The autoclaving and re-implantation of an infected prosthesis as a spacer during resection knee arthroplasty: a systematic review
| Autor: | Lorenzo Moretti, Biagio Moretti, Davide Bizzoca, Raffaele Garofalo, Antonio Spinarelli, Giovanni Vicenti |
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| Rok vydání: | 2021 |
| Předmět: |
Reoperation
medicine.medical_specialty Prosthesis-Related Infections medicine.medical_treatment Periprosthetic Cochrane Library Prosthesis Resection 03 medical and health sciences 0302 clinical medicine medicine Humans Orthopedics and Sports Medicine Arthroplasty Replacement Knee Retrospective Studies 030222 orthopedics business.industry 030229 sport sciences Arthroplasty Surgery Anti-Bacterial Agents Systematic review Treatment Outcome Re implantation Reinfection Orthopedic surgery business Knee Prosthesis |
| Zdroj: | Musculoskeletal surgery. 106(2) |
| ISSN: | 2035-5114 |
| Popis: | Background Hofmann et al., in 1995, first described an articulating spacer made by cleaning and autoclaving the original femoral component, which is then re-implanted with a new tibial polyethylene. This systematic review aims to assess the state of existing evidence on the intraoperative autoclaving and re-use of an infected prosthesis, as a spacer, during a two-stage revision following Periprosthetic Joint Infections (PJI). Methods A systematic review was conducted with methods described in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. OVID-MEDLINE®, EMBASE, Cochrane Library, SCOPUS, Web of Science, Google Scholar and PubMed were searched from 1995 to April 2020 to identify relevant studies. Results Fourteen studies were included in this systematic review: two prospective case series; six retrospective comparative studies and six retrospective case series. The reviewed studies included 567 patients (571 knees): 394 patients treated with autoclaved components and 173 with a spacer made of new components. The cumulative re-infection rate in patients treated with re-used autoclaved components was 13.7% (54 re-infections in 394 patients), whereas in control patients the re-infection rate was 13.3% (23 re-infections in 173 patients). The final Range of Movement in patients treated using the autoclaved components as a spacer, compared with patients receiving static spacers, was significantly higher in three out of four comparative studies. Conclusion There is a moderate level of evidence that the intraoperative autoclaving and re-use of an infected prosthesis as a spacer, during a knee resection arthroplasty, is an effective procedure in the management of knee PJI. |
| Databáze: | OpenAIRE |
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