Use of an Antibiotic-Impregnated Spacer in Revision Total Knee Arthroplasty

Two-stage reimplantation remains the gold standard for the treatment of infected total knee arthroplasty, with success rates ranging from 90% to 96%. It is currently the standard of care in North America when dealing with chronic periprosthetic joint infections. The use of antibiotic-impregnated spacers between stages has been advocated. Selection of antibiotic dosage and type of spacer is typically tailored to the individual situation. Two varieties of spacers exist, static and articulating, each with their benefits and disadvantages. The current literature shows no difference between both varieties in terms of reinfection rates. Even though the ideal spacer design has not yet been established, articulating spacers seem to improve knee ROM and function scores in multiple series and may provide improved patient satisfaction during this difficult process.