Prosthetic articulating spacers as a preferred option for two-stage revision arthroplasty in chronic periprosthetic joint infection

Abstract Purpose The study aimed to compare the infection control rates, mechanical complications, and functional outcomes between prosthetic and cement spacers in two-stage revision arthroplasty for chronic periprosthetic joint infection (PJI). Patients and methods Data from patients treated for ch...

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Main Authors: Jiamin Lin, Hongyan Li, Yang Chen, Haiqi Ding, Qijin Wang, Jianhua Lv, Wenbo Li, Wenming Zhang, Xinyu Fang
Format: Article
Language:English
Published: BMC 2025-01-01
Series:Arthroplasty
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Online Access:https://doi.org/10.1186/s42836-024-00288-6
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author Jiamin Lin
Hongyan Li
Yang Chen
Haiqi Ding
Qijin Wang
Jianhua Lv
Wenbo Li
Wenming Zhang
Xinyu Fang
author_facet Jiamin Lin
Hongyan Li
Yang Chen
Haiqi Ding
Qijin Wang
Jianhua Lv
Wenbo Li
Wenming Zhang
Xinyu Fang
author_sort Jiamin Lin
collection DOAJ
description Abstract Purpose The study aimed to compare the infection control rates, mechanical complications, and functional outcomes between prosthetic and cement spacers in two-stage revision arthroplasty for chronic periprosthetic joint infection (PJI). Patients and methods Data from patients treated for chronic PJI in our center from 2014 to 2023 were retrospectively collected and the patients were divided into the prosthetic spacer (PS) and cement spacer (CS) groups based on the type of spacer used for the first-stage surgeries. Data on patients’ demographics and clinical scores were harvested. Infection control rates and mechanical complications were compared between the two groups by using chi-square tests and log-rank analysis. Results The study involved 113 cases, with a mean age of 64 ± 11.45 years (range, 31–88 years), with 48 cases in the PS group, 65 in the CS group, and all patients were followed up for at least 1 year (average 52.68 ± 26.07 months). Five patients in the PS group (10.42%) and six in the CS group (9.23%) developed recurrent infections, with no significant difference found in infection control rates (P = 0.833). The joint function score after the first-stage surgeries was higher in the PS group than in the CS group (P = 0.021). The incidence of mechanical complications, including dislocation, spacer fracture, and periprosthetic fracture, was significantly lower in the PS group than in the CS group (P = 0.024). The proportion of patients who underwent second-stage surgeries was lower in the PS group than in the CS group (58.3% vs 70.77%, P = 0.169). Conclusion For most patients with chronic PJI, PS can be used as the preferred option for two-stage revision arthroplasty.
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spelling doaj-art-d3fde012e0324c89b182f52e44051ab82025-01-12T12:08:13ZengBMCArthroplasty2524-79482025-01-01711910.1186/s42836-024-00288-6Prosthetic articulating spacers as a preferred option for two-stage revision arthroplasty in chronic periprosthetic joint infectionJiamin Lin0Hongyan Li1Yang Chen2Haiqi Ding3Qijin Wang4Jianhua Lv5Wenbo Li6Wenming Zhang7Xinyu Fang8Department of Orthopedic Surgery, the First Affiliated Hospital, Fujian Medical UniversityDepartment of Orthopedic Surgery, the First Affiliated Hospital, Fujian Medical UniversityDepartment of Orthopedic Surgery, the First Affiliated Hospital, Fujian Medical UniversityDepartment of Orthopedic Surgery, the First Affiliated Hospital, Fujian Medical UniversityDepartment of Orthopedic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical UniversityDepartment of Orthopedic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical UniversityDepartment of Orthopedic Surgery, the First Affiliated Hospital, Fujian Medical UniversityDepartment of Orthopedic Surgery, the First Affiliated Hospital, Fujian Medical UniversityDepartment of Orthopedic Surgery, the First Affiliated Hospital, Fujian Medical UniversityAbstract Purpose The study aimed to compare the infection control rates, mechanical complications, and functional outcomes between prosthetic and cement spacers in two-stage revision arthroplasty for chronic periprosthetic joint infection (PJI). Patients and methods Data from patients treated for chronic PJI in our center from 2014 to 2023 were retrospectively collected and the patients were divided into the prosthetic spacer (PS) and cement spacer (CS) groups based on the type of spacer used for the first-stage surgeries. Data on patients’ demographics and clinical scores were harvested. Infection control rates and mechanical complications were compared between the two groups by using chi-square tests and log-rank analysis. Results The study involved 113 cases, with a mean age of 64 ± 11.45 years (range, 31–88 years), with 48 cases in the PS group, 65 in the CS group, and all patients were followed up for at least 1 year (average 52.68 ± 26.07 months). Five patients in the PS group (10.42%) and six in the CS group (9.23%) developed recurrent infections, with no significant difference found in infection control rates (P = 0.833). The joint function score after the first-stage surgeries was higher in the PS group than in the CS group (P = 0.021). The incidence of mechanical complications, including dislocation, spacer fracture, and periprosthetic fracture, was significantly lower in the PS group than in the CS group (P = 0.024). The proportion of patients who underwent second-stage surgeries was lower in the PS group than in the CS group (58.3% vs 70.77%, P = 0.169). Conclusion For most patients with chronic PJI, PS can be used as the preferred option for two-stage revision arthroplasty.https://doi.org/10.1186/s42836-024-00288-6Periprosthetic joint infectionTwo-stage revisionProsthetic spacerCement spacer
spellingShingle Jiamin Lin
Hongyan Li
Yang Chen
Haiqi Ding
Qijin Wang
Jianhua Lv
Wenbo Li
Wenming Zhang
Xinyu Fang
Prosthetic articulating spacers as a preferred option for two-stage revision arthroplasty in chronic periprosthetic joint infection
Arthroplasty
Periprosthetic joint infection
Two-stage revision
Prosthetic spacer
Cement spacer
title Prosthetic articulating spacers as a preferred option for two-stage revision arthroplasty in chronic periprosthetic joint infection
title_full Prosthetic articulating spacers as a preferred option for two-stage revision arthroplasty in chronic periprosthetic joint infection
title_fullStr Prosthetic articulating spacers as a preferred option for two-stage revision arthroplasty in chronic periprosthetic joint infection
title_full_unstemmed Prosthetic articulating spacers as a preferred option for two-stage revision arthroplasty in chronic periprosthetic joint infection
title_short Prosthetic articulating spacers as a preferred option for two-stage revision arthroplasty in chronic periprosthetic joint infection
title_sort prosthetic articulating spacers as a preferred option for two stage revision arthroplasty in chronic periprosthetic joint infection
topic Periprosthetic joint infection
Two-stage revision
Prosthetic spacer
Cement spacer
url https://doi.org/10.1186/s42836-024-00288-6
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