Küntscher nails with static cement spacer: A simple technique in periprosthetic knee infections with massive bone loss and instability
| Autor: | Cosimo Vasco, Giuseppe Agrò, A. Poggi, Maria Pia Neri, Stefano Zaffagnini, Giuseppe Gianluca Costa, M. Lo Presti |
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| Přispěvatelé: | Lo Presti M., Costa G.G., Vasco C., Agro G., Poggi A., Neri M.P., Zaffagnini S. |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_treatment Cement spacer Periprosthetic Bone Nails Prosthesis law.invention Intramedullary rod 0302 clinical medicine law Retrospective Studie Medicine Internal Fixator Orthopedics and Sports Medicine Amputation Arthroplasty Replacement Knee Aged 80 and over 030222 orthopedics Cement spacers TKA Bone Cements Middle Aged Fracture Fixation Intramedullary Treatment Outcome Female Knee Prosthesis Infection Human Adult Reoperation medicine.medical_specialty Prosthesis-Related Infections Arthrodesis Bone lo Amputation Surgical 03 medical and health sciences Bone Cement Humans Antibiotic Prophylaxi Prosthesis-Related Infection Arthrodesi Retrospective Studies Aged business.industry Intramedullary nail Mean age Knee Prosthesi 030229 sport sciences Antibiotic Prophylaxis Internal Fixators Surgery Total knee arthroplasty Two-stage revision business |
| Popis: | Background Two-stage revision for periprosthetic knee infection is challenging in cases of massive bone loss and instability. The present study aims to describe our experience with an alternative technique of reinforced cement spacer, usually necessary in these situations, focusing on its advantages and clinical results. Methods We retrospectively identified all patients who underwent a two-stage revision for periprosthetic knee infection using two intramedullary Kuntscher nails as reinforcement from January 2010 to September 2018. From each medical record, we extracted the type of explanted prosthesis, isolated micro-organism, number of cement spacers before index procedure (and related episodes of spacer dislocation) and final treatment. Results Twelve patients were identified, mean age of 64.0 years (range 39–85). In four of them, the reinforced spacer was used twice for persistent infection, with a total of 16 procedures performed and no cases of dislocation. Ten patients were finally treated with reimplantation or arthrodesis with intramedullary nails, whereas an above-knee amputation was necessary for two patients. Infection was eradicated in 10 patients out of 12 (83%) at a mean follow up of 34.3 months (range 10–62). Conclusions This technique is an effective alternative to traditional spacers in cases of massive bone loss, producing a mechanically stable joint and preserving adequate tissue tensions. The construct is technically easy to perform and, not less importantly, to remove during stage 2. Further studies, with larger groups, are necessary to determine its validity. |
| Databáze: | OpenAIRE |
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