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- W3025629059 abstract "Antibiotic-loaded cement spacers are used in two-stage revision knee arthroplasty for infection, but commercially available spacers may not always be suitable for significant bone loss or soft tissue failure in multiply revised cases. We describe a technique for producing an on-table, static, reinforced cement spacer – the ‘apple core’ spacer – with the intended outcome of providing joint stability in such patients, prior to undertaking a second-stage procedure. Following a radical debridement, the spacer is made of three components: (1) a ‘central bar’ of external fixator connecting rods, combined using cerclage wires as needed; (2) a standard polymethylmethacrylate cement ‘apple core’; and (3) a covering ‘skin’ of high dose antibiotic-loaded cement, which is stippled as it sets, to increase the surface area and facilitate antibiotic elution. This technique was performed in nine patients who underwent two-stage salvage revision for complex, recurrent infected total knee arthroplasty at a single institution. All patients successfully went on to definitive second-stage reimplantation and have retained their limbs. The ‘apple core’ cement spacer allows massive bone defects to be effectively managed between staged revision procedures." @default.
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- W3025629059 date "2020-07-01" @default.
- W3025629059 modified "2023-10-01" @default.
- W3025629059 title "The ‘apple core’ cement spacer for the management of massive bone loss in two-stage revision knee arthroplasty for infection" @default.
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- W3025629059 doi "https://doi.org/10.1016/j.jor.2020.05.011" @default.
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