ArticleJournal of orthopaedic surgery and research2025
Novel post-cam endoskeleton-reinforced posterior-stabilized cement articulating spacer reduced the rate of mechanical complications in prosthetic knee infection.
Article in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPosterior-stabilized cement articulating spacers (PS spacers) have superior knee scores and a greater range of motion in a two-stage exchange for chronic prosthetic knee infections (PKIs); however, mechanical complications are associated with the use of PS spacers. In the present study, we investigated a novel post-cam endoskeleton-reinforced PS spacer and its outcomes.
methodsThis single-surgeon retrospective cohort study included patients with chronic PKIs treated with PS spacers between 2015 and 2022. PS spacers with three different configurations, based on endoskeleton reinforcement, were compared: non-reinforced (n-PS), cam-reinforced alone (C-PS), and post- and cam-reinforced (PC-PS). Rates of mechanical complications, reoperation, and infection eradication were evaluated. The constraint choice of the revision prosthesis and risk factors for mechanical complications were analysed.
resultsIn total, 186 patients, including 75 with n-PS, 61 with C-PS, and 50 with PC-PS spacers, were included. All patients were followed up for 2 years. The rate of overall mechanical complications was lowest in patients treated with PC-PS spacers, particularly in patients with unstable joints after femoral cam and tibial post fracture and tibial spacer dislodgement. Moreover, neither spacer exchange nor rotating-hinge knee revision prosthesis was required in PC-PS spacers. Independent risk factors for mechanical complications were body mass index ≥ 25 kg/m
conclusionThe novel PC-PS spacers prevented mechanical complications, spacer exchange, and the need for high-level constraint revision prostheses. We recommend the use of novel PC-PS spacers in two-stage exchange for chronic PKIs, especially in patients with a high body mass index, small femoral spacer size, and high knee flexion.
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