2025 ISAKOS Congress in Munich, Germany

2025 ISAKOS Biennial Congress ePoster


Periprosthetic Joint Infection After Total Knee Arthroplasty: Knee Function And Quality Of Life With An Articulating Spacer

Domenico De Mauro, MD ITALY
Giovanni Balato, Prof. ITALY
Tiziana Ascione, MD, Naples ITALY
Enrico Festa, MD, Naples ITALY
Lucrezia Marasco, MD, Naples ITALY
Donato Di Gennaro, MD, Naples ITALY
Massimo Mariconda, Prof., Naples ITALY

Federico II University, Naples, ITALY

FDA Status Not Applicable

Summary

Aims of the study are: (i) analyzing differences in quality of life and knee function in patients with diagnosis of chronic PJI of the knee, before and after articulating spacer implantation for a first stage of a two-stage revision; and (ii) comparing QoL and knee function in patients three months after articulating spacer implantation, with patients two months after uncomplicated primary TKA.

ePosters will be available shortly before Congress

Abstract

Background

Periprosthetic Joint Infection (PJI) after Total Knee Arthroplasty (TKA) represents one of the most feared complications in Joint replacement surgery. Patients undergo numerous surgeries, and spend several months with a temporary spacer (2-stage) or definitive spacer (1.5-stage). Sub-optimal quality of Life (QoL) and knee functions in those patients is often considered unescapable, a necessary suffering until the revision TKA.

Objectives: The study aims to assess QoL and joint function before reimplantation, in order to demonstrate that articulating spacer can be a valuable implant to allow the patient a progressive return-to-normality.

Study Design & Methods: A retrospective observational study was made. All the patients treated with a metal-on-poly spacer for chronic PJI were included. The EQ-5D-5L Index Value, WOMAC, and KSS were assessed preoperatively and before scheduling the reimplantation. The infection eradication was defined as the disappearance of all evidence of PJI during the 96-week follow-up period.

Results

The study included 108 patients with a median age of 73 (46–91) years. The KSS, WOMAC, and QoL scores, before scheduling the revision, were improved than preoperative ones (p<0.001). A lower Anxiety level was also retrieved after spacer placement. Gram-negative infections and infections affecting revision knee arthroplasty were negative predictors for pre-reimplantation QoL. Thirteen patients (12%) experienced an infection recurrence.

Conclusions

The choice of a mobile spacer guarantees good patient QoL and knee function, allowing a good relief for the patients suffering PJI.