Related Experiment Video
Updated: May 1, 2026

In Vitro Application of a Wireless Sensor in Flexion-Extension Gap Balance of Unicompartmental Knee Arthroplasty
Published on: May 5, 2023
Functional interest of an articulating spacer in two-stage infected total knee arthroplasty revision
T Classen1, M von Knoch2, M Wernsmann1
1Orthopaedic Department, University of Duisburg - Essen Medical School, Hufelandstrasse 55, 45147 Essen, Germany.
Introduction:
Deep periprosthetic infection is one of the most serious complications after total knee replacement. The two-stage procedure with implantation of a temporary cement spacer and later re-implantation of a revision total knee prosthesis is an accepted procedural standard. The use of articulating spacers has been proposed to enhance ease of revision and functional results.
Patients And Methods:
Twenty-three patients treated with an articulating spacer were retrospectively studied. All patients had undergone a two-stage surgery. The infected prosthesis was explanted and the femoral component was sterilized and re-implanted. On the tibial side a block of gentamicin-loaded bone cement was produced intraoperatively using specially manufactured templates. Eighteen total knee arthroplasty revisions and 5 arthrodesis were finally performed.
Results:
A total of three (13%) re-infections occurred 5-20 months after revision total knee arthroplasty in a mean follow-up period of 47 months. Prior to re-implantation, flexion with the articulating spacer ranged between 15 and 100° (mean 68±28°). The average postoperative flexion after re-implantation of total knee replacement was 105±11°.
Conclusion:
The articulating spacer used in this study appears to be as effective as the standard procedures in terms of re-infection risk rate and postoperative range of motion recovery.
Level Of Evidence:
Level IV.
