Late infections of the knee joint: Two-stage articulating solutions

O. B. Nikolaus, Matthew P. Abdel

Research output: Chapter in Book/Report/Conference proceedingChapter


Two-stage exchange is the gold standard for the treatment of chronic total knee arthroplasty (TKA) infections in North America. Cement spacers impregnated with high- dose antibiotics have successfully been utilized in the interim period of the two-stage exchange. A number of non-articulating and articulating spacers have been described. With an intact extensor mechanism, a reasonable soft-tissue envelope, and adequate bone, articulating antibiotic spacers provide several advantages. These include an infection eradication rate of approximately 90 %, a higher range of motion after reimplantation, and lower complication rates when compared with non-articulating spacers. In the appropriate patient, articulating antibiotic spacers are an effective and a safe treatment choice in the two- stage exchange process for infected TKAs.

Original languageEnglish (US)
Title of host publicationPeriprosthetic Joint Infections
Subtitle of host publicationChanging Paradigms
PublisherSpringer International Publishing
Number of pages16
ISBN (Electronic)9783319300917
ISBN (Print)9783319300894
StatePublished - May 31 2016


  • Articulating antibiotic spacer
  • Non-articulating antibiotic spacer
  • Periprosthetic joint infection (PJI)
  • Total knee arthroplasty (TKA)
  • Two- stage exchange

ASJC Scopus subject areas

  • General Medicine
  • General Health Professions


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