Results of the Articular Spacer Application in Treatment of Knee Periprosthetic Infection
Background. Currently, on the general background the number of primary totak knee arthroplasties (TKA) increasing, so does the revisions. Among all the causes of revisions, periprosthetic joint infection occupies one of the leading positions. The generally accepted tactics of two-stage revisions, al...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | Russian |
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Vreden Russian Research Institute of Traumatology and Orthopedics
2022-12-01
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| Series: | Travmatologiâ i Ortopediâ Rossii |
| Subjects: | |
| Online Access: | https://journal.rniito.org/jour/article/viewFile/1750/pdf |
| _version_ | 1797901492257030144 |
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| author | Vyacheslav N. Mitrofanov Svyatoslav B. Korolеv Dmitrii V. Presnov Roman N. Komarov Mikhail M. Akulov |
| author_facet | Vyacheslav N. Mitrofanov Svyatoslav B. Korolеv Dmitrii V. Presnov Roman N. Komarov Mikhail M. Akulov |
| author_sort | Vyacheslav N. Mitrofanov |
| collection | DOAJ |
| description | Background. Currently, on the general background the number of primary totak knee arthroplasties (TKA) increasing, so does the revisions. Among all the causes of revisions, periprosthetic joint infection occupies one of the leading positions. The generally accepted tactics of two-stage revisions, along with the infection suppression, implements other tasks: reducing pain, preserving and/or restoring joint function. Articular antibacterial spacers allow you to complete all the tasks and preserve/restore the quality of patients` life on staged treatment. However, studies demonstrating the results of periprosthetic joint infection treatment and the use of various articular spacers still do not clear it`s optimal design.
The aim of the study was to improve the intermediate treatment results of periprosthetic knee joint infection using articular spacer implantation.
Methods. A single-center retrospective cohort study was performed. At the first stage of the study, the results of surgical treatment of 420 patients with periprosthetic knee joint infection treated at the clinic in 20112019 were analyzed. At the second stage, after applying the inclusion and exclusion criteria, 182 patients were included in the analysis. Two representative groups are identified among them. In the comparison group, hand-made cement liner with articulating surface was used, in the main group conventional one.
Results. The implantation of the endoprosthesis components with the restoration of anatomical relationships in the joint and the ligamentous balance, the replacement of the cement liner with conventional one made of ultra-high molecular weight polyethylene led to reduction in the surgery duration, intraoperative blood loss and period of hospitalization, an increase in the range of motions in the joint, greater stability of the components and suppression of infection in 94.6% of patients.
Conclusion. The use of various spacers did not significantly affect the probability of infection suppression; however, the number of infection relapses was lower in the group where the liner made of ultra-high molecular weight polyethylene was used. Optimization of surgical treatment techniques and the use of articular spacer based on a three-component conventional endoprosthesis has significantly improved the treatment results of patients with periprosthetic infection of the knee joint. |
| first_indexed | 2024-04-10T09:02:55Z |
| format | Article |
| id | doaj.art-109ce8e87f1a473f81494539a8ad3054 |
| institution | Directory Open Access Journal |
| issn | 2311-2905 2542-0933 |
| language | Russian |
| last_indexed | 2024-04-10T09:02:55Z |
| publishDate | 2022-12-01 |
| publisher | Vreden Russian Research Institute of Traumatology and Orthopedics |
| record_format | Article |
| series | Travmatologiâ i Ortopediâ Rossii |
| spelling | doaj.art-109ce8e87f1a473f81494539a8ad30542023-02-21T09:41:31ZrusVreden Russian Research Institute of Traumatology and OrthopedicsTravmatologiâ i Ortopediâ Rossii2311-29052542-09332022-12-01284314110.17816/2311-2905-17501230Results of the Articular Spacer Application in Treatment of Knee Periprosthetic InfectionVyacheslav N. Mitrofanov0https://orcid.org/0000-0003-2046-3865Svyatoslav B. Korolеv1https://orcid.org/0000-0003-0286-8404Dmitrii V. Presnov2https://orcid.org/0000-0002-3905-7958Roman N. Komarov3https://orcid.org/0000-0002-2705-8224Mikhail M. Akulov4https://orcid.org/0000-0002-4383-9370Privolzhsky Research Medical UniversityPrivolzhsky Research Medical UniversityPrivolzhsky Research Medical UniversityPrivolzhsky Research Medical UniversityPrivolzhsky Research Medical UniversityBackground. Currently, on the general background the number of primary totak knee arthroplasties (TKA) increasing, so does the revisions. Among all the causes of revisions, periprosthetic joint infection occupies one of the leading positions. The generally accepted tactics of two-stage revisions, along with the infection suppression, implements other tasks: reducing pain, preserving and/or restoring joint function. Articular antibacterial spacers allow you to complete all the tasks and preserve/restore the quality of patients` life on staged treatment. However, studies demonstrating the results of periprosthetic joint infection treatment and the use of various articular spacers still do not clear it`s optimal design. The aim of the study was to improve the intermediate treatment results of periprosthetic knee joint infection using articular spacer implantation. Methods. A single-center retrospective cohort study was performed. At the first stage of the study, the results of surgical treatment of 420 patients with periprosthetic knee joint infection treated at the clinic in 20112019 were analyzed. At the second stage, after applying the inclusion and exclusion criteria, 182 patients were included in the analysis. Two representative groups are identified among them. In the comparison group, hand-made cement liner with articulating surface was used, in the main group conventional one. Results. The implantation of the endoprosthesis components with the restoration of anatomical relationships in the joint and the ligamentous balance, the replacement of the cement liner with conventional one made of ultra-high molecular weight polyethylene led to reduction in the surgery duration, intraoperative blood loss and period of hospitalization, an increase in the range of motions in the joint, greater stability of the components and suppression of infection in 94.6% of patients. Conclusion. The use of various spacers did not significantly affect the probability of infection suppression; however, the number of infection relapses was lower in the group where the liner made of ultra-high molecular weight polyethylene was used. Optimization of surgical treatment techniques and the use of articular spacer based on a three-component conventional endoprosthesis has significantly improved the treatment results of patients with periprosthetic infection of the knee joint.https://journal.rniito.org/jour/article/viewFile/1750/pdftotal knee arthroplastyperiprosthetic joint infectiontwo-stage revisionarticular spacer |
| spellingShingle | Vyacheslav N. Mitrofanov Svyatoslav B. Korolеv Dmitrii V. Presnov Roman N. Komarov Mikhail M. Akulov Results of the Articular Spacer Application in Treatment of Knee Periprosthetic Infection Travmatologiâ i Ortopediâ Rossii total knee arthroplasty periprosthetic joint infection two-stage revision articular spacer |
| title | Results of the Articular Spacer Application in Treatment of Knee Periprosthetic Infection |
| title_full | Results of the Articular Spacer Application in Treatment of Knee Periprosthetic Infection |
| title_fullStr | Results of the Articular Spacer Application in Treatment of Knee Periprosthetic Infection |
| title_full_unstemmed | Results of the Articular Spacer Application in Treatment of Knee Periprosthetic Infection |
| title_short | Results of the Articular Spacer Application in Treatment of Knee Periprosthetic Infection |
| title_sort | results of the articular spacer application in treatment of knee periprosthetic infection |
| topic | total knee arthroplasty periprosthetic joint infection two-stage revision articular spacer |
| url | https://journal.rniito.org/jour/article/viewFile/1750/pdf |
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