TY - JOUR
T1 - Customized intraoperatively molded articulating cement spacers for two-stage revisions TKA with major bone defects
AU - Rossi, Stefano Marco Paolo
AU - Medetti, Marta
AU - Perticarini, Loris
AU - Ghiara, Matteo
AU - Benazzo, Francesco
N1 - Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer-Verlag France SAS part of Springer Nature.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021
Y1 - 2021
N2 - Background: The use of articulating spacers, molded or prefabricated, becomes difficult in case of severe bone losses. Our idea was to customize the Molded Articulating Cement Spacers with cement stem extensions and if necessary metaphyseal cement augmentations in order to use them also in case of major bone defects. Methods: Fifty-four knees in fifty-three patients undergoing 2-stage exchange arthroplasty were divided in 4 groups, treated with 4 different types of spacers (Static, articulating molded, customized molded and metal on Poly) and evaluated in terms of Range of Motion (ROM), Knee Society Score (KSS), patients’ related outcome measures (PROMs), rate of complication and ease of the surgical exposure at the time of reimplantation. Results: At final follow-up, no statistical differences in terms of ROM and KSS were found between the articulating groups. Static Spacers showed statistically significant lower results both in terms of ROM and KSS comparing to the other 3 groups (P < 0.05). Considering PROMs, statistically better outcomes for all articulating spacers were found both when spacer was in place and at final follow-up comparing to the static spacers group (P < 0.05). No statistically significant difference was found between the 3 articulating spacers groups. Radiographic analysis did not show signs of loosening, migration or major bone loss. Conclusions: Customized Intraoperatively Molded Articulating Cement Spacers are a safe solution for two-stage revisions TKA with major bone defects and may provide a better quality of life for patients when in place comparing to static ones.
AB - Background: The use of articulating spacers, molded or prefabricated, becomes difficult in case of severe bone losses. Our idea was to customize the Molded Articulating Cement Spacers with cement stem extensions and if necessary metaphyseal cement augmentations in order to use them also in case of major bone defects. Methods: Fifty-four knees in fifty-three patients undergoing 2-stage exchange arthroplasty were divided in 4 groups, treated with 4 different types of spacers (Static, articulating molded, customized molded and metal on Poly) and evaluated in terms of Range of Motion (ROM), Knee Society Score (KSS), patients’ related outcome measures (PROMs), rate of complication and ease of the surgical exposure at the time of reimplantation. Results: At final follow-up, no statistical differences in terms of ROM and KSS were found between the articulating groups. Static Spacers showed statistically significant lower results both in terms of ROM and KSS comparing to the other 3 groups (P < 0.05). Considering PROMs, statistically better outcomes for all articulating spacers were found both when spacer was in place and at final follow-up comparing to the static spacers group (P < 0.05). No statistically significant difference was found between the 3 articulating spacers groups. Radiographic analysis did not show signs of loosening, migration or major bone loss. Conclusions: Customized Intraoperatively Molded Articulating Cement Spacers are a safe solution for two-stage revisions TKA with major bone defects and may provide a better quality of life for patients when in place comparing to static ones.
KW - Articulating
KW - Bone loss
KW - Infection
KW - Spacer
KW - Static
KW - Two-stage revision
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U2 - 10.1007/s00590-020-02844-7
DO - 10.1007/s00590-020-02844-7
M3 - Article
AN - SCOPUS:85099222194
JO - European Journal of Orthopaedic Surgery and Traumatology
JF - European Journal of Orthopaedic Surgery and Traumatology
SN - 1633-8065
ER -