A 2-stage protocol is standard of care treatment in the United States for chronic periprosthetic joint infection of the knee. While many patients benefit from insertion of an articulating spacer, there are instances in which this is not feasible, and a static spacer is indicated. However, many static spacer techniques risk instability and lack durability. The ideal static spacer construct should provide immediate brace-free weight-bearing to maximize function during the spacer stage and, if needed, permit delayed reimplantation in the case of medically high-risk patients. Here, we describe our surgical technique for a femoral nail and cement static spacer in the treatment of chronic knee periprosthetic joint infection, a reproducible, stable, and durable construct essential to the armamentarium of the arthroplasty surgeon.
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http://dx.doi.org/10.1016/j.artd.2025.101630 | DOI Listing |
Arthroplast Today
April 2025
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Background: Patients undergoing two-stage exchange arthroplasty for chronic periprosthetic joint infection (PJI) with real component spacers (RC) benefit from improved function. While RCs have similar reinfection rates compared to other spacer types, concerns exist regarding the potential for bacterial colonization and biofilm formation on the RC metal components.
Methods: Patients who completed two-stage exchange arthroplasty for treatment of Musculoskeletal Infection Society-defined hip or knee PJI were included and explanted spacer components were sent for sonication fluid culture (SFC).
Arthroplast Today
April 2025
Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO, USA.
A 2-stage protocol is standard of care treatment in the United States for chronic periprosthetic joint infection of the knee. While many patients benefit from insertion of an articulating spacer, there are instances in which this is not feasible, and a static spacer is indicated. However, many static spacer techniques risk instability and lack durability.
View Article and Find Full Text PDFJ Shoulder Elbow Surg
February 2025
Congress Biomechanics Laboratory, Congress Medical Foundation, Pasadena, CA, USA.
Background: This study aimed to investigate the biomechanical effect of subacromial spacer (physically depressing the humeral head) and magnets (concavity compression restoration) in massive rotator cuff tear (MRCT). We assessed the influence on superior stability by employing the subacromial spacer (the spacer effect) and magnets (concavity compression effect) separately or in combination in MRCT.
Methods: A customized shoulder testing system tested seven fresh-frozen cadaveric shoulders.
Orthop Traumatol Surg Res
February 2025
Service de Chirurgie Orthopédique et Médecine du Sport, Centre d'Excellence FIFA, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France; Univ Lyon, Université Claude Bernard Lyon 1, IFSTTAR, LBMC UMR_T9406, 69622 Villeurbanne, France.
In two-stage revision of infected implants, the first stage involves removing the implant and implanting a joint spacer, and the second stage involves implanting a new prosthesis at least 6 weeks later. Spacers have two main functions: local administration of high-dose antibiotics, and preservation of the joint space by reducing soft tissue retraction and improving patient comfort until reimplantation. The present review aims to detail the necessary characteristics of antibiotics added to cement to achieve good joint diffusion, to describe the steps of two-stage revision, and to present the types of spacer available according to the joint and complications.
View Article and Find Full Text PDFJ Phys Condens Matter
December 2024
School of Physical Science and Technology, Inner Mongolia University, Hohhot 010021, People's Republic of China.
The introduction of intermediate hexagonal boron nitride (hBN) between the bilayer transition metal dichalcogenide (TMD) heterostructures has been considered an efficient approach to manipulate the interlayer excitations. However, the hBN intercalation primarily serves as a spacer to increase the interlayer distance and alter the screening, without producing a significant band offset shift. Here, we use Janus monolayer CSiH, possessing a prominent out-of-plane intrinsic dipole moment and large enough band gap, as an intercalation to build trilayer MoS/CSiH/WSheterostructures.
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