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Clinical Orthopaedics and Related Research®

Published in:

01-04-2011 | Basic Research

Articulating Spacers Used in Two-stage Revision of Infected Hip and Knee Prostheses Abrade with Time

Authors: Bernd Fink, MD, Annett Rechtenbach, PhD, Hubert Büchner, PhD, Sebastian Vogt, PhD, Michael Hahn, PhD

Published in: Clinical Orthopaedics and Related Research® | Issue 4/2011

Abstract

Background

Articulating spacers used in two-stage revision surgery of infected prostheses have the potential to abrade and subsequently induce third-body wear of the new prosthesis.

Questions/purposes

We asked whether particulate material abraded from spacers could be detected in the synovial membrane 6 weeks after implantation when the spacers were removed for the second stage of the revision.

Patients and Methods

Sixteen hip spacers (cemented prosthesis stem articulating with a cement cup) and four knee spacers (customized mobile cement spacers) were explanted 6 weeks after implantation and the synovial membranes were removed at the same time. The membranes were examined by xray fluorescence spectroscopy, xray diffraction for the presence of abraded particles originating from the spacer material, and analyzed in a semiquantitative manner by inductively coupled plasma mass spectrometry. Histologic analyses also were performed.

Results

We found zirconium dioxide in substantial amounts in all samples, and in the specimens of the hip synovial lining, we detected particles that originated from the metal heads of the spacers. Histologically, zirconium oxide particles were seen in the synovial membrane of every spacer and bone cement particles in one knee and two hip spacers.

Conclusions

The observations suggest cement spacers do abrade within 6 weeks. Given the presence of abrasion debris, we recommend total synovectomy and extensive lavage during the second-stage reimplantation surgery to minimize the number of abraded particles and any retained bacteria.

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Title: Articulating Spacers Used in Two-stage Revision of Infected Hip and Knee Prostheses Abrade with Time
Authors: Bernd Fink, MD
Annett Rechtenbach, PhD
Hubert Büchner, PhD
Sebastian Vogt, PhD
Michael Hahn, PhD
Publication date: 01-04-2011
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 4/2011
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-010-1479-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Articulating Spacers Used in Two-stage Revision of Infected Hip and Knee Prostheses Abrade with Time

Abstract

Background

Questions/purposes

Patients and Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Questions/purposes

Patients and Methods

Results

Conclusions

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