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Archives of Orthopaedic and Trauma Surgery

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01-03-2017 | Knee Revision Surgery

Outcome following subluxation of mobile articulating spacers in two-stage revision total knee arthroplasty

Authors: Brent A. Lanting, Adrian Lau, Matthew G. Teeter, James L. Howard

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 3/2017

Abstract

Introduction

Infection after total knee arthroplasty (TKA) is a severe complication. It is usually treated with two-stage revision and implantation of a cement spacer. Few studies describe the complications associated with a mobile articulating spacer. This study examined the subluxation of articulating antibiotic spacers in knees and correlated it with prospectively collected early outcome scores after implantation of a revision prosthesis.

Methods

Staged revisions for 72 infected primary total knee arthroplasties between 2004 and 2012 were examined. The mean age of the patients was 70.2 ± 10.8 years, with 40 right and 32 left knees. Sagittal and coronal subluxation was measured using radiographs prior to second-stage revision and grouped to be within (Group 1) or outside (Group 2) one standard deviation from the mean. Medical Outcomes Study Short Form-12 (SF-12), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Knee Society Score (KSS) were obtained via patient-administered questionnaire. Statistical analysis was carried out to look at the correlation between subluxation and outcome.

Results

Significant improvements were observed between the interim outcome scores prior to implantation of a revision prosthesis and scores obtained after second-stage revision. Debonding occurred in 5.6%, and one dislocation was found. Mean coronal subluxation was 4.8 ± 5.5% of the tibia width, in the lateral direction. Coronal subluxation did not affect SF12, WOMAC or KSS outcome scores. Mean sagittal subluxation was 6.1 ± 16.4% posteriorly. However, sagittal subluxation had a significant influence on Knee Society Scores, with Group 2 having a lower mean Knee Society Function Score of 39.3 than Group 1 (60.2) (p = 0.045). Sagittal subluxation did not affect SF12 or WOMAC scores.

Conclusion

Sagittal subluxation of the knee may influence the early to midterm outcome scores following a staged revision TKA for infection.

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Title: Outcome following subluxation of mobile articulating spacers in two-stage revision total knee arthroplasty
Authors: Brent A. Lanting
Adrian Lau
Matthew G. Teeter
James L. Howard
Publication date: 01-03-2017
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 3/2017
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-017-2630-1

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Outcome following subluxation of mobile articulating spacers in two-stage revision total knee arthroplasty

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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