A new technique for articulated cement spacers in infected total knee arthroplasty

Chronically infected total knee arthroplasty (TKA) represents a surgical challenge with many potential complications. The standard of care is a 2-stage reimplantation. This report describes a modification of the first stage using the protocol described by Hofmann and colleagues in 1995. This modification was developed by the senior author (GPD) in response to episodes of tibial subluxation and postoperative instability detected between the first and second stages. This modification utilizes a rotating platform all polyethylene tibial component insert with a keel that offers a more stable construct which allows increased stability of the component. Employing this technique, we have had good clinical results with an average knee flexion of 105º, no cases of tibial component migration or subluxation, or recurrence of infection.