Mistretta Katherine, Granger Caroline, Kromka Joseph, Schneider Andrew M
Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO, USA.
Arthroplast Today. 2025 Feb 15;32:101630. doi: 10.1016/j.artd.2025.101630. eCollection 2025 Apr.
A 2-stage protocol is standard of care treatment in the United States for chronic periprosthetic joint infection of the knee. While many patients benefit from insertion of an articulating spacer, there are instances in which this is not feasible, and a static spacer is indicated. However, many static spacer techniques risk instability and lack durability. The ideal static spacer construct should provide immediate brace-free weight-bearing to maximize function during the spacer stage and, if needed, permit delayed reimplantation in the case of medically high-risk patients. Here, we describe our surgical technique for a femoral nail and cement static spacer in the treatment of chronic knee periprosthetic joint infection, a reproducible, stable, and durable construct essential to the armamentarium of the arthroplasty surgeon.
在美国,两阶段方案是治疗膝关节慢性假体周围感染的标准治疗方法。虽然许多患者受益于插入活动间隔物,但在某些情况下这不可行,此时需使用静态间隔物。然而,许多静态间隔物技术存在不稳定风险且耐久性不足。理想的静态间隔物结构应能在间隔物阶段提供即时免支具负重,以最大限度地发挥功能,并在必要时允许对医学高风险患者进行延迟再植入。在此,我们描述了一种用于治疗慢性膝关节假体周围感染的股骨钉和骨水泥静态间隔物的手术技术,这是一种可重复、稳定且耐用的结构,对关节置换外科医生的装备库至关重要。