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Articulating spacers: what are available and how to utilize them?
Zhuo Li1,2, Chi Xu2,3, Jiying Chen4,5
1School of Medicine, Nankai University, Tianjin, 300071, China.
Arthroplasty (London, England)
|April 9, 2023
Summary
Articulating spacers improve function and control infection in two-stage exchange arthroplasty for periprosthetic joint infection (PJI). While various types exist, no significant outcome differences have been found among them.
Area of Science:
- Orthopedic surgery
- Infectious disease management
- Biomaterials engineering
Background:
- Periprosthetic joint infection (PJI) is a severe complication of total joint arthroplasty (TJA).
- Two-stage exchange arthroplasty with antibiotic-loaded spacers is a primary treatment for chronic PJI.
- Rising TJA demand exacerbates the global PJI healthcare challenge.
Purpose of the Study:
- To review key concepts, types, and outcomes of articulating spacers in PJI treatment.
- To synthesize current evidence on the efficacy of different articulating spacer subtypes.
- To inform surgical decision-making regarding spacer selection for PJI.
Main Methods:
- Literature review of studies on articulating spacers for PJI.
- Analysis of spacer types: hand-made, molded, preformed, custom, 3D printed, etc.
- Evaluation of functional outcomes and infection control rates.
Main Results:
- Articulating spacers offer better functional improvement than static spacers for PJI.
- Infection control rates are comparable between articulating and static spacers.
- Limited evidence shows no significant clinical outcome differences among various articulating spacer subtypes.
Conclusions:
- Articulating spacers are a valuable tool in managing PJI via two-stage exchange.
- A wide array of articulating spacer designs are available, including innovative 3D-printed options.
- Surgeons require comprehensive knowledge of available spacer strategies to optimize patient care.
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