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 104° (range, 89°–122°). 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.