Antibiotic-loaded articulating cement spacer in the 2-stage exchange of infected total knee arthroplasty

An antibiotic-loaded articulating cement spacer (ALACS) was used in the 2-stage exchange of infected total knee arthroplasty. Specially designed molds produced articulating femoral and tibial spacer components. Twenty-four consecutive patients were followed for an average of 33 months (range, 28-51 months). Two patients (8%) had a persistent infection after the first stage. Twenty-two patients (92%) underwent a successful 2-stage exchange. Minimal soft-tissue contracture and minimal bone loss were encountered during reimplantation. None of these patients developed a recurrent or persistent infection. The average postoperative knee flexion was 104degrees (range, 89degrees-122degrees). The average Hospital for Special Surgery score was 82 (range, 63-96). The ALACS spacer preserved knee function between stages, resulting in effective treatment of infection, facilitation of reimplantation, and improved patient satisfaction.