Neurobionplus
Home About Journal AHEAD OF PRINT Current Issue Back Issues Instructions Submission Search Subscribe Blog    
Login 

Users Online: 1120 
Print this page  Email this page Small font sizeDefault font sizeIncrease font size 
ORIGINAL ARTICLE
Year : 2019  |  Volume : 53  |  Issue : 6  |  Page : 695-699

Cement pedestal spacer technique for infected two-stage revision knee arthroplasty: Description and comparison of complications


Department of Trauma and Orthopaedics, Charing Cross Hospital, London, UK

Correspondence Address:
Mr. Ahsan Akhtar
20 Mount Drive, Wembley Park, Middlesex, London HA9 9ED
UK
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ortho.IJOrtho_90_19

Rights and Permissions

Background: Infection following total knee arthroplasty (TKA) is a significant complication, with an incidence of up to 2% in primary TKA and 4%–8% in revision cases. Two-stage revision is the gold standard treatment for long-lasting infections of TKA. The purpose of this study was to describe the cement pedestal spacer technique used in infected two-stage revision knee arthroplasty and compare complications against conventional fixed and mobile cement spacers. Patients and Methods: A retrospective review was conducted in all cases who underwent two-stage TKA revision for infection between 2009 and 2015. These cases were separated into groups depending on the cement spacer utilized (fixed, mobile nonpedestal, and mobile spacers with cement pedestal). The cement pedestal technique involves press fitting a cement cylinder into the femur before definitive spacer insertion. Results: Forty four patients underwent two-stage revision TKA. Fewest complications were observed in the pedestal group, with no spacers having subluxed/tilted. The longest followup was also observed in the pedestal group (mean 52.5 months). Mobile spacers with no cement pedestal displayed the highest reinfection rate (16.7%) and the greatest number of cases with complications (malalignment, subluxation, tilting, and spacer fracture). All patients in the pedestal group were ambulatory after the first-stage revision. Conclusions: The cement pedestal technique minimizes complications by optimizing component positioning and balancing. It also safely extends the indication for an articulated spacer into a set of cases with more extensive bone loss and allows for extended monitoring of inflammatory markers.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed88    
    Printed2    
    Emailed0    
    PDF Downloaded15    
    Comments [Add]    

Recommend this journal