The Ball and Socket Articulating Spacer for Infected Total Knee Arthroplasty

Articulated antibiotic impregnated cement spacers permit knee motion and may facilitate patient mobilization during 2-stage treatment of infected total knee arthroplasty (TKA). However, molds for articulating knee spacers are not always readily available. We have treated 13 infected total knee arthroplasties with large bone defects or collateral ligament loss using the rubber bulb portion of an irrigation syringe and a bipolar trial to create a ball and socket articulating spacer. This technique was successful in controlling infection in 9 of 13 knees. All patients were able to ambulate independently with the spacer in place using a walker or crutches, including one patient with bilateral spacers. At an average follow-up of 28 months after reimplantation, average knee flexion was 98°.