The autoclaving and re-implantation of an infected prosthesis as a spacer during resection knee arthroplasty: a systematic review.
Autoclaving
Knee osteoarthritis
Periprosthetic joint infection
Re-use
Total knee replacement
Two-stage revision strategy
Journal
Musculoskeletal surgery
ISSN: 2035-5114
Titre abrégé: Musculoskelet Surg
Pays: Italy
ID NLM: 101498346
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
received:
31
01
2021
accepted:
12
07
2021
pubmed:
30
7
2021
medline:
27
5
2022
entrez:
29
7
2021
Statut:
ppublish
Résumé
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). A systematic review was conducted with methods described in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. OVID-MEDLINE 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. 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.
Sections du résumé
BACKGROUND
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
METHODS
A systematic review was conducted with methods described in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. OVID-MEDLINE
RESULTS
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
CONCLUSIONS
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.
Identifiants
pubmed: 34322843
doi: 10.1007/s12306-021-00722-x
pii: 10.1007/s12306-021-00722-x
pmc: PMC9130160
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Review
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
111-125Informations de copyright
© 2021. The Author(s).
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