic or static spacers.

Articulating spacers are called dynamic or mobile spacers or simply articulating spacers. These spacers are assumed to provide some advantages over the static, i.e., non-articulating ones, in selected patients. During the course of clinical applications, it was revealed that the use of antibiotic-impregnated cement following removal of implants and until reimplantation significantly increased the success rate of revision due to infection. Followingly, placement of antibiotic-impregnated cement rather than leaving the joint empty became a routine procedure. However, as experience gathered, it was revealed that static spacers caused unexpected bone loss due to migration of unstable spacer. This led to introduction of dynamic spacers, which would theoretically decrease complications occurring when static spacers are used, such as bone loss, immobility-related problems, and adhesions around the operation site. Currently, reliable scientific evidence in favor of neither type exists in the literature. This is mainly caused by the multifactorial setting between cases and studies.

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Author information

Authors and Affiliations

  1. Department of Orthopedics and Traumatology, Istanbul Taksim Training and Research Hospital, Istanbul, Turkey

    M. Enes Kayaalp

  2. Department of Orthopaedics and Traumatology, Center of Joint Replacement, Medical Director of the University Hospital, University of Brandenburg an der Havel, Brandenburg, Germany

    Roland Becker

Authors
  1. M. Enes Kayaalp
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  2. Roland Becker
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Editors and Affiliations

  1. Università Campus Bio-Medico di Roma, Rome, Italy

    Umile Giuseppe Longo

  2. Arthroplasty & Sports Medicine, Nicolaas Institute of Constructive Orthopedic Research, Jakarta, Indonesia

    Nicolaas C. Budhiparama

  3. Département de Chirurgie Orthopédiq, Hôpital de la Croix-Rousse, Lyon Cedex 04, France

    Sébastien Lustig

  4. Department of Orthopaedics and Traumatology, Center of Joint Replacement, Medical Director of the University Hospital, University of Brandenburg an der Havel, Brandenburg, Germany

    Roland Becker

  5. Clínica do Dragao - Espregueira-Mendes, Braga, Portugal

    João Espregueira-Mendes

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Kayaalp, M.E., Becker, R. (2022). Dynamic (Mobile) Spacers in Infected Total Knee Arthroplasty. In: Longo, U.G., Budhiparama, N.C., Lustig, S., Becker, R., Espregueira-Mendes, J. (eds) Infection in Knee Replacement. Springer, Cham. https://doi.org/10.1007/978-3-030-81553-0_19

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  • DOI: https://doi.org/10.1007/978-3-030-81553-0_19

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