Antibiotic-loaded Cement Spacer In Diagnosis And Management Of Infected Total Knee Arthroplasty

Part one:Objecticompare the clinical results and radiological changes between static andmobile cement spacer.Method:All patients were treated by two-stage revision protocol using antibiotic-loadedcement spacers (AICS) for infected TKAs. Observe the joint exposure methods, and boneloss,clinical outcomes included success rates of TKR revisions,ranges of motion(ROM),and Hospital for Special Surgery knee scores (HSS), pain and function scores ofthe Knee Society (KS).Outcome:Reinfections within two years after TKA revision in the mobile groups is lower thanthose in the static groups, and greater ROM, higher HSS scores. The diiffculty of theoperation of mobile group is lower,with the obviously less bone loss.Conclusion:The mobile spacer is a better selection.Part two:Object:Using sonication culture bacteiral on the surface of antibiotic-loaded cement spacersin two-stage revision protocol.Method:Performed a two-stage revision protocol procedure in21consecutive patients. Atfertaking out the mobile cement spacer in two-stage revision protocol, put the cement spacerinto steirle container, subject to sonication and plate in aerobic and anaerobic bacteira. Outcome:The sonication lfuid culture of the removed spacer was positive in six cases. In threeof these positive cases，the traditional culture of peirprosthetic tissue was positive.Conclusion:The antibiotic-loaded cement spacers dealing with the sonication can detect out thebacteira on the surface of cement spacers, also it has higher sensitivity and specificity.